One in four diabetics could develop kidney disease.
When 51-year-old Huda Al Ali was first diagnosed with type-2 diabetes in 2019, little did she know that her high blood sugar was slowly damaging her heart.
The Emirati mother of two adult daughters has been suffering from Crohn’s disease, a type of inflammatory bowel disease (IBD) — which increases the risk of type-2 diabetes — since 2002. To alleviate the symptoms of this condition, she was prescribed cortisone shots, which can raise blood sugar levels in people with diabetes.
Unaware of her underlying chronic condition, Huda continued to take the shots for several years without checking her blood sugar levels. She finally stopped taking them in 2014 and went for an infusion therapy instead.
Two years ago, Huda started feeling extremely lethargic, drowsy and thirsty. She knew something wasn’t right and went in for a check-up at a clinic in Abu Dhabi, where she was told that her blood sugar levels were dangerously high. “I was shocked to hear that my blood sugar was 500mg/dl. The doctor asked me to consult a diabetes expert at the Imperial College London Diabetes Centre,” she says.
When she was evaluated by the care team at Imperial College London Diabetes Centre (ICLDC) – a Mubadala Health partner – she learnt that not only was her recent diabetes diagnosis impacting her health, but that her unchecked levels of cholesterol and blood pressure were putting an immense strain on her heart as well.
Huda’s doctor, ICLDC’s consultant endocrinologist and diabetologist Prof. Aftab Ahmad, explained that when the body is unable to properly use insulin, a hormone that regulates blood sugar in people, it has an indirect effect on other health markers, increasing their chances of heart disease.
People with diabetes, he said, are twice as likely to get heart disease, and at a younger age. According to the International Diabetes Federation, there are more than one million people living with diabetes in the UAE.
“High blood sugar levels can lower the HDL or good cholesterol and raise triglycerides, the harmful blood fats. At the same time, insulin resistance can lead to hardened narrow arteries, which causes high blood pressure. When Huda came to me, she was suffering from all these risk factors, which meant that we had to put her on an aggressive diabetes management and healthy lifestyle plan to bring those numbers down,” Dr Ahmad said.
Her holistic plan to manage her glucose levels and reduce her cardiovascular risk factors involved an appropriate and structured insulin regime, and lifestyle and diet changes with regular monitoring of health markers.
Phenomenal change in three months
In three months, Huda’s HbA1c level, a measure of how well-controlled a patient’s blood sugar has been over a period of three months, dropped significantly from 13.7 per cent to six per cent. She was also able to reduce her weight and lipid levels, bring her blood pressure levels down from 140/70mmHG to an average of 125/65mmHG. Also, there was a drop in her LDL or bad cholesterol level by almost 50 per cent from 2.6mmol/L to 1.3mmol/L within a year. This resulted in a reduction of her overall cardiovascular risk score from a very high 17 per cent to a negligible 0.7 percent.
Calling the outcome “phenomenal”, especially in such a short period of time, Dr Ahmad said: “Such drastic change is only possible when we are able to help the patient understand the pathophysiology of diabetes and how it impacts every organ and function in the body.
When we discuss how their current plan or lifestyle choices are contributing to the issue, they realise how simple it is to manage the disease and feel empowered to make gradual changes in their daily life to reverse these risk factors,” said Prof. Ahmad.
Huda described her new lifestyle choices as an “investment in her future.”
“I knew that high blood sugar is bad for my kidneys, but I had no idea that it was also damaging my heart. I immediately changed my diet and now eat only eat lean meats and fish, without too much fat, oil or salt in my diet. I also make it a point to walk or do some light exercise for 20 minutes each day. I feel so much more in control and healthier now. I’m not just doing this for myself but for my children. I also keep reminding my daughters to watch their diet and go for regular health check-ups,” she said.
Prof. Aftab Ahmad shares his top five tips for a health heart:
>Monitor your health parameters regularly and use a log or chart to keep track of your A1C, blood pressure, blood sugar and cholesterol.
>Dedicate about 150 minutes each week to exercise. You can allocate this time however you like during the week, with a combination of light to moderate aerobic and resistance training for overall physical wellbeing. Even a 15-minute walk daily does wonders for your heart in the long run!
>Adopt a sustainable diet that is nutritionally dense and does not cause blood sugar spikes. Use the Diabetes Plate Method to create portions with a healthy balance of vegetables, protein and carbohydrates.
>Take your medications as directed by your doctor as this is the best defense against heart disease. Try setting an alarm or use a pill box if you have trouble remembering.
>Manage stress for your emotional and physical well-being. Stress hormones can lead to high blood pressure and make it more difficult to have good diabetes management.
One in four diabetics could develop kidney disease.
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“I had ignored my bloated stomach. However later, I learnt a lesson never to ignore a health hazard,” said Arroyo, an Abu Dhabi resident.