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Macrovascular complications: Involve damage to the large vessels providing circulation to the brain, heart and extremities. The 3 major types of macrovascular disease are cardiovascular disease (CVD), cerebral vascular accident (stroke) and peripheral vascular disease (PVD). Atherosclerosis, which is common in diabetes, is a soft hardening in which mounds of lipid material mixed with smooth muscle cells and calcium accumulate in the inner walls of blood vessels. These plaques become enlarged over time. Eventually the plaque may block blood flow, weaken and rupture its contents into the blood stream and/or cause the formation of a blood clot.
1.Risk factors include: lipid abnormalities, hypertension, smoking, obesity, physical inactivity, nutrition, hyperinsulinemia, insulin resistance.
2.Cardio vascular diseases are the most frequent, serious, lethal and costly of complications.
3. Persons with diabetes appear to be prone to cerebral vascular disease developing at an earlier age than non-diabetics. People with diabetes seem to be at risk for both TIAs and thrombotic CVAs.
4. Peripheral Vascular Disease is common, especially with long standing diabetes. Clinically characterized by intermittent claudication, lower-leg and vascular ulcers, often needing amputations.
Reference: Pathophysiology, 3rd edition: Copstead and Banasik
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