Atherosclerosis in Diabetic Patients

by Richard J. Manager

Atherosclerosis is the most common chronic cardiovascular disease that affects the walls of the arteries and results in the build-up of atherosclerotic plaques inside the arteries, which makes the walls of these arteries thicker and less elastic. In atherosclerosis, the lumen of the arteries becomes narrower and the blood flow to the organs is disturbed.

Diabetes is a risk factor for the development of atherosclerosis; diabetic patients suffer from this pathology 5 times oftener than non-diabetic patients. Moreover, atherosclerosis accounts for about 80% of all lethal cases in diabetic patients. The course of atherosclerosis in combination with diabetes is more aggressive and provokes frequent complications.

In diabetes, all types of vessels can be affected by atherosclerosis, but most often it progresses in the following vessels:

Coronary arteries;
Renal arteries;
Cerebral vessels;
Vessels in the eye fundus;
Arteries and capillaries of the lower extremities.

The symptoms of atherosclerosis that develops in the setting of diabetes are the same as in non-diabetic patients; however, they are more clinically apparent and rapidly developing. Diabetes increases the risk of atherosclerosis due to the following diabetes-associated factors:

Disturbed regulation of fat metabolism;
Disturbed oxidation processes in the form of ketoacidosis;
Disturbed blood coagulation and increased blood clotting;
Specific diabetes-related damage of the blood vessels – diabetic angiopathies;
High risk of hypertension and other cardiovascular disorders.

Atherosclerosis can provoke certain complications in diabetic patients:

Aneurysms of the aorta and other blood vessels, aneurysm rupture;
Organ ischemia;
Coronary artery disease and myocardial infarction;
Diabetic encephalopathy leading to a stroke;
Nephropathy resulting in chronic renal failure;
Angiopathy of the vessels of the eye fundus that can lead to retinal detachment and blindness;
Diabetic angiopathy of the lower extremities and poor circulation that lead to chronic trophic ulcers and gangrene often requiring amputation;

Treatment of atherosclerosis in diabetic patients includes the following:

Diet and insulin therapy, control of blood glucose;
Maintaining healthy lifestyle and giving up bad habits;
Control of blood pressure and hypertension treatment;
Use of medications that lower the levels of cholesterol, such as nicotinic acid and other preparations for the treatment of atherosclerosis;
Surgical methods, when needed.