Interview with Dr. Egom

This interview is part of the Patient Corner Series.

As a leader in the battle against diabetes & heart conditions in Mississauga, we wish to focus on preventative and treatment options.

Mitigation against cardiometabolic disorders is possible when equipped with the proper information.

Strengthen your heart and prolong your life. Schedule your risk consultation today.

How is diabetes related to cardiology?

Heart disease is common among people with diabetes. Evidence suggests that 65% of people with diabetes will die from some sort of heart disease or stroke. Heart disease is the number one cause of death among people with Type 2 Diabetes. The probability of dying from heart disease is 2 to 4 times higher in a person with diabetes. The most common cause of heart disease in a person with diabetes is hardening of the coronary arteries or atherosclerosis, which is a buildup of cholesterol in the blood vessels that supply oxygen and nutrition to the heart.

Diabetes is a metabolic disorder that by its nature causes heart diseases. Unfortunately, the complications of diabetes and heart diseases are the major cause of death in the developed world. Treating and preventing diabetes and its allied diseases protects the heart and reduces the risks of fatalities. We have all seen loved ones struggle with this towards the end of their lives. I have made it my mission to fight back these diseases.

What is geriatric cardiology, and how is it different from traditional Geriatric/Internal medicine consults?

Unfortunately we lack evidence on which to base our clinical decisions in older adults, since most clinical studies exclude elderly participants, especially those with the complexities associated with old age. Without including seniors in clinical studies, it is impossible to predict how well a drug will be tolerated since the risk of drug-related side effects rises with age. This creates uncertainty about the benefit of using medication versus the risks of not using it. In order to address issues pertaining to heart disease in seniors, we need to get more cardiovascular clinicians with a special interest in Geriatric Cardiology, which is often confused with Geriatrics that is practiced by a cardiologist or simply with Cardiology that is applied to seniors. It would be more adequate to define it as integrated and age-adequate cardiovascular care, centered on the patients and their functionalities.

Beyond age 65, the body’s physiology, that is the way the body functions, changes. The way the kidneys, heart and brain among other organs work changes. The number of medical conditions presented with either diabetes or heart conditions increase and the heart capacity for pumping blood decreases. This gave birth to the medical discipline of Geriatrics Cardiology as distinctive from Cardiology. I have been researching and practicing this for more than 15 years to enable me to offer evidence-based care to our seniors. I am passionate about this.

Can high blood pressure or diabetes be prevented or delayed?

The good news is that we can prevent or delay high blood pressure or diabetes (Type 2) by taking good care of ourselves. This includes keeping your blood sugar levels as close to your target as possible, eating healthy, getting regular physical activity, keeping your blood pressure (and cholesterol by the way) at the levels your physician sets, taking medications if needed, and getting regular checkups. It may sound like a lot, but it’s worth it to improve your health and feel your best.

For patients who wish to advance science, I run studies on optimizing treatment algorithms and options specifically for disease prevention. I encourage them to discuss these options with their family doctor.

How did the treatment of diabetes change in the last ten years?

While a cure continues to remain out of reach, the pace of diabetes treatment innovation is faster than ever. Looking back over the past two decades, it’s pretty amazing how far diabetes management has come with new medications and therapies that can make a living with diabetes a whole lot easier as well as longer. This is an exciting time for Diabetes Specialists.

The last ten years brought us more meaningful therapeutic options than anytime before. New classes of medications have proven their worth for tighter diabetes control, Weight loss, Delay of complications. Medications that were mainstream in the 90s and early millennium are now upgraded. For example, one of the most difficult tasks for a diabetic patient is to lose weight. This is part of the side effects of older treatments. Now we have options that allow us to achieve tight diabetes control and enable weight loss.

Is achieving normal blood sugar (normoglycemia) an achievable goal for most diabetic patients?

What’s normal (blood sugar) may be different depending on your age, other health conditions, medications you’re taking, and other factors. The best thing to do is to work with your doctor to establish an individualized, desired and achievable blood sugar goal for you. This goal should be dynamic and can change over time depending on many health & non-health related factors.

What are the most common cardiovascular diseases do you treat?

My practice focuses on lowering people’s risk of developing heart disease while also preventing further issues in those who already have cardiovascular disease. I typically see people with a strong family history of heart disease or a personal history of cardiovascular disease (heart attack, heart failure, etc.) as well as those with risk factors for heart disease, particularly individuals with elevated cholesterol, high blood pressure, high blood sugar or diabetes, obesity (especially with excess abdominal fat), smokers, unhealthy diet, and lack of exercise/sedentary lifestyle.

Can proactive cardiac screening detect heart attack risk (Myocardial Infarction) or Atrial Fibrillation among men and women? Can this risk be mitigated or managed?

Proactive screening might improve early recognition and prevent disease progression or sudden/unexpected cardiovascular events such as heart attack or stroke. Having test results that are less than ideal during a regular screening doesn’t mean you’re destined to develop a serious cardiovascular disease. On the contrary, it means you’re in a position to begin changing your health in a positive way.

At what age should men and women be screened? How can a patient start this process?

Some routine measurements such as body weight and blood pressure may be taken during routine medical appointments. Some cardiovascular screening tests begin at age 20. The frequency of follow-up will depend on your level of risk. To start this process, I would suggest you speak to your family physician, who may also conduct or request screening tests during your regular visit.

Can you share with us something about your latest or upcoming publication?

As we are currently living in a COVID-19 era, it makes sense to talk about my ongoing COVID-19 related research interests.

We know that lung vessel injury is a common finding among hospitalized COVID-19 patients. Patients with severe COVID-19 exhibit a high prevalence of lung vessels damage, which may lead to pulmonary hypertension (high pressure in the lungs) potentially deadly and disabling disease. As the world recovers from the acute stages of the COVID-19 pandemic, it will be faced with new challenges regarding the long-term consequences of lung vessels damage. Given the large number of patients infected by SARS-CoV-2 worldwide, the surge of patients with lung vessels damage could become a major public health problem beyond the acute stages of the pandemic. Therefore, there is an immediate unmet need to gain an in-depth understanding of the clinical relevance of the development of lung vessels abnormalities in the context of the COVID-19 pandemic.

What’s your favourite sport and team?

This is probably the most difficult question among all asked today. I would probably say Soccer although Formula one and Tennis are not far behind. A few years ago, I would have picked up Inter Milan as my favourite team. However, more recently my favourite team has been changing game by game depending upon their likelihood of winning. We are all too blessed to be stressed. Let’s try to be happy all the time.