Unless corrective measures are taken at this stage, the disease stage increases in severity. The increasing size of the plaque as well as some of the complications which can occur in a smaller plaque results in further narrowing of the artery and a reduction of blood flow. Eventually it might result in the complete blockage, leading to the death of the cells or part of an organ supplied by that artery.

Some of these more severe stages are shown below, finally resulting in a complete block.

Thrombosis.

The formation, development or presence of a thrombus.

Diabetes and Atherosclerosis.

If you have diabetes, you have a major risk factor for getting atherosclerosis. Not only do the arteries get affected earlier, but the rate at which the disease progresses is much faster in people who have diabetes.

Coronary and cerebral artery disease is 2-4 times as common in a person with diabetes and whilst vascular blocks in the legs (peripheral vascular disease) is 4-6 times more common.

The prevalence of atherosclerosis is increased manifold in people with diabetes, occurs earlier in life, progresses faster to the more sever forms and is associated with an increased chance of death from these complications.

Not only is diabetes itself a major factor in causing damage to the endothelium, people with diabetes have other risk factors which themselves can damage the inner linings of the arteries. In the presence of high blood glucose levels, the potential of these other risk factors to cause atherosclerosis is increased manifold.

Can one protect against atherosclerosis?

Everyone gets atherosclerosis. It is said that if we all lived to be 100 years old, we would eventually die of atherosclerosis. So one cannot prevent atherosclerosis. But what one can do is to see that the additional burden placed by the presence of diabetes is decreased significantly.

As we have seen above, a person with diabetes is definitely more prone to atherosclerosis. Not only that, but the damage to the arteries occurs earlier, progresses faster and is seen in a much more severe form.

It is in this area that one can, and must, do all that is possible.

If you see the risk factors for people with diabetes to get macrovascular disease, it is obvious that there are some risk factors over which we have no control. It is still not possible to change your genes and neither is it possible to stop the passage of time. One gets older everyday!

But modifying many of the other risk factors is in your hands!

It is obvious that a good control of the blood glucose level, normalizing the blood pressure and the levels of "fats" found in the blood can go a long way to decrease the severity of atherosclerosis. Your doctor can keep telling you to exercise and lose weight especially if you have a large waist line, but your doctor cannot "exercise" for you!

Many of these aspects are covered in more detail in other sections of the booklet. But there is one area which is of utmost importance. Smoking and tobacco in any form MUST be avoided.

You can see for yourself why tobacco is so harmful to your arteries. Compared to a non smoker, many changes take place in the blood of the smoker which are not only injurious to the intima ( where atherosclerosis starts) but increases the rate at which the damage proceeds.

Moroever, you can see clearly that a smoker has arteries which are narrowed. This not only increases the blood pressure, but also compromises the blood flow in the artery which in any case may be decreased due to atheromatous plaques!

As a joke goes," Smoke….make a Cardiologist happy!"

So there are many ways by which you can prevent the damage caused by diabetes to your arteries.

Your doctor will advise you about all this, but finally, it is up to you!

Is there a treatment for atherosclerosis?

Inspite of the tremendous strides have taken place in treating atherosclerosis, especially in the surgical procedures such as angioplasty and bypass surgeries, and the routine use of aspirin as a blood thinner, diet and lifestyle modification still remain the mainstay of treatment.