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Recent studies on macrovascular disease in SSc suggest that ischemic demarcation and loss of digits occur secondary to narrowing or occlusion of larger digital arteries (vessels of the palmar arch, radial, or ulnar artery) or medium-sized and large arteries in the lower extremities.
In the long-term development of DM, the chronic complications in patients are very complicated, including the macrovascular diseases, microvascular diseases, the complications of the nervous system and the diabetes feet.
The evidence that improved glycemic control reduces the risk of microvascular complications is clear (UK Prospective Diabetes Study Group 1998), but the evidence for a causal relationship between blood glucose and macrovascular disease are however weaker even though a low glycemic control is a risk factor for macrovascular disease.
Macrovascular complications: This is the leading cause of death in diabetes: 65-75 per cent of people with diabetes will die from macrovascular disease (compared with about 35 per cent of the general population).
Significant differences were seen in diabetes duration, retinopathy, neuropathy, macrovascular disease and infection between the patient groups.
In this study, we aimed to evaluate the CIMT in patients with type 1 DM without manifest macrovascular disease and to investigate its relation with diabetic microvascular complications (diabetic nephropathy and retinopathy).
Interestingly, the same was not observed in macrovascular disease prevalence.
The final chapters address insulin resistance and complications such as macrovascular disease. Major studies are summarized in most chapters, and patient education and prevention strategies are also included.
The HNF1[alpha] mutation causes progressive deterioration in [beta]-cell function, with associated micro- and macrovascular disease. Many of these patients may be assumed to have poorly controlled type 2 diabetes and may have used insulin therapy for decades.
Even more important is macrovascular disease (including coronary artery disease, stroke, and peripheral vascular disease).
Last May Mr Fitzpatrick had a leg amputated after he developed severe macrovascular disease.