Macrovascular complications

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[Up] [Hypoglycemia] [Diabetic Eye complications] [Diabetes and Kidney damage] [Diabetic Neuropathy] [Macrovascular complications] [Lipid disorder in diabetics] [Hypertension in diabetics] [Diabetic Ketoacidosis] [Diabetic Foot]


Macro vascular disease in diabetics.



Coronary artery disease leading to angina and heart attacks is 2-4 times as common in a diabetic                                                                            






Atherosclerotic changes in blood vessel



Diabetes melitus is a major risk factor for disability and increased death rate through premature and accelerated Atherosclerosis. (deposits in blood vessels leading to their narrowing).





               heart attacks                                               stroke                                 high blood pressure

     (narrowing of arteries of heart)               (narrowing of brain arteries)      (generalized narrowing of arteries)



Incidence of macrovascular complications in diabetics

Coronary artery disease leading to angina and heart attacks is 2-4 times as common in a diabetic. (sudden heart attack can occur without much pain)


Cerebrovascular disease leading to stroke is 2-4 times as common in a diabetic.


Peripheral vascular disease is common, causing foot problems.


Hypertension also more common in diabetics. 


Damage to large blood vessels


Perhaps the greatest problem caused by damaged large blood vessels is heart disease.


When the blood vessels of the heart become blocked or damaged, the heart does not get enough blood. 


You may be at an even greater risk for heart disease if you smoke or have high blood pressure or high cholesterol levels.


If the damage centers around the blood vessels in the arms, legs, or feet, this is called peripheral vascular disease.


The warning signs for heart disease and peripheral vascular disease include chest pain, shortness of breath, swollen ankles, and an irregular heartbeat.


With peripheral vascular disease, you may also have weakness, pain, and cramping when you walk; you will not experience these feelings when standing or sitting. Other symptoms include cold feet, loss of hair on your feet or legs, and a reddening of dangling feet. Report any symptoms to your doctor.


Damage to small blood vessels


Diabetes can affect the small blood vessels in the eyes and kidneys.


Blood from a leaking vessel can cause blurred vision, dark spots, loss of some vision, and even lead to blindness. Sometimes you may not know that small blood vessels in the eye have been damaged. Have your eyes checked regularly.


Kidney disease is another serious complication of small blood vessel damage. The tiny vessels of the kidney filter waste products out of the blood and excrete them in the urine. When the vessels are damaged, the filters cannot take all of the waste out of the blood. Regular visits to your doctor are crucial, especially at the first sign of trouble.


Mechanism of damage to blood vessels in a diabetic patient.

When blood-glucose levels remain high for too long, the excess glucose stiffens red blood cells and weakens blood vessel walls. When the stiffened red blood cells try to squeeze into the extremely small blood vessels, they damage the vessels even more. This can cause small blood vessels to become weaker and burst. As the stiffened red blood cells pass through the large vessels, they damage the inside walls and scar tissue forms. Cholesterol in the blood becomes trapped by the rough scar tissue and begins to build up. It can gradually close off the large blood vessels and force your heart to pump harder.




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