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January 15, 2020

The Link Between Diabetes, Heart Disease and Stroke

Written by: Compliance blogger

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Heart disease and stroke are the most common causes of death in adults with diabetes. In fact, diabetics are almost twice as likely to die from heart disease or stroke as those without diabetes, according to the National Institutes of Health (NIH). This is partly due to the fact that people with diabetes are more likely to have other conditions, or risk factors, that increase their chances of heart disease or stroke. Fortunately, because diabetes, heart disease and stroke share common risk factors, the same steps taken to manage diabetes can also decrease the likelihood of developing heart disease or of having a stroke.


Diabetes and Heart Disease

Heart disease is caused by a substance called plaque building up in the arteries. This buildup results in a narrowed artery which reduces the amount of blood that can reach the heart. For diabetics this is of great concern because their high blood sugar levels can contribute towards this buildup making the blood vessels stiff. The high blood glucose can also damage the nerves controlling the function of the heart. As reported by the Centers for Disease Control and Prevention (CDC), heart disease is the leading cause of death in the United States. More than 600,000 Americans die of heart disease each year. That means it causes one in every four deaths in the U.S. The risk for diabetics is much higher with almost 7 in 10 over the age of 65 dying of heart disease.


Diabetes and Stroke

A stroke occurs when a clot blocks the blood supply to the brain or when a blood vessel in the brain bursts. This is more likely with diabetics because the extra sugar in the blood can cause increased deposits of fat or clots on the vessel walls restricting the flow of blood. Stroke is the fifth leading cause of death in the United States. It kills about 140,000 Americans each year which equates to about 1 in every 20 deaths, states the CDC. Again, the risk of this occurring is higher for diabetics with about 1 in 6 dying of a stroke.


Risk Factors

Below are the common risk factors that can increase the chances of diabetes, heart disease and stroke.

  • Smoking
  • High blood pressure
  • Abnormal cholesterol levels
  • Obesity and belly fat
  • Family history of heart disease
  • Lack of physical activity

Managing the Risk Factors

Keeping diabetes under control is important to help support heart health. Taking the usual steps to regulate your diabetes and its risk factors will keep your heart and blood vessels healthy and in turn decrease the likelihood of developing heart disease or having a stroke. These steps include:

  • Managing your diabetes ABCs
    o  A is for the A1C test
    o  B is for blood pressure
    o  C is for cholesterol
    o  S is for stop smoking
  • Maintaining a healthy lifestyle by eating right, maintaining a healthy weight, exercising and getting enough sleep
  • Managing your stress which will also help lower glucose and blood pressure
  • Taking your medications as directed

Other Important Interventions

Managing Stress - Long-term stress can raise blood glucose and blood pressure. Learn ways to lower stress, such as deep breathing, gardening, taking a walk, doing yoga, meditating, doing a hobby, or listening to music.


Coding ICD-10-CM

When the patient has both diabetes and cardiovascular disease, assign the correct diagnosis code based on the provider’s assessment recorded in the patient’s medical record.


E08-E13 Diabetes mellitus is the code range


E08.00 ‑ E08.9   Diabetes mellitus due to underlying condition

E09.00 ‑ E09.9   Drug or chemical induced diabetes mellitus

E10.10 ‑ E10.9   Type 1 diabetes mellitus

E11.00 ‑ E11.9   Type 2 diabetes mellitus

E13.00 ‑ E13.9   Other specified diabetes mellitus


Patients with Diabetes and cardiovascular disease may also have kidney problems as well. The code range for these conditions can be found in ICD-10-CM:


I10                   Essential hypertension

I11.0 ‑ I11.9   Hypertensive heart disease

I12.0 ‑ I12.9   Hypertensive chronic kidney disease

I13.0 ‑ I13.2   Hypertensive heart and chronic kidney disease

I15.0 ‑ I15.9   Secondary hypertension

I16.0 ‑ I16.9   Hypertensive crisis


Cerebral infarction (stroke) is also a danger to those with diabetes. Category I63 denotes cerebral infarction and the code ranges are:


I63.00 ‑ I63.09   Cerebral infarction due to thrombosis of precerebral arteries

I63.10 ‑ I63.19   Cerebral infarction due to embolism of precerebral arteries

I63.20 ‑ I63.29   Cerebral infarction due to unspecified occlusion or stenosis of precerebral arteries

I63.30 ‑ I63.39   Cerebral infarction due to thrombosis of cerebral arteries

I63.40 ‑ I63.49   Cerebral infarction due to embolism of cerebral arteries

I63.50 ‑ I63.59   Cerebral infarction due to unspecified occlusion or stenosis of cerebral arteries

I63.6                    Cerebral infarction due to cerebral venous thrombos, nonpyogenic

I63.81 ‑ I63.89   Other cerebral infarction

I63.9                    Cerebral infarction, unspecified


Conclusion

Heart disease and stroke are among the biggest killers in the United States. When you add diabetes to the mix, the amount of fatalities from these conditions is astounding! However, learning about the risk factors and the steps necessary to combat them are a step in the right direction. We hope you are following our diabetes blog series and join in our mission of educating the public about diabetes and its serious effects. Also, don’t forget to watch out for our new course Key to ICD-10-CM Compliance – Coding Diabetes coming in early 2020 for more in-depth diabetes coding information!

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