People with diabetes may not always feel classic symptoms like acute chest pain when they have a heart attack, according to a small study offering an explanation for the increased risks of heart attacks among diabetes patients.
Researchers examined data from detailed interviews with 39 adults in the UK who had been diagnosed with diabetes and had also experienced a heart attack.
Patients ranged in age from 40 to 90. Most were male, and half of them were white. The majority had what’s known as type 2 diabetes, while four of them had type 1 diabetes.
According to Reuters, most of the participants reported feeling some chest pain, but they often said it didn’t feel like they expected or that they didn’t think it was really a heart attack.
Researches who participated in the study, which was published in the journal BMJ Open, noted that this may have contributed to delays in seeking care, which are in turn associated with lower survival odds and a higher risk of complications and disability for people who do live through the event.
The study co-author Dr. Melvyn Jones of University College London said: “Long term diabetes damages your heart in many ways (increased blocking of the heart’s blood vessels), but it also damages your nerves.”
He said: “So a bit like a diabetic might not feel the stubbing of their toe, they also feel less pain from damaged heart muscle when the blood supply gets cut off, so they don’t get the classical crushing chest pain of a heart attack.”
People with diabetes are three times more likely to die from heart disease than the general population and possibly six times more likely to have a heart attack, Jones added.
The study was small, and it was not a controlled experiment designed to prove whether or how diabetes might lead people to experience different heart attack symptoms. Still, it confirms a longstanding belief that people with diabetes may be prone to heart attack symptoms.
Dr. John Wilkins, a researcher at Feinberg School of Medicine in Chicago, who was not involved in the study, said that patients with diabetes should understand that they are more likely to have a heart attack than other people, so they should have regular follow-up with their physicians.
They should also be familiar with the symptoms that suggest that they might be having a heart attack or an impending heart attack and know how to respond if those symptoms develop, he added.