Unlock the Power of NT-proBNP: A Game-Changing Biomarker to Prevent Heart Failure in Diabetic Patients

Assoc. Prof. Dr. Thada Kunavisarut, Endocrinology and Metabolism Siriraj Hospital gives an interview on the global diabetes situation. and guidelines to prevent heart failure in diabetic patients to prevent loss of life.world diabetes day which falls every year on 14 November 2024, organized by Roche Diagnostics (Thailand) Company Limited to promote a campaign aimed at diabetes patients to raise awareness of the importance

Assoc.Prof.Dr.Thada said Diabetes (Diabetes) is a chronic disease that results from a deficiency of the hormone insulin. which is produced by the pancreas Makes blood sugar higher than normal This may be caused by the body’s inability to produce enough insulin. or the body cannot use insulin effectively. As a result, it causes an imbalance in blood sugar levels and has a negative effect on health.

Divided into 4 types depending on the cause of the disease:

1. Type 1 diabetes mellitus, T1DM: caused by destruction of pancreatic cells. By the body’s immune system This makes it unable to produce enough insulin. Or lack of insulin is often found in children. In which patients have to take insulin to control sugar levels.

2. Type 2 diabetes mellitus, T2DM: is the most common type (95% of all diabetes patients) caused by insulin resistance. Often found in adults or overweight people.

3. Diabetes other specific types: can have many causes, such as pancreatic disease. Endocrine disease or steroid medicine, etc.

4. Gestational diabetes mellitus (GDM): is diabetes that occurs during pregnancy, usually in the 2nd-3rd trimester of pregnancy. This can increase the risk of future diabetes for both mother and baby.

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About the Diabetes Association of Thailand and the Bureau of Risk Communication and Health Behavior Development, Department of Disease Control found outdiabetesThis can cause complications. heart failureIt is one of the most common and serious complications in people with diabetes. Currently, as many as 6 million Thais have diabetes, or 1 in 11 people aged 15 and over. People with diabetes have a chance or are at risk. three times more likely to die from heart disease than people without diabetes

Patients with diabetes are at risk of being hospitalized becauseheart failureIncrease to 33% in patients with type 2 diabetes and congestive heart failure. The risk of death is three times greater than in people without heart failure.

Furthermore, 14.1% of patients with type 2 diabetes were found to have heart failure, which is considered the second most serious complication occurring in patients with type 2 diabetes.Ba Wan Female diabetic patients are at greater risk than male patients. Women are at 3.5 times greater risk, while men are at 2.1 times greater risk. Diabetes patients aged 65 and older have a 70% higher heart disease mortality rate.

Methods for the examination and risk assessment of cardiovascular disease

The Assoc. Prof. Dr. Thada recommends such risk assessmentHeart diseaseAnd blood vessels in diabetic patients are important for preventing and reducing complications. This can be done through various inspection and evaluation methods, such as:

• Blood sugar (HbA1c) measurement: Helps evaluate blood sugar control over the past few months. An HbA1c level above 7% indicates poor blood sugar control. and have a higher risk of heart disease and stroke
• Blood lipid level test: measures cholesterol and triglyceride levels. If the fat level is high, the risk of coronary heart disease increases.
• Blood pressure measurement: Diabetic patients with high blood pressure are at increased risk of heart disease and stroke. It should be controlled at a level below 140/90 mm.Hg (depending on the doctor’s advice).
• Kidney function tests (eGFR and urine protein): People with diabetes are often at risk for kidney failure. This is also related to the risk of heart disease. Tests for eGFR (glomerular filtration rate) and protein in urine help evaluate kidney function.
• Electrocardiogram (Electrocardiogram or EKG): Checks the function of the heart to see if there is an irregular heartbeat or signs of coronary heart disease.
• Body mass index (BMI) measurement: helps assess the risk of being overweight. which is a major risk factor for cardiovascular disease in people with diabetes
• Assessment of lifestyle behaviors: such as smoking, drinking alcohol, exercise and eating behavior Because these factors influence cardiovascular health.
• Echocardiographic exam In short, Echo is a test of the heart that uses high-frequency sound waves. (ultrasound) to create images of the function and structure of the heart Plays an important role in evaluating heart conditions in patients.diabetes Because it can help detect many anomalies. This is useful in the prevention and treatment of cardiovascular disease in this group of patients. Especially in high-risk cases

NT-proBNP test to evaluate heart failure

Prof. Dr. Thada further stated that there is currently an NT-proBNP (N-terminal pro-B-type natriuretic peptide) test by blood sampling in the arm for use in the evaluation of heart failure and abnormal heart conditions in patients including diabetic patients who are at high risk of cardiovascular disease Very useful in risk assessmentHeart diseasein diabetic patients for the following reasons:

NT-proBNP levels are often elevated in patients at risk or with early onset of heart failure. This helps doctors detect and manage this condition before it gets worse. It can be used as a risk indicator.heart failureor cardiovascular problems in the future Especially in diabetic patients who already have high risk factors.

However, NT-proBNP should be used in conjunction with other tests such as ECG and echocardiography. (Echocardiogram) and blood pressure measurement To provide a more complete assessment of heart health, elevated NT-proBNP levels (above 125 pg/ml) may indicate that the heart is working harder or has abnormalities. This is important information that helps in managing patient care.diabetesand reduces the risk of heart failure and vascular problems.

Advantages of the NT-proBNP test

Population over 40 years of age or people with diabetes. High blood fat hypertension and cardiovascular disease Should be examined to assess the risk of heart failure. It can help assess the risk of people who may develop serious chronic diseases. This includes heart failure. And the onset of critical coronary disease is an indicator that helps quickly and accurately diagnose heart failure, even if the patient has only mild heart failure. or have not yet shown symptoms precisely

“Recent studies have shown that using NT-proBNP to guide heart failure treatment is more effective than standard treatment and allows doctors to personalize treatments more effectively. It can help reduce the incidence of coronary heart disease by 40% in patients with chronic heart failure. Reduce the mortality rate of heart failure patients and reduce the rate of hospital admissions There is a better quality of life overall,” said Prof. Dr. Thada.