What Is Diabetic Vascular Disease?

Vascular health — keeping your blood vessels working their best — is important for everyone. Healthy blood vessels keep your heart, brain, and other organs working properly.

If you have diabetes, your vascular health is even more important. That’s because diabetes and vascular disease (including heart disease) are connected.

Diabetes doubles your chances of having heart disease or a stroke compared to someone without diabetes. That’s according to the Centers for Disease Control and Prevention.

With diabetes, you also have a higher risk of heart disease at a younger age. And the longer you have diabetes, the greater your chances of having heart disease.

Among adults with diabetes worldwide, diabetic vascular complications are the leading cause of death. That’s according to a report in the Journal of Diabetes Research.

Diabetes can also affect your vascular health in other ways. Here’s what you need to know about diabetes and vascular disease.

How the Vascular System Works

Your body’s vascular system includes vessels that carry blood throughout your body. You may know the vascular system by a different name: the circulatory system.

Your vascular system contains pulmonary vessels and systemic vessels. Pulmonary vessels carry blood from your heart to your lungs and back to your heart. Systemic vessels carry blood from your heart to tissues throughout your body and back to your heart.

The vascular system has three types of blood vessels:

  • Arteries. These blood vessels carry oxygen-rich blood from your heart to all parts of your body. These vessels are used to measure blood pressure.
  • Veins. These carry deoxygenated blood toward your heart.
  • Capillaries. These are your body’s smallest and most abundant blood vessels. Capillaries connect your arteries to your veins. They also exchange oxygen and nutrients between your blood and tissue cells.

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What Is Diabetic Vascular Disease?

Diabetic vascular disease isn’t a specific disease. Rather, having diabetes increases your risk of vascular diseases that can affect your heart, brain, kidneys, and other vital organs. According to the Journal of Diabetes Research, having diabetes can cause both macrovascular and microvascular diseases.

Macrovascular diseases

Macrovascular diseases affect large blood vessels, such as those in your heart, brain, arms, and legs. Macrovascular disease can lead to the following:

  • Cerebrovascular disease. This happens when vascular disease damages blood vessels in your brain. These blood vessels can burst, bleed, or become clogged with fatty deposits. When this happens, it can stop blood flow to your brain and cause a stroke.
  • Cardiovascular disease (CVD). This happens when vascular disease damages the blood vessels of your heart. CVD can increase your risk of heart attack. CVD includes heart disease and atherosclerosis.
  • Peripheral vascular disease (PVD). This happens when blocked blood vessels stop blood from flowing to where it’s needed in the body. Peripheral artery disease (PAD) is a type of PVD and diabetic arterial disease. It’s when arteries in your legs, and sometimes arms, become blocked, which can cause wounds, gangrene, or need for amputation.

Microvascular diseases

Microvascular diseases affect smaller blood vessels, such as those found in your eyes, nerves, and kidneys. When diabetes causes microvascular diseases, it can lead to complications, including:

  • Diabetic retinopathy. Diabetes can damage the blood vessels in the retinas of your eyes. Diabetic retinopathy is one of the leading causes of blindness in the U.S.
  • Neuropathy. Diabetic microvascular disease can damage nerves, which can result in numbness in your hands and feet. It’s common for people with diabetes to not feel cuts, scrapes, or injuries to their feet. If this happens, the wounds may not heal properly, and, in extreme cases, may result in amputation.
  • Diabetic nephropathy. This diabetes-related kidney failure happens when diabetes vascular disease causes damage to the blood vessels of the kidneys. This may result in needing dialysis. Diabetes is the most common cause of kidney failure in the U.S.

How Does Diabetes Cause Vascular Disease?

When it comes to diabetes, high blood sugar, over time, can damage the blood vessels and nerves that control your heart. Diabetes changes the chemistry, or make up, of your blood. It increases your risk of the following health problems that can lead to heart disease, including:

  • High blood pressure, which can push on artery walls, damaging your arteries.
  • Excess LDL (“bad”) cholesterol, which can lead to the formation of plaque that clogs or hardens artery walls. The medical term is atherosclerosis.
  • High triglycerides combined with high LDL and low HDL (“good”) cholesterol can also contribute to hardening or narrowing of your arteries.

Preventing Diabetic Vascular Disease

While diabetes increases your risk of vascular disease, that doesn’t mean there’s nothing you can do. Avoiding serious damage to your blood vessels starts with preventing your diabetes from getting worse.

You can’t feel damage to your blood vessels until it’s too late. Preventing vascular damage from happening in the first place, or from getting worse, starts with keeping close watch of your diabetes. That means seeing your doctor regularly and getting tested for important diabetes numbers, including blood glucose and hemoglobin A1C.

You should also keep tabs on other important heart health numbers, including your blood pressure, cholesterol levels, and body mass index (BMI). Along with routine blood tests, your doctor may recommend other tests to check your heart health. These include:

  • ECG, or electrocardiogram, to measure the electrical activity of your heart.
  • Echocardiogram, or an ultrasound of your heart.
  • Cardiac catheterization, to examine your heart’s vessels and check for plaque deposits.
  • Angiogram, an X-ray of the blood flow throughout your veins and arteries.

Treatment for Diabetic Vascular Disease

The treatment for diabetic vascular disease depends on the type and extent of your vascular disease. Different vascular diseases have different treatments.

You may need medication to control your blood pressure and reduce your cholesterol. You may need to take medication, such as blood thinners, to improve blood flow in your blood vessels. You may also need surgery to fix hardened, clogged, or narrowed arteries.

Whether you can reverse vascular damage caused by diabetes depends on the type of vascular disease and the extent of the damage. The earlier you catch vascular disease, the better the chance that you can prevent it from getting worse and possibly reverse the damage. You will need to follow your doctor’s treatment plan, including taking any prescribed medications, to slow down or undo the damage.

Preventing and treating diabetic vascular diseases also includes making important lifestyle changes to manage your diabetes. These including eating the right foods and getting regular physical activity.

Diabetes and Heart Disease. Centers for Disease Control and Prevention. Link.

Cardiovascular Diseases. Centers for Disease Control and Prevention. Link.

Liu, R., Li, L., Shao, C., Cai, H., & Wang, Z. The Impact of Diabetes on Vascular Disease: Progress from the Perspective of Epidemics and Treatments. Journal of Diabetes Research. 2022. Link.

Stratmann B. Dicarbonyl Stress in Diabetic Vascular Disease. International Journal of Molecular Sciences. 2022. Link.

Your Vascular System. Society for Vascular Surgery. Link.

High Blood Pressure: Symptoms and Causes. Centers for Disease Control and Prevention. Link.

Classification and Structure of Blood Vessels. National Cancer Institute. Link.

About Heart and Vascular Institute

The UPMC Heart and Vascular Institute has long been a leader in cardiovascular care, with a rich history in clinical research and innovation. As one of the first heart transplant centers in the country and as the developer of one of the first heart-assist devices, UPMC has contributed to advancing the field of cardiovascular medicine. We strive to provide the most advanced, cutting-edge care for our patients, treating both common and complex conditions. We also offer services that seek to improve the health of our communities, including heart screenings, free clinics, and heart health education. Find an expert near you.