Blood vessel disease (atherosclerosis)

Blood Vessel Disease

Coronary heart disease, stroke, and peripheral vascular disease are up to four times more likely in people with diabetes. This is because the fat in the blood builds up and sticks to the inside of the blood vessels. When these deposits get large enough, they actually harden and narrow the arteries, restricting the flow of blood and supply of oxygen.

Cholesterol blockages in the heart arteries are the most threatening to life as there is no collateral flow when an artery becomes blocked – and this is what happens during a heart attack. But arteries can get narrowed elsewhere in the body with undesirable consequences. A blockage in a brain artery is a stroke – which can cause paralysis or difficulty with speech. Narrowing to the arteries to the feet initially causes pain on walking but, when blockages are complete, can lead to gangrene or poor healing of ulcers in the feet. Narrowing of the arteries in the penis are one of the most common causes of erectile dysfunction in men.

The legs and feet are usually the first body parts to feel the effects of this, since without sufficient oxygen from the blood, they’re less able to heal. For that

reason, injuries don’t heal themselves as quickly, and become increasingly susceptible to infection. It can also hinder how well you’re able to exercise, as oxygen can’t reach the muscles as quickly as it needs to.

Blood also carries oxygen and other nutrients to the heart via the three coronary arteries. If this isn’t as effective as it needs to be, you can get chest pain, known as angina. If this problem becomes particularly severe, you can have a heart attack. Similar issues can occur with blood flow to the brain, which can ultimately lead to a stroke.

What can be done about these complications?

• Ensure your LDL cholesterol is treated appropriately for your level of risk.   All patients with diabetes are recommended to be on a statin
• Keep your blood sugar and pressure within the target range. This may help to prevent or delay these problems.
• Avoid smoking. Smoking is dangerous as it causes damage to the heart and blood vessels, and so can diabetes. Together, they dramatically increase the risk of heart disease.
• Avoid alcohol, which is high in calories, and low in food value. Too much can damage the heart, blood vessels, and liver.
• Be active. Physical activity makes the heart much stronger, increases your blood flow, lowers blood pressure and helps weight loss.
• Follow a balanced Mediterranean or DASH diet. It’s not just about avoiding sugar; a low fat, balanced diet will help to prevent heart disease. We advise all patients to have at least one session with one of our dieticians.
• Keep in close contact with your healthcare team. Regular check-ups help to get problems fixed sooner.
• Get your eyes checked annually.
• Have regular blood and urine tests. These will test for blood fats, risk factors for heart disease, and kidney function.
• Look after your feet.
• Follow your drug regimen. In most cases, diabetes can be controlled with diet and exercise, as well as drugs. Compliance with this regime is very important, as you will not reach your blood sugar targets otherwise.