Is particularly high among diabetics, the risk of coronary heart disease. This is due to the fact that here is a arteriosclerosis (hardening of the arteries colloquially called) is much faster and more intensively developed. The consequence of a poorly controlled metabolism is often an overactive clotting. This means that blood platelets sticky and tend to form clumps more quickly. Represent a serious hazard in addition to the damaged nervous system of diabetic patients. Because of nerve damage, the pain that induces a reduced perfusion of the heart, not perceived. It may be that a heart attack occurs without any warning pain, not being noticed and therefore goes untreated.

Symptoms of coronary heart disease
The symptoms of coronary heart disease are numerous technical. They are regarded as warning signs that something is wrong and a doctor should be consulted. Primary symptoms are pain in the chest and shortness of breath or palpitations or irregular heartbeats. This unusual referred pain in the arms should be, in the jaw or back, tiredness or nausea, heartburn, and excessive sweating will be given more consideration.

Other cardiac complications
But not only with coronary heart disease have to reckon with diabetes. Other complications around the heart are just as widespread. Heart failure occurs, for example also increasingly on people with diabetes. This is due to a thickening, in turn, a stiffening of the walls of the smallest blood vessels and capillaries causes. Because of this failure, the pumping of the heart is significantly reduced. For this reason, diabetics should avoid especially smoking.

Diabetic neuropathy in diabetic patients is often pioneer of a diabetic foot ulcers. Nerve damage can also occur in the nerves that control the heart rate. This is referred to as: cardiac autonomic neuropathy. For the limitation of our heartbeat is the parasympathetic nervous system responsible. If this fails, predominates in the conduct of our heartbeat of the sympathetic nervous system is responsible for the performance. A consistent and not necessary, increased heart rate is the consequence, which in turn causes Frequenzstarre. The slowdown associated with the expiration of the pulse takes place here and not the heart is overwhelmed due to lack of recovery phases.

Prevention of Cardiovascular Diseases
An important component of diabetes treatment is therefore mainly the prevention of cardiovascular diseases. It begins with the patient knows about his diabetes, a healthy, balanced diet and enough exercise movement. In addition, the observation of his blood lipid levels is essential. A lipid metabolism disorder is considered a major cardiovascular risk factor. Also, the intake of bad cholesterol (and lipo-protein) should be avoided, since this is deposited on the walls of blood vessels and leads to narrowing.
The diabetes guideline of the German Diabetes Society, moreover, show that to be achieved as the main prevention is a must normal glycemic control. This assumes that the HbA1c did not – value in diabetic patients is higher than 7%. The A1C test indicates the long-term blood sugar levels. The doctor can because of this value, determined regardless of the current measurement, the average blood sugar levels of the last two to three months. The UK prospective diabetes study (UKPDS) has shown that a reduction was achieved by 16% incidence of heart attacks by lowering of HbA1c from 7.9 to 7.0%.

This pioneering initiative in our country, has been launched to improve care for patients suffering from severe mental illness. For Dr. Julio Bobes, President of the Spanish Society of Biological Psychiatry, “The consensus aims to initiate cooperation and joint attention between different professionals and enhance awareness of the psychiatrists who care for severely mentally ill regard to the screening and treatment of this increased incidence of cardiovascular risk factors and diabetes. ”

“This is warning of a problem that has largely been ignored until now. We have to consider that mental health is not just fighting a set of psychiatric symptoms, but health as a whole. The physical must accompany the mental and we can not neglect this aspect of such significance that accompanies this group of diseases, “says Dr. Jerome Saiz Ruiz, President of the Spanish Society of Psychiatry.

“The presence of schizophrenia or bipolar disorder significantly raises the risk of cardiovascular disease and also significantly increases the risk of premature death due to any cardiovascular complication. It is estimated that patients with schizophrenia have twice the risk of dying from a cardiovascular problem, the first cause of death in this group, “says Dr. Carlos Macaya, President of the Spanish Society of Cardiology.
The cardiovascular risk profile of people with serious mental illness is influenced by an unhealthy lifestyle such as smoking, poor diet or sedentary lifestyle. There is also a direct effect of the disease and / or antipsychotic treatment in the progressive development of cardiometabolic risk factors, since some medication induced weight gain and increased risk of adverse metabolic effects.

“Psychopharmacological treatments affect not only the brain but throughout the body, modifying the patient’s lifestyle and metabolism. However, not all drugs produce the same effect cardiometabolic, some are more neutral and more influence measure. Several studies have shown that while some antipsychotics cause weight gain, and impaired glucose and lipid metabolism, others have a minor or negligible effect on these parameters, “says Dr. Bobes.

With regard to diabetes, is shown an increased prevalence of this disease in patients with schizophrenia and bipolar disorder. Not only the prevalence is higher but the secondary complications of diabetes occur more frequently. “Therefore, in cases where we know they have a higher risk of developing diabetes or by family history, obesity and lack of exercise, it would be advisable to use those antipsychotics with lower metabolic risk,” said Dr. Edelmiro Menendez, Second Vice President of the Spanish Society of Diabetes. “The important thing is the approach to the multidisciplinary treatment of a form with a close collaboration between psychiatrists and endocrinologists, internists or family physicians,” concludes Dr. Menendez.

To prevent and reduce the impact of cardiovascular disease in this group, which is proposed from the consensus is “monitoring the overall health of patients diagnosed with serious mental illness periodically conduct a comprehensive patient intervention and those that present factors risk, both metabolic and cardiovascular diseases, assess the antipsychotic treatment based on your medical history, “concludes Dr. Bobe

Diabetic ketoacidosis: is a real danger, contrary to what occurs with hypoglycemia, is fatal to the fetus

Retinopathy (damage to the retina) retinopathy is already present in many women in early pregnancy, and may progress as it moves. Regular ophthalmoscopy is therefore important. Paradoxically, the progression of retinopathy may be related to the initiation of a strict metabolic control. When neovascularization occurs, can be controlled with photocoagulation, and it is therefore an indication for abortion.

Nephropathy (kidney damage): diabetic nephropathy in pregnant women is defined as the presence during the first half of pregnancy, proteinuria (protein in urine), persistent over 400 mg in 24 hours, in the absence of infection.

Many patients also have high blood pressure and other complications of renal injury. These cases require careful monitoring and control of hypertension and diabetes mellitus, hospitalization proceeding quickly and inducing labor.

Patients with functioning kidney transplants often have successful pregnancies.

Intrauterine death (death of the fetus in the uterus) may occur unexpectedly and inexplicably

Malformations: Congenital malformations occur in 6-8% of children of diabetic mothers: they are three times more frequent than in the general population. The rate of malformations covers a wide spectrum, but the defects of the neural canal and the cardiac lesions are not uncommon.

Therefore, patients should be advised diabetic women to plan pregnancy and tell her earlier, in order to achieve the best possible control before conception takes place. Compliance with this advice may reduce the number of malformations

Neonates small for gestational age: Although usual in children of diabetic mothers is macrosomia, some infants are small for gestational age due to intrauterine growth retardation. This is more common in patients with longstanding DM with vascular complications.

Respiratory distress syndrome (RDS) or hyaline membrane disease: when patients routinely gave birth at 36-37 weeks of gestation, due to lack of maturation of the lungs of the newborn, respiratory disturbance occurred that many times was fatal. Today this problem can be provided in time avoiding many deaths from this cause.

Hypoglycemia Neonatal hypoglycemia is common, especially in macrosomic children. Strict metabolic control of the mother and newborn after delivery decreases the frequency and severity of neonatal hypoglycemia.

Hyperbilirubinemia: It may appear associated with premature birth.