Diabetes and Your Cardiovascular System

Those with diabetes are at high risk for heart and vascular disease. The heart is a muscle that pumps blood throughout the body to supply it with nutrients and oxygen and to take away by-products of metabolism, such as carbon dioxide. Compared to other muscles in the body, the heart consumes a high amount of nutrients and oxygen. It pumps blood to itself through specialized vessels called coronary arteries. These arteries are critical to the integrity of the functioning of the heart. We know that diabetes can cause harm to these vessels, called coronary artery disease. This disease can be in the form of thickening of the vessels that can cause decreased blood flow through the vessel or the formation of fatty material, commonly referred to as a plaque, that blocks the flow of blood through the vessel. Both of these conditions can lead to a decreased or arrested blood flow to the heart, which will cause severe impairment to this pumping muscle. This is referred to as a myocardial infarction, or heart attack.

Similar problems can occur in larger vessels in the body, such as those leading to your arms and legs. Problems such as these are classified as peripheral vascular disease. With this condition, the blood vessels leading to the arms and legs can be impaired by thickening of the walls of the vessels or development of fatty plaque on the inside of the vessels. Peripheral vascular disease can lead to decreased blood flow to the limbs, causing pain and changes in the tissues. This tissue damage can lead to infections. Pain is a common complaint when the blood flow is decreased to most tissues in the body. Sometimes this will occur during activities when the muscles require increased oxygen. For instance, you may have vascular disease, causing a decreased blood flow to your extremities. When you are at rest you may not have pain because the flow is good enough for muscles to function. But when you start walking, activating your muscles, the oxygen demand is greater than the flow of blood allows, causing pain in the leg muscles. If you develop any problems like this, your doctor will order a test to assess the blood flow in your vessels in the affected limb. This is typically done with a machine that uses ultrasonic waves to measure flow in a blood vessel. Other tests can measure the amount of oxygen in the blood that is flowing, which can provide information helpful to determining the health of the limb.

The results can be devastating when the vessels that are diseased are in the brain. The brain requires oxygen at all times. Even a short period of oxygen deprivation can cause significant damage, which is often irreversible. This condition is commonly referred to as a stroke, or a cerebrovascular accident. The carotid arteries in the neck that supply your brain with oxygenated blood can become diseased (called carotid artery disease) thus decreasing blood flow, which can result in a stroke. If your physician suspects you may be at risk for a stroke, he may order an ultrasound test similar to that used to assess blood flow in the arms or legs.

It is well known that all people with diabetes have an increased risk of infections. This risk is further increased with the presence of vascular disease. The body's immune system consists of specialized cells that identify and destroy invading organisms. But when the blood flow that carries these cells to their destination is decreased, the ability of the cells to function normally is also decreased, leading to increased rates of infection.