Can diabetes lead to vascular disease? How to prevent vascular complications in diabetes

People with diabetes are at higher risk of developing atherosclerosis, the most common cause of peripheral artery disease, which is a kind of vascular disease. (Photo: X)

The World Health Organisation states that a person is diagnosed with diabetes when the fasting blood sugar levels are more than 125 mg/dL on two separate tests or HbA1c of 6.5 per cent or more or random blood sugar levels of 200 mg/dL. The condition revolves around the hormone insulin that regulates glucose metabolism. When the body either doesn’t make enough insulin, (type 1 diabetes) or can’t utilise it properly (type 2 diabetes), too much glucose or sugar flows in the bloodstream.

Over time, this is essentially what happens to your blood vessels when you have diabetes:

1.    Production of harmful sticky molecules: Excess glucose molecules combine with proteins and fats in the blood to make harmful molecules called Advanced Glycation End products (AGEs). These AGEs stick to the inner lining of your blood vessels, making them relatively stiffer, less flexible, and more prone to damage.

2.    Swelling/inflammation: Chronically high blood sugar levels trigger inflammation throughout the body. This inflammation weakens the blood vessels and contributes to the buildup of plaque, a fatty substance that sticks to the walls of the arteries.

3.    Narrowing of blood vessels: Also known as “Blood Flow Bottleneck”, the plaque deposits on the inner lining of the blood vessel cause their narrowing over time. Consequentially, blood flow gets restricted. This can lead to high blood pressure, a major risk factor for heart disease and stroke.

4.    Antioxidant Imbalance: Also known as Oxidative Stress Overload, in this condition, the balance of free radicals and antioxidants gets disrupted because of diabetes. This state of oxidative stress damages the cells and tissues in the body, including the cells that line the blood vessel walls.

5.    Cumulative effect: The combined effect of everything mentioned above leads to the development of atherosclerosis, a condition where the blood vessels progressively weaken and harden. This cumulative effect can lead to the following serious complications:

a.    Heart diseases like chest pain, heart attack, or heart failure.

b.    Stroke, in which a clot forms and gets stuck in a narrowed artery in the brain.

c.    Peripheral arterial disease in which narrow arteries in the legs can cause pain, cramps, and tissue death.

d.    Diabetic retinopathy in which blood vessels of the eye are damaged leads to vision loss and consequential blindness.

e.    Aneurysms where weak blood vessels rupture and may sometimes cause life-threatening bleeding.

It is worrisome to know about the consequences of diabetes, but the bright side is that all of this can be prevented by getting your blood sugar levels in control. Here’s how a lifestyle change can prevent diabetes from damaging your body any further:

1.    Controlling and maintaining blood sugar levels: The cornerstone of preventing diabetic complications is reducing blood glucose levels. Work with your doctor to develop a treatment plan that includes lifestyle changes and medication, if needed.

2.    Managing blood pressure and cholesterol: High blood pressure and cholesterol levels significantly increase your risk of vascular disease. Regularly monitor your blood pressure and cholesterol levels and follow your doctor's recommendations for managing them.

3.    Eating a balanced diet: Focus on fruits, vegetables, whole grains, and lean protein. Limit processed foods, sugary drinks, and unhealthy fats. These dietary changes not only help manage blood sugar, they also control high blood pressure and cholesterol levels.

4.    Maintaining a healthy weight: Losing even a small amount of weight can significantly improve your blood sugar control.

5.    Getting regular exercise: Aim for exercising 3-5 days a week. If you cannot perform intense exercise, start with brisk walking and gradually increase your time over months. This will not only keep your sugar levels in control but also keep your heart healthy.

6.    Managing stress: Chronic stress can cause more damage to your body than you know, including raising blood sugar levels. Find a way to decompress and relax. The most commonly adopted methods include yoga, meditation, or spending time in nature. If you need to, seeking professional help from a therapist can work wonders.

7.    Stopping smoking: Smoking is a proven risk factor for vascular disease. If you have diabetes, the risk gets even higher because smoking has an additive effect and speeds up the development of cardiovascular complications.

8.    Seeing your doctor regularly: Go for regular checkups and screenings every six months or as per your doctor’s recommendation. Early detection and treatment can help prevent serious complications.

Getting diagnosed with diabetes can be overwhelming. However, following these steps can significantly control your blood sugar levels, reduce your risk of vascular complications, and live a longer, healthier life. Remember, diabetes is a chronic condition, but it doesn't have to control your life.