The Vicious Cycle

International Diabetes Federation

What Causes CVDin Diabetes?

• Atherosclerosis• Hypertension

AND• Microangiopathy• Neuropathy• Damage to blood vessel walls

More severe consequences

International Diabetes Federation

Coronary Heart Disease:Heart Attack

• People with diabetes have the same risk of heart attack as people without diabetes who have already suffered a heart attack

International Diabetes Federation

Coronary Heart Disease:Heart Attack

• More difficulty with emergency treatments

• ‘Silent’ heart attackPeople with diabetes can have a heart attack without even knowing it

International Diabetes Federation

Coronary Heart Disease• Angina

‘Silent’ ischaemia

• Sudden death50-300% more frequent

• Heart failureTwo to three-fold greater risk

• Fainting attack

International Diabetes Federation

Cerebrovascular Disease

• StrokeTwice as common in people with diabetes and hypertension as in those with hypertension alone

• Mini-stroke (transient ischaemic attack)Two-six times more frequent

• Dementia

International Diabetes Federation

Peripheral Vascular Disease

• Gangrene70-fold increased risk over the age of 70

• Calf pain (intermittent claudication)Three to nine times more frequent

• Foot ulcers

International Diabetes Federation

A Worse Prognosis

• The prognosis of a CVD event is worse for people with diabetes

CVD is the leading cause of death in people with diabetes in developed countries