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HEALTH WATCH
Small Signs, Big Strike
Diabetics often do not feel pain. So how can they
recognise a heart attack?
 Intensity
is rarely a reliable indicator of impact. It is a point that diabetics
in the country should should take serious note of, according to eminent
cardiologists at the First Asia Pacific Centre of Excellence in Coronary
Interventions in Delhi recently. "Popular imagination associates
devastating heart attacks with excruciating chest pains," says Mathew
Samuel, Director, Interventional Cardiology, Apollo Hospital, Chennai.
But the truth is, the severest cardiac arrests are frequently heralded
only by a dull ache that is, more often than not, ignored. By the time
the person realises the insidious nature of a suspected muscle cramp or
gastric pains it can be too late.
This is worrying for diabetics as one of the
characteristics of the disease is neuropathy-a loss of nerve sensation.
Diabetics, therefore, are less likely to feel the pain that accompanies
a heart attack. This is dangerous considering that a diabetic is three
times more prone to heart attacks than the average person. India has the
highest number of diabetics in the world-25 million men, women and children.
For them the only warning of a heart attack is perhaps heavy sweating.
But how does a sweating diabetic decide whether
he is suffering from a life-threatening attack or the natural effect of
a hot, humid day? The first step is to recognise other signs like breathlessness
and fatigue. But the wisest move is to let the doctor decide. Emphasises
Martin Rothman of London Chest Hospital, UK: "Patients should not
be embarrassed. They have nothing to lose and everything to gain by heading
straight to the doctor."
The precautions which keep heart diseases at
bay are as effective for diabetics as the next man-diet, exercise and
no smoking. "It need not be a workout at an expensive gym,"
says Rothman. "A brisk, 40-minute walk every day is all that's needed
to delay or reduce the risk of an attack." Exercise has another major
benefit-it is probably the only reliable indicator of heart disease in
a diabetic. When you exercise daily, you know what you're capable of.
"So if you start panting one day after only a few minutes on the
treadmill which is usually not an exertion, you know you're in for trouble,"
explains Rothman. Awareness and a little bit of effort is all it takes
to distance diabetes from disaster.
IN SMALL DOSES
 Fat
and Fit: Fat is not always bad. Obese but fit people have half the
death rate of those who are trim but don't exercise, according to a British
study presented at the International Conference on Obesity in London recently.
A team of doctors arrived at this surprising conclusion after observing
25,000 middle-aged men and 8,000 women for 10 years. Obesity is better
known for its intimate links with killer diseases like heart attacks.
But, apparently, these theories miss the point; the key is fitness, not
weight. So forget dieting-but hang wisely on to that gym membership.
 Smoking
Horrors: We have always suspected it, now they have proved it. Women
who smoke risk infertility and invite early menopause, according to a
report in Nature Genetics. A class of chemicals in tobacco smoke called
polycyclic aromatic hydrocarbons (PAHs) stimulates genes that command
the egg cells in the ovaries "to commit suicide", it says. But
it is not just smoking that is dangerous. Pollution is just as harmful.
The same class of chemicals are released into the air when fossil fuels
are burnt.
 Herbal
Flipside: Herbs don't always heal. Sometimes they have the opposite
effect. Common herbal remedies can cause serious complications for patients
undergoing operations, says a report in the Journal of the American Medical
Association. That extra pod of garlic, for example, could cause more bleeding,
while ginseng brings down blood sugar levels. After an extensive study
of eight common herbs, the scientists attributed 101 deaths in the US
between 1993-1998 to these harmless herbs. Also, more than 5,000 adverse
reactions were reported to the World Health Organisation.
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