|
|
|
| Treatment & Prevention > Macrovascular Complications |
|
Treatment and Prevention of Cardiovascular Disease
Diabetic cardiovascular disease (CVD) is the leading cause of premature death among people with diabetes since chronic hyperglycemia leads to damage to many of the body's tissues, particularly the vasculature. As a result, macrovascular complications, which include cardiovascular, cerebrovascular and peripheral vascular disease, are common complications in people with diabetes. Demographic trends in favor of developing CVD are obesity and inactivity, age, ethnic origin (ie, African Americans, Hispanic/Latino Americans, American Indians, Asian Americans and Pacific Islanders) and smoking (which doubles the risk for CVD in people with diabetes). |
Treatment and Prevention of Cerebrovascular Disease
Stroke is the third leading cause of death among Americans and is the most prevalent cause of permanent disability in the Western world. There are two types of stroke: ischemic stroke, which occurs when a blood vessel supplying blood to the brain is obstructed, and hemorrhagic stroke, which occurs when a blood vessel ruptures. Given the 7- to 10-year delay between the onset and diagnosis of diabetes, stroke and transient ischemia attacks (TIA) are often present the first time an elevated glucose is recognized triggering a long-standing diagnosis of diabetes. Although A1C is not yet used for the diagnosis of diabetes, an elevated A1C in the face of an acute stroke or TIA, accompanied by hyperglycemia, indicates that there have been glucose elevations for months prior to the hospital presentation.
|
Treatment and Prevention of Peripheral Arterial Disease
Peripheral arterial disease (PAD) affects approximately 12 million people in the United States. The prevalence of PAD among patients with diabetes is estimated to be 20% in those greater than age 40 and as high as 30% among those with diabetes who are over the age of 50. Diabetes and smoking are the strongest risk factors for PAD. Other risk factors include advanced age, hypertension, and hyperlipidemia. The most frequent symptom of PAD is intermittent claudication, or muscle pain that occurs with activity and is relieved during rest. Guidelines for the management of PAD are presented.
|
|
|
