Diabetes and Vascular Disease

What is Diabetes and Vascular Disease?

Diabetics have a high incidence of stroke. Diabetes is a disease in which the body does not produce or properly use insulin. Insulin is a hormone that is needed to convert sugar, starches, and other food into energy needed for daily life. There are several types of diabetes:The majority of adults with diabetes die from Vascular Disease. Their risk is 2-4 times higher than adults without diabetes.

Type 1 diabetes (previously called “juvenile diabetes”) is an autoimmune disorder, in which the insulin producing beta cells are destroyed by the body’s immune system. As a result, the body cannot produce insulin, the hormone that allows glucose to enter and fuel the cells. To survive, individuals with type 1 diabetes must take insulin every day. It is estimated that 5-10% of Americans who are diagnosed with diabetes have type 1 diabetes.

Type 2 diabetes (previously called “adult onset diabetes”) is the most common type of diabetes, accounting for 90-95% of all diabetes. In type 2 diabetes, the body does not produce enough insulin and/or the body’s cells become resistant to insulin.

Gestational diabetes occurs in some women who have high blood glucose levels during pregnancy but have never had diabetes. It affects about 4% of all pregnant women, with about 135,000 cases in the United States each year. Women who have gestational diabetes have a 20-50% chance of developing type 2 diabetes in the next five to ten years.

Prediabetes is a condition that occurs when a person’s blood glucose levels are higher than normal but not high enough for a diagnosis of type 2 diabetes. There are 41 million Americans who have prediabetes, in addition to the 20.8 million with diabetes.

If you do not manage your diabetes or maintain healthy habits, you could develop serious health conditions, including blindness, severe kidney disease, stroke, heart attack, sores in your feet, or gangrene (dead tissue) that could lead to infection and eventually to amputation.

Diabetes is linked to several vascular diseases:

  • Retinopathy, which is an abnormal growth of blood vessels in your retina
  • Nephropathy, a disease that damages the tiny filtering units of the kidney
  • Neuropathy, a condition causing a loss of sensation in the feet and toes
  • Atherosclerosis
  • Stroke
  • Peripheral Artery Disease (PAD)

Diabetes causes vascular disease if there is too much glucose in the blood. This excess glucose damages the blood vessels.

Doctors do not know why Type 1 diabetes occurs, though they believe there is a hereditary link.

Type 2 diabetes is associated with older age, obesity, physical inactivity, a family history of diabetes, a history of gestational diabetes, and race and ethnicity. African Americans, Hispanic/Latino Americans, American Indians, and some Asian Americans and Native Hawaiians or other Pacific Islanders are at high risk of developing Type 2 diabetes. Recently, studies show that type 2 diabetes in children and adolescents is increasing, particularly in American Indians, African Americans, and Hispanic/Latino Americans.

Less Invasive Treatments of AAA
Recent advances in catheter-based technologies have led to exciting new treatments for aortic aneurysms. Now, endovascular grafting technology allows the repair of the AAA by inserting a graft through a small incision in the groin. The endovascular method allows the graft to be delivered through a catheter or tube inserted in a groin artery. X-ray guidance is then used to accurately position the graft in the AAA. The graft is then expanded inside the aorta and held in place with metallic hooks rather than sutures. The hospital stay is usually only one or two days, and most patients can return to work or normal daily activities in about a week. Patients with other medical problems or those that could not withstand major surgery can be considered for repair by an endovascular graft. Endovascular grafting may not be possible in every case. Endovascular grafts are specially manufactured and don’t “fit” everyone’s anatomical situation. Standard surgery may still be the best option for many. As a fairly new procedure, endografts do not yet have a 50-year track record to compare to that of surgery for AAA. Speak with your physician about the best option for you.

The combination of early diagnosis with safer, simpler, and ever more successful treatments can prevent deaths due to ruptured abdominal aortic aneurysms.

Warning Signs

Some symptoms of diabetes include:

  • Frequent urination
  • Excessive thirst
  • Extreme hunger
  • Unusual weight loss
  • Increased fatigue
  • Irritability
  • Blurry vision

Some symptoms of diabetes-related vascular problems include:

  • Blurred vision
  • Floating spots in your vision
  • Unexpected weight gain or swelling in your face or limbs
  • Foamy looking urine
  • Sores on your feet
  • Loss of feeling in your hands or feet
  • Burning feeling in your hands or feet
  • Pain in your legs when walking
  • High blood pressure
  • Chest pain

Prediabetes is a serious medical condition that can be treated. The good news is that the Diabetes Prevention Program study conclusively showed that people with prediabetes can prevent the development of type 2 diabetes by making changes in their diet and increasing their level of physical activity. Some medications may help in preventing diabetes. See your doctor for more information.

You might prevent complications from diabetes by doing the following:

  • By eating well-balanced meals in the correct amounts, you can keep your blood sugar level as close to normal (non-diabetes level) as possible. Manage your diet so that you are eating a wide variety of foods including vegetables, whole grains, fruits, non-fat dairy products, beans, lean meats, poultry, and fish. There is no one perfect food, so including a variety of different foods and watching portion sizes is key to a healthy diet. Also, make sure your choices from each food group provide the highest quality nutrients you can find. In other words, pick foods rich in vitamins, minerals, and fiber over those that are processed.
  • Regular physical activity helps you manage your diabetes. Physical activity can lower your blood glucose (sugar), blood pressure, and cholesterol. It also reduces your risk for heart disease and stroke, relieves stress, and strengthens your heart, muscles, and bones. In addition, regular activity helps insulin work better, improves your blood circulation, and keeps your joints flexible.
  • If you are overweight, losing some weight could help you better manage your diabetes. People with diabetes are more likely to be overweight and to have high blood pressure and high cholesterol. At least one out of every five overweight people has several metabolic problems at once, which can lead to serious complications, like heart disease.
  • Stop smoking. Both smoking and diabetes put you at risk of vascular disease, and together they can kill you.

Risk Factors

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