Diabetes, both type 1 and type 2, is a chronic condition that affects the body’s ability to manage blood sugar (glucose). Over time, high blood sugar levels may lead to health complications, especially concerning heart health. A significant health hazard for individuals living with diabetes is the development of macrovascular complications. These involve complications in the largest blood vessels in the body, namely the arteries that run to the brain and heart, as well as the legs. When blood vessels are damaged, they can lead to life-threatening conditions such as stroke, heart disease, and peripheral arterial disease.
In this blog, we will examine how to cope with the macrovascular complications of diabetes, their causes, and how to prevent them.
What Are Macrovascular Complications?
Macrovascular issues are the damage that occurs in the body’s large blood vessels (arteries and veins). These issues are induced mainly by atherosclerosis, which is a condition that leads to fat deposits (plaques) developing inside blood vessels. Over time, plaques start narrowing and widening the arteries, constricting blood flow. High blood glucose levels that are linked with diabetes can speed up the progression of atherosclerosis and increase the likelihood of serious cardiovascular issues.
The most prevalent types of macrovascular complications experienced in diabetes are:
- Coronary Artery Disease (CAD) – It is a disease that affects the arteries that provide to the heart muscle.
- Cerebrovascular Disease – It involves the arteries that provide the brain, resulting in strokes.
- Peripheral Artery Disease (PAD) – Involves the blood vessels that supply the limbs, especially the legs.
1. Coronary Artery Disease (CAD)
Coronary arterial disease is the most common cause of coronary heart disease and is one of the leading causes of death among people living with diabetes. The coronary arteries carry high-oxygen blood to heart muscles, and if these arteries become narrowed or blocked by atherosclerosis, the heart won’t get enough oxygen. It may result in a disease called angina (chest pain), heart attacks, and heart failure.
How Diabetes Complicates CAD:
- Increased blood sugar: Excessive glucose levels lead to plaque formation inside the arteries, thereby narrowing them.
- Increased inflammation: Diabetes promotes a condition of inflammation. This results in damage to the blood vessels.
- Disturbance in the level of lipids: Diabetes patients usually have higher Triglyceride levels and lower high-density lipoprotein (HDL) cholesterol, which tends to enhance the probability of the onset of atherosclerosis.
Prevention and Treatment:
Control of the blood sugar level is critical in preventing CAD. Other ways are:
- Lifestyle modifications: Eating healthy with regular exercise and control of weight.
- Medications: Statins are used to control cholesterol levels, and aspirin is used to prevent blood clotting.
- Control of blood pressure: Keeping the blood pressure in a healthy range is critical.
2. Cerebrovascular Disease (Stroke)
Diabetes raises the risk of stroke. Strokes occur when there is an interruption of blood flow to a certain area of the brain, leading to brain damage. Like CAD, cerebrovascular disease in diabetes is often due to atherosclerosis of the blood vessels that provide blood to the brain.
How Diabetes Contributes to Stroke:
- Increased plaque buildup: Increased blood sugar levels cause plaque buildup in the carotid arteries (the main arteries that supply blood to the brain) and limit blood flow.
- Poor blood clotting: Diabetes can make blood more likely to clot, raising the likelihood of the clot being obstructed in an artery to the brain.
- Blood pressure rises: High blood pressure, which is prevalent in diabetics, is a significant risk factor for stroke.
Prevention and Management:
- Blood sugar control: Tight glycemic control reduces the risk of cerebrovascular disease.
- Blood pressure management: Maintaining blood pressure within a normal range is necessary to prevent strokes.
- Antiplatelet therapy: In some instances, drugs such as aspirin are prescribed to avoid clot formation.
3. Peripheral Artery Disease (PAD)
Peripheral artery disease is an issue that impacts blood vessels in the legs, leading to a lack of adequate blood flow to the muscles and other tissue that is in the lower limbs. Individuals with diabetes who have PAD can lead to pain-causing walking (claudication), non-healing wounds, and, in severe cases, gangrene, which could result in amputation of the limbs.
How Diabetes Contributes to PAD
- Low circulation: Atherosclerosis in the veins that supply the legs reduces circulation, weakening the tissues’ ability to receive oxygen and nutrients.
- Neuropathy: Diabetic nerve damage can result in loss of feeling in the legs and feet and inhibits the timely identification of wounds and injuries that can worsen due to the absence of circulation.
- Risk of infection: Diabetes weakens the immune system and makes it difficult for the body to defend against infections, especially on the legs and feet.
Prevention and Management:
- Good foot hygiene: Proper foot inspections and proper footwear can prevent injuries.
- Exercise Regularly: Exercise enhances circulation and can help maintain an ideal weight.
- Smoking quitting: Smoking may significantly worsen PAD and may improve the likelihood of developing complications.
- Drugs: Drugs that decrease blood pressure and cholesterol might prevent the risk of PAD.
Mechanisms Responsible for Macrovascular Complications
The development of macrovascular complications with the diabetes pandemic is mainly due to a network of inter-related factors:
- Hyperglycemia: An increase in blood sugar can lead to the formation of advanced glycation end products (AGEs), which damage the lining of blood vessels and promote inflammation.
- Insulin resistance: This trait in type 2 diabetes leads to increased amounts of insulin, which can add to the production of plaques of fatty material in the blood vessels.
- Chronic inflammation: Diabetes causes an ongoing low-grade inflammation reaction that can harm the blood vessels and accelerate the development of atherosclerosis.
- Dyslipidemia: Diabetic patients often have deranged levels of lipids, such as elevated triglycerides and reduced HDL cholesterol, both of which are the primary cause of atherosclerosis.
Conclusion: Prevention of Macrovascular Complications
Complications of diabetes, like macrovascular, are serious and have a significant impact on quality of life, but the best part is that they’re largely preventable and manageable with the right strategy. The most efficient strategies are:
- Strict control of blood sugars to maintain blood sugar levels within target ranges.
- Healthy lifestyle: Proper diet, regular physical exercise, and maintaining the weight of a healthy individual.
- Medical treatment: Utilization of drugs for cholesterol, blood pressure, and blood sugar control.
- Regular checks: Frequent monitoring for cardiovascular risk factors, and early identification of possible complications.
If they take these steps, individuals with diabetes will significantly decrease their chances of developing macrovascular issues and enjoy the rewards of a healthier, more active life.
