Treating Macrovascular Complications with Diabetes


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The macrovascular complications that occur alongside diabetes are severe and can be life threatening. The major cause of these complications is atherosclerosis that builds up on the walls of your blood vessels. To help prevent this, there are a number of treatments.

Aspirin

The first treatment that is used to help prevent macrovascular complications is aspirin. Aspirin is an anti-coagulant, a drug that prevents red blood cells from sticking together.  This is used to prevent clumps of blood cells from clotting and blocking blood vessels within your body. This drug can help to prevent you from suffering a heart attack or stroke.

Decreasing Blood Pressure

The second type of treatment is used to help decrease your blood pressure. High blood pressure is a risk factor for having a stroke and heart attack, as it damages the walls of your blood vessels. To help you get your blood pressure down to a desirable value (130/80), there are a large number of drugs you may be given. These are:

  • Diuretics. These remove water from your body, helping to lower your blood pressure. There are 3 main types.
  • Angiotensin Converting Enzyme (ACE) inhibitiors. These work in your kidneys to prevent angiotensin II from being made. This usually activates a cascade of events that cause your blood vessels to narrow, raising your blood pressure.
  • Angiotensin Receptor Blockers. Work in the same way as ACE inhibitors, by preventing angiotensin II from working.
  • β blockers. Act by decreasing the force the heart pumps with, helping to keep the blood pressure low.
  • Calcium channel blockers. They work by blocking calcium from entering the heart muscle. This then decreases the force of the heart when it pumps. Allowing your blood pressure to fall.

All of these drugs have their own advantages and disadvantages, each of them may be given to you to help decrease your blood pressure. The doctor will decide which one is best for you.

In helping decrease the risk of developing macrovascular complications associated with diabetes, it is vital to treat the cause of atherosclerosis, high cholesterol levels. This is vital to ensure that blood is allowed to flow freely throughout your body. There are a number of ways to help you decrease your blood cholesterol, the best being taking enough exercise and decreasing your daily fat intake. Sometimes your doctor may decide that you need to take some medication to help control the amount of cholesterol in your blood. You should aim to get the amount of LDL (low density lipoproteins) within your blood as low as possible, as these are the ‘bad’ fats. HDL cholesterol on the other hand is ‘good’ fat. There are a number of drugs you can take:

  • Statins. These are the most common and best drugs used to lower cholesterol. They include atorvastatin and simvastatin. They work by decreasing the amount of LDL within your blood. They do have some side effects and as such you may experience some problems when taking them. If so please inform your doctor.
  • Fibrates. These drugs are sometimes used before statins as they have fewer side effects associated with their use. The main form is gemfibrozil. They are particularly good as they decrease LDL levels whilst maintaining HDL levels.


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