Macrovascular complications of Diabetes

3 Alarming Macrovascular Complications of Diabetes.

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Author- Dr. Md. Shamim, MD.

Introduction of macrovascular complications of Diabetes:

Macrovascular complications of Diabetes affecting many organ systems. It is responsible for a large number of morbidity and mortality related to Diabetes. Diabetes has been the leading cause of new blindness in adults, renal failure, and nontraumatic lower extremity amputation in United States. Recently, diabetes has emerged as leading cause of coronary artery disease (CAD). So, proper diagnosis and management is key factor to prevent complications. And minimise complications related morbidity and mortality.

Types of macrovascular complications of Diabetes:

    1. Coronary artery disease (CAD)
    2. Peripheral arterial disease
    3. Cerebrovascular disease

 Coronary artery disease (CAD)

    • Common clinical manifestation of CAD is chest pain (angina), heart attacks (MI), and finally heart failure.

    • CAD increases the mortality rate two to four times greater in patients with type 2 DM.

    • Coronary artery disease in patients with diabetes is due to coronary atherosclerosis.

    • Myocardial infarction is 3-5 times more common in Type 2 diabetic patients.

    •  It is the leading cause of death in patients with type 2 diabetes.

    • Cardiovascular disease risk is increased in patients with type 1 diabetes as compared to type 2 diabetes.CAD is a major macrovascular complications of diabetes  

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Peripheral arterial disease:

    • Atherosclerosis is mainly associated with large arteries.

    • It is often diffuse, with localized enhancement in certain areas of turbulent blood flow, such as at the bifurcation of the aorta or other large arteries.

    • Clinical manifestations of peripheral arterial disease include- ischemia of the lower extremities, erectile dysfunction, and intestinal angina.

    • Ischemia of the lower extremities causes pain in leg, delayed wound healing and leg cramp.

    • The incidence of gangrene of the feet in patients with diabetes is 30 times mor than normal individuals at that particular age.

Cerebrovascular disease:

    • In this condition the blood vessels affecting that supply to the brain.

    • It is due to atherosclerosis inside the cerebral arteries.

    • Stroke, transient ischemic attacks (TIAs), and vascular dementia are common cerebrovascular complications of Diabetes.

    • Stroke is the major cerebrovascular complications of diabetes.

    • It is related with duration and type of diabetes.

    • This complication is more commonly associated with Type 2 Diabetes.

    • It is leading cause of death in Type 2 Diabetes.

High Risk Factors associated with macrovascular complications of Diabetes:

    • Hyperglycemia

    • Dyslipidemia

    • Smoking

    • Obesity

Tips for Preventions of macrovascular complications of Diabetes:

Fortunately, many of the diabetes associated complications can be prevented or delayed by-

    • Healthy and proper diet

    • Physical activity

    • Regular exercise

    • Maintain Fitness

    • Proper weight management

    • Cessation of cigarette smoking

    • Early detection of Diabetes

    • Aggressive and proper glycemic control

    • Regular follow-up visits with healthcare professionals.

Diagnostic tests of macrovascular complications of Diabetes:

There are many tests to diagnose macrovascular complications depends on affected sites-

    • Angiography- for CAD

    • ECG- for CAD

    • Echocardiography- for CAD

    • Doppler ultrasound- for Peripheral Arterial Disease (PAD)

    • Carotid ultrasound (Doppler)- for Cerebrovascular Disease

    • MRI- for Cerebrovascular disease.

Treatment of macrovascular complications of Diabetes:

Supportive treatment

Life Style Modification (LSM)

  1. Healthy and proper diet
  2. Physical activity
  3. Regular exercise
  4. Cessation of cigarette smoking

Pharmacotherapy of Diabetes

  1. Early diagnosis and treatment of Diabetes.
  2. Aggressive and tight control of Diabetes as advised by your physician.
  3. Regular check-up and monitoring of blood glucose level and titrated the drug accordingly.
  4. Regular follow-up to the clinics.

Treatment of Complications

Treatment depends upon types of complications.

  1. Angioplasty or Stenting– for CAD.
  2. Coronary Artery Bypass Graft (CABG)- for CAD.
  3. Endovascular treatments or Surgical interventions- for PAD.
  4. Carotid endarterectomy- for Cerebrovascular Disease
  5. Carotid Angioplasty- for Cerebrovascular Disease

Conclusion:

Macrovascular complications are major health concerns for patients with diabetes. These are major cause of morbidity and mortality in Diabetes patients. After knowing the macrovascular complications, a diabetic patients can improve their health and prevent the life threatening and deadly complications of Diabetes. These are burning health topics in modern medical science. It is necessary for Diabetes patients to give priority to their health by regularly taking medications, monitoring and follow-up to prevent these deadly complications.

Reference:

Current Medical Diagnosis and Treatment.

Harrison’s Principle of Internal Medicine.

Katzung, Basic and Clinical Pharmacology.

Diabetes Complications

Microvascular and Macrovascular Complications of Diabetes

  

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