There is one diabetic patient for every 10 Hong Kong people, that is, there are currently about 700,000 patients in Hong Kong. Zhou Zhenzhong, a specialist in endocrinology and diabetes, pointed out that the most terrifying thing about this disease is that the ultimate cause of death for most type 2 diabetics is a serious complication of cardiovascular disease and kidney disease. He suggested that patients can have regular blood tests for NT-proBNP to assess the risk of heart failure early and treat the disease before it occurs.
Diabetic patients need to pay attention to their diet and improve their living habits. They also need to check and evaluate their condition regularly to avoid common complications such as diabetic eye and diabetic foot. However, the prevention of complications of cardiovascular disease is rarely mentioned. Dr. Zhou Zhenzhong said: “People with diabetes are two to four times more likely to suffer from various cardiovascular diseases than the general population, among which heart failure is the most common. A study found that 30% of people with type 2 diabetes will eventually develop heart failure. There are many People with diabetes don’t even know they have chronic heart failure, and that’s a major reason for their hospital admissions.”
Common complications of diabetes are roughly divided into small vessel disease and macrovascular disease. Doctors routinely recommend annual comprehensive complication assessment examinations, including blood, urine, foot and eye examinations, but this can only effectively determine the risk of small-vessel complications, namely diabetic kidney, diabetic eye, and diabetic foot. Macrovascular disease, namely diabetic heart disease, cannot be assessed, including coronary heart disease and acute myocardial infarction, atrial fibrillation and its associated ischemic stroke, and heart failure.
NT-proBNP helps find heart problems
Dr. Zhou pointed out that heart failure is a chronic disease. The initial symptoms are not obvious. Most of them are fatigue, fatigue, cough, poor appetite, etc., or asthma while walking. method. Common CT coronary angiography, cardiac magnetic resonance imaging and cardiac ultrasonography. In the past 5 years, the blood test NT-proBNP has been regarded as the gold indicator for diagnosing and monitoring heart failure.
To put it simply, NT-proBNP measures the hormone levels in the blood. When the ventricle undergoes structural changes such as dilation, hypertrophy or compression, the ventricular cells will produce and secrete hormones, which are then released into the blood. Generally, 50pg/mL to 125pg/mL is the normal value. The lower the value, the lower the probability of suffering from heart failure.
Make up for the lack of traditional inspection
The survey found that even with better diabetes management, about 10% of participants had abnormal NT-proBNP tests, requiring improved treatment options or further cardiac testing. Dr. Zhou pointed out that some apparently healthy “diabetics” may have different degrees of heart health problems, and the addition of NT-proBNP testing can make up for the lack of cardiac function assessment in the current diabetes complication test.
Some studies have pointed out that people who have no heart disease record but have higher NT-proBNP values should consider prescribing heart-protecting drugs hypoglycemic agents to reduce hospital admissions or death rates. Among the existing hypoglycemic drugs in Hong Kong, oral SGLT2 inhibitors and subcutaneous injection of GLP-1 receptor agonists have empirical support, which can effectively reduce the risk of diabetic heart disease in patients with type 2 diabetes. Once diabetic heart failure is diagnosed, 4 drugs that have been shown to be effective in the treatment of systolic heart failure can also be prescribed to improve symptoms and heart function.
Author: Liu Miaoxian
Responsible editor: Zhou Meihao
(excerpt)
【original:Diabetic patients beware of diabetes, regular blood test to reduce fatal risk】
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