When UAE national 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 51-year-old 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 having her blood sugar levels checked. She finally stopped taking them in 2014 and went on an infusion therapy instead.
"But I believe the damage was already done. Because I was not monitoring my sugar levels while on the cortisone shots, it just escalated. Two years ago, I started feeling more and more lethargic, drowsy and thirsty. I knew something wasn’t right," says Huda.
She visited 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 was even more surprised to find out 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, explains that because the body cannot properly use insulin, a hormone that regulates blood sugar, in people with diabetes, it has a knock-on effect on other health markers, increasing their chances of heart disease. People with diabetes are twice as likely to have heart disease, and at a younger age, than those who don’t. 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."
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. 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 percent to six percent. 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 and drop her LDL or "bad cholesterol" by almost 50 per cent from 2.6mmol/L to 1.3mmol/L within a year. This has resulted in a reduction of her overall cardiovascular risk score from a very high 17 percent to a negligible 0.7 percent.
"This outcome is phenomenal, especially in such a short period of time. It 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," says Prof. Ahmad.
Huda describes 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 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 daily. 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 says.
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 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.