Type 2 Diabetes:Complications of Diabetes

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Why Diabetes Boosts the Risk of Heart Attack and Stroke


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Heart attacks and strokes are the number one causes of death in people with diabetes. To help prevent heart attack and stroke, you'll need to keep a sharp eye on your cholesterol and blood pressure, in addition to watching your blood glucose levels.

Blood pressure is a biggie—it's also a major factor in the risk of kidney and eye problems.

"Blood pressure control is extremely important, because high blood pressure can lead to the same kinds of complications as high blood sugar," says William Bornstein, MD, an endocrinologist at the Emory Clinic in Atlanta. "And so in people with diabetes it's that much more important to control the blood pressure. Same with high cholesterol."

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In a landmark study of more than 5,000 patients with type 2 diabetes, researchers in the United Kingdom found that lowering hemoglobin A1C levels (by controlling blood sugar) to a median of 7% reduced the "microvascular" (small blood vessel) complications that threaten the eyes, kidneys, and nerves.

But it was blood pressure control that reduced heart problems (a "macrovascular," or large blood-vessel complication) in addition to microvascular problems.

Macrovascular diabetes complications
Macrovascular diabetes complications are diseases and conditions of the large blood vessels caused by diabetes. These complications can occur in blood vessels in any part of the body.

Factors that contribute to macrovascular complications are high blood sugar, high insulin levels, high cholesterol, high blood pressure, smoking, and abnormalities in blood clotting.

Doctors do not understand what causes some people to develop diabetes complications while others do not. Some people may have tissue and unidentified factors that are resistant to damage. Lifestyle and inherited factors may also affect the risk for developing complications. For example, if you smoke, you are at higher risk for developing heart and blood vessel disease than someone who does not smoke.

Macrovascular diabetes complications include heart disease, stroke, and peripheral arterial disease.
Last Updated: August 9, 2007 See Full Credits Disclaimer


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Last Updated: April 07, 2008


Last Updated: August 9, 2007
Author:
Caroline Rea, RN, BS, MS
Medical Review:
Caroline S. Rhoads, MD - Internal Medicine

Matthew I. Kim, MD - Endocrinology & Metabolism


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