Diabetes increases macrovascular risk primarily through accelerated atherosclerosis leading to which conditions?

• A. Deep vein thrombosis is the primary macrovascular complication.
• B. Peripheral edema is the primary macrovascular complication.
• C. Pulmonary embolism is the primary macrovascular complication.
• D. Coronary artery disease, stroke, and peripheral arterial disease.

Answer: (D)

Diabetes speeds up atherosclerosis in the large arteries, so the major macrovascular problems arise from narrowed or blocked arteries supplying the heart, brain, and limbs. This leads to coronary artery disease, ischemic stroke, and peripheral arterial disease. When plaque builds up in the coronary arteries, blood flow to the heart is reduced, causing angina or heart attack. In the brain, plaque in carotid or intracranial vessels can cause an ischemic stroke. In the limbs, narrowed leg arteries produce claudication and, if severe, critical limb ischemia.

Other options don’t fit as the primary macrovascular outcomes because deep vein thrombosis and pulmonary embolism involve veins, not the arterial system affected by atherosclerosis. Peripheral edema is a symptom rather than a macrovascular disease outcome. The key idea is that atherosclerotic disease of the large arteries is driving the major macrovascular risks in diabetes.