Macrovascular Complications of Diabetes

There are two major macrovascular complications of diabetes, stroke and a heart attack. If you suffer from diabetes, the risk of having a stroke is twice as likely as in the normal population, whereas the risk of having a heart attack is increased nearly 5 fold. Both these complications occur due to the increased likely hood of developing atherosclerosis.


Atherosclerosis is a problem that leads to the narrowing of blood vessels. It occurs when the walls of blood vessels become damaged not only by high blood pressure, but also by high sugar concentrations and chemicals that occur in smoke (if you smoke). Once the blood vessels have been damaged, fat in the form of foam cells becomes deposited on the walls, causing them to narrow. The higher the concentration of fat in your blood, the more likely this is to occur. As this develops, it begins to prevent blood from flowing through the vessels, causing damage to the tissue they supply. This is particularly problematic within the brain and also the heart. If vessels in the brain become blocked this causes specific parts to die, which do not regenerate. This is called a cerebrovascular accident or stroke. If the same occurs within the heart, you will experience crushing chest pain and possibly a tingling down your left arm, common symptoms of a heart attack. Atherosclerosis is made worse if you:

  • Smoke
  • Are increasing in age
  • Are obese
  • Have poor blood glucose control
  • Take little exercise
  • Have a high fat diet
  • Have a high blood pressure

By stopping smoking, decreasing the fat in your diet and taking more exercise you can rapidly decrease your risk of having a stroke or heart attack. You can also decrease your risk of developing atherosclerosis by controlling your blood glucose within well defined limits.

The macrovascular complications that occur with diabetes are often seen much more if you suffer from type 2 instead of type 1 diabetes. The nature of type 2 diabetes means that it usually occurs with a number of other cardiovascular risk factors, often referred to as ‘syndrome X’. This includes hypertension (increased blood pressure), obesity and lipid or fat problems. The more of these risk factors you have, the greater the chance is that you will develop cardiovascular problems.

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