Article Sections

Introduction

This article reviews the major complications associated with diabetes mellitus (DM).

  • Macrovascular complications affect larger blood vessels and include atherosclerotic diseases, including coronary artery disease, cerebrovascular disease, and peripheral artery disease.  These complications are driven by accelerated atherosclerosis, plaque formation, and vascular occlusion, as well as effects of comorbid risk factors such as hypertension, dyslipidemia, and obesity.
  • Microvascular complications involve damage to small blood vessels (ie, microangiopathic damage), including diabetic retinopathy, nephropathy, and neuropathy.  These complications are driven by chronic hyperglycemia-induced endothelial dysfunction.

This article will discuss:

  • Common pathophysiologic pathways underlying both macrovascular and microvascular complications
  • Common risk factors, centered on the duration and severity of hyperglycemia (and, in type 2 DM [T2DM], insulin resistance) along with compounding lifestyle factors (eg, smoking, diet, exercise)

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