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:

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 - 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 5-10 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)

Causes

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.

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

Treatment & Prevention

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, and 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.

Resources

American Diabetes Association

WebMD

National Institute of Diabetes and Digestive and Kidney Disease