• The risk of stroke is 2 to 4 times higher in people with diabetes.
• An estimated 60% to 65% of people with diabetes have high blood pressure.

Being in good cardiovascular health means having a healthy heart and healthy blood vessels. Heart disease is the leading cause of death among adults in the United States. People with diabetes have extra reason to be mindful of heart and blood vessel disease. Diabetes carries an increased risk for heart attack, stroke, and complications related to poor circulation.

Some people with diabetes may be at greater risk for changes in large blood vessels. This is called vascular disease and starts when the linings of the blood vessels get thicker (narrowed vessel). As a result, heart disease or stroke can result. Damage to small blood vessels can occur in the eyes and kidneys of people with diabetes. There may be no outward symptoms but damage to blood vessels can lead to blindness and kidney disease.

Foot ulceration and lower limb amputation are still common complications of diabetes. Diabetic peripheral neuropathy and peripheral vascular disease are the most important etiologic factors, but there is a complex interplay between these abnormalities and a number of other contributory factors, such as altered foot pressures, limited joint mobility, glycemic control, ethnic background, and cardiovascular parameters. Identification of patients at high risk of ulceration is nevertheless simple, and education of such patients can achieve a major reduction in amputation and ulceration rates.