For diabetics, less pain might prove deadly

Heart attack may not produce usual symptoms

People with diabetes may not always feel classic symptoms like acute chest pain when they have a heart attack, according to a small study that offers a potential explanation for why these episodes are more deadly for diabetics.

Researchers examined data from detailed interviews with 39 U.K. adults who had been diagnosed with diabetes and had experienced a heart attack. 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.

“Long-term diabetes damages your heart in many ways (increased blocking of the heart’s blood vessels), but it also damages your nerves,” said study co-author Dr. Melvyn Jones of University College London.

“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,” Jones said by email.

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.

All patients in the study received care at one of three hospitals in London, and they ranged in age from 40 to 90. Most were male, and roughly half were white. The majority had type 2 diabetes. Four of them had type 1 diabetes.

Many of the participants described heart attack symptoms such as chest pain and discomfort. However, many felt like their pain wasn’t severe enough to be a heart attack or didn’t consider the discomfort they felt in their chest as similar to what they would expect with a heart attack.

This may have contributed to delays in seeking care, researchers said.