Macrovascular (atherosclerotic plaque)
Coronary arteries MI
Cerebral arteries strokes
Peripheral vessels foot ulcers, amputations
Microvascular (capillary damage)
Retinopathy partial or complete blindness
Neuropathy autonomic nerve damage: for example diabetic gastroparesis, bladder
dysfunction, unawareness of hypoglycemia, (somatic nerve damage, foot ulcers, due to
loss of sensations.)
Nephropathy proteinuria (microalbuminuria) chronic renal failure requires dialysis.
Macrovascular Complications
- Macrocirculation
- Blood vessel walls thicken, sclerose, and become occluded by plaque that adheres to
the vessel walls. finally, blood flow is blocked.
- Complications
- Coronary artery disease
- Stroke
- Peripheral vascular disease
Although it may be tempting to attribute the increased prevalence of macrovascular
diseases to the increased prevalence of certain risk factors (eg, obesity, increased
triglyceride levels, hypertension) in patients with diabetes, there is a higher-than-
expected rate of macrovascular diseases among patients with diabetes compared with
patients without diabetes who have the same risk factors (ADA, 2004d). Therefore,
diabetes itself is seen as an independent risk factor for accelerated atherosclerosis.
Other potential factors that may play a role in diabetes-related atherosclerosis include
platelet and clotting factor abnormalities, decreased flexibility of red blood cells,
decreased oxygen release, changes in the arterial wall related to hyperglycemia, and
possibly hyperinsulinemia.
Complication: CAD
- CAD account for 50% to 60% of all deaths among patients with diabetes.
- High cholesterol and high triglycerides