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Dr. LeWinter introduces himself and explains how insulin resistance and diabetes contribute to heart disease.
Dr. LeWinter:
My name is Dr. Martin LeWinter. I am a professor of medicine at the University of Vermont, and I am also the director of our Heart Failure and Cardiomyopahty program in Burlington, Vermont.
Well, it does it in a couple of ways. First of all, both insulin resistance and diabetes have direct effects over time on the heart muscle, which interferes with its ability to function properly and that can actually, evidence of that can actually appear quite early in the course of diabetes and/or insulin resistance.
So, for example, we use a method called echocardiography, which is a very common non-invasive diagnostic technique in cardiology, and when we look at otherwise healthy patients with diabetes and insulin resistance, we can actually detect very subtle abnormalities of the heart muscle in a fairly large number of people who have no other obvious evidence of heart problems.
So one aspect of what diabetes does to the heart has to do, again, with direct effects of having insulin resistance, high blood glucose, etc. Direct effects on the heart muscle but the other way that diabetes affects the heart is through secondary effects, these are other conditions for which diabetes is a major risk factor.
So diabetes is a very important, diabetes and insulin resistance are very important risk factors for heart failure, for problems with the heart muscle, but they are also major risk factors for coronary artery disease, which itself causes changes in the heart muscle with heart attacks and things like that.So because diabetes, again, is an important risk factor for coronary disease, that’s kind of a secondary way that it affects the heart muscle.
Another factor that diabetes is closely associated with is high blood pressure, and high blood pressure also has deleterious effects on the heart muscle. So it’s both direct, and it’s also related to these other conditions that diabetes has a lot of associations with.
About Dr. LeWinter, M.D.:
Dr. Martin M. LeWinter, M.D., was Director of the Cardiology Unit at the University of Vermont College of Medicine for more than 15 years and is currently the Director of the Heart Failure Program. He is an Associate Editor for the journal Coronary Artery Disease and serves on the Editorial Board of several cardiology journals. He is currently Professor of Medicine at the University of Vermont.