Diabetic Vascular Disease
- Diabetic vascular disease refers to the hardening of the arteries throughout the body, caused by diabetes mellitus—a condition in which too much sugar, or glucose, builds in the blood because of a lack of insulin or because the body is unable to effectively use insulin.
- Diabetic vascular disease typically affects the smaller arteries of the body, including those of the feet, fingers, toes, eyes, and kidneys.
- People with diabetes are 5 times as likely to have a stroke than people without diabetes; 2 to 4 times as likely to have coronary artery disease; and, up to 5 times as likely to have peripheral arterial disease.
- Controlling blood sugar levels may help to prevent or slow the development of vascular disease.
- Diabetes is linked to a number of vascular problems, including: Retinopathy (an eye condition); Nephropathy (a kidney condition); Atherosclerosis (hardening of the arteries); and Coronary heart disease. These problems arise mainly from having too much glucose (blood sugar) in the blood, called hyperglycemia.
- With type 2 diabetes, the more common form of diabetes, the body becomes resistant to the effects of insulin. This leads the pancreas to secrete more insulin. As a result, the body can end up accumulating too much insulin over time, a state known as hyperinsulinemia. Hyperinsulinemia is associated with events in the bloodstream that lead to vascular damage.
- Diabetes patients may develop foot ulcers.
Common symptoms of diabetes include:
- Frequent urination
- Nausea and vomiting
- Itchy skin
- Extreme thirst
- Infections that do not heal
- Weight loss
Patients with diabetes-related vascular problems may experience the following symptoms:
- Blurry vision
- Floaters (floating spots in vision)
- Swelling of the face or extremities or unexpected weight gain
- Urine that is foamy in appearance
- Foot ulcers (sores)
- Loss of feeling or a burning sensation in the hands or feet
- Claudication (pain in the legs when walking)
- Hypertension (high blood pressure)
- Chest pain
Causes & Risk Factors
Type 1 diabetes typically begins in childhood (often thought to be a hereditary condition). Type 2 diabetes is more likely to occur in adults who are overweight (as a result of lifestyle conditions). Vascular disease in people with diabetes is accelerated by the following factors:
- Duration of diabetes
- Lack of exercise
- A diet that is high in saturated fat
For diabetes testing, patients are required to fast for at least 8 hours and then have blood tests done to measure the glucose level in the blood. Other tests that diagnose diabetic vascular disease, include:
- Fluorescein angiography
- Urine tests
- Kidney biopsy
- Exercise treadmill testing
- Ankle/brachial index
- Duplex ultrasound
- Blood tests for lipid levels
Commonly prescribed medications include:
- Insulin or glucose-lowering medications
- Antihypertensive medications
- Lipid-lowering medications
- Antiplatelet medications
When used in conjunction with medication therapy, a mind-body technique called thermal biofeedback may also help to improve symptoms of diabetic disease.
Patients who have retinopathy as a result of their condition, must undergo laser eye surgery. When foot ulcers develop or leg circulation is impaired, a surgeon may need to perform a skin graft or bypass surgery to prevent amputation. Another treatment option is angioplasty and stenting, to widen the blocked leg artery.
Lifestyle modifications help to slow the progression of the disease. Recommended changes include:
- Quitting smoking
- Eating a low-fat diet
- Maintaining a healthy weight
To minimize the risk for foot ulcers, all people with diabetes should examine their feet every day and protect their feet from surface injury and excess moisture.
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Medical Review Date: May 26, 2009 / Copyright © 2012 NorthPoint Domain, Inc. All rights reserved. This material cannot be reproduced in digital or printed form without the express consent of NorthPoint Domain, Inc. Unauthorized copying or distribution of NorthPoint Domain’s Content is an infringement of the copyright holder’s rights.