Lifestyle changes may be one of the first steps in the treatment of atherosclerosis. This treatment also may decrease the severity of or prevent atherosclerosis in the future. Lifestyle changes are particularly important to individuals with diabetes as these individuals are at higher risk for the disease. As with diabetes, many of the risk factors for atherosclerosis can be controlled. Lifestyle changes that can be used to treat and possibly prevent atherosclerosis include:

• Glucose control. Research has shown that strict glycemic management in people with type 1 diabetes reduces the development of atherosclerosis. The research suggests that glucose control should begin as early as possible because the greatest amount of damage occurs in the first few years of the disease. Individuals with diabetes should follow their diabetes management plan as designed by their healthcare professionals.
  
  
• Healthy diet. A diet low in saturated fats and trans fats and high in fiber can help control weight, blood pressure and cholesterol. Excess blood fats (lipids) and cholesterol contribute to atherosclerosis and other medical complications. An unhealthy diet can lead to obesity, which is closely linked to diabetes and atherosclerosis.
  
  
• Exercise. Regular physical exercise can improve circulation and condition muscles to use oxygen more efficiently. Physical activity can also develop new blood vessels that form a natural bypass around obstructions, allowing more blood to reach the arms and legs. Research on obese individuals indicated that people who lost just 7 percent of their body weight and did moderate physical exercise improved their blood vessel function by 80 percent. Thirty minutes or more of exercise each day can reduce the risk of atherosclerosis as well as other complications associated with diabetes.
  
  
• Weight control. If an individual is overweight or obese, the chances of developing atherosclerosis and cardiovascular problems increase significantly. Maintaining a healthy weight and body mass index (BMI) is important for control of diabetes and atherosclerosis.
  
  
• Not smoking. Nicotine has been shown to narrow the arteries and restrict the blood vessels. In addition, tobacco use has been linked to high cholesterol and damage to the artery walls. One of the best ways to improve cardiovascular health as well as glucose control in diabetes is to quit smoking.
  
  
• Stress management. Stress can contribute to atherosclerotic risk factors such as overeating and high blood pressure.

Although lifestyle changes can improve the health of the arteries, certain types of medications can help slow or reverse the effects of atherosclerosis. Types of medications that physicians may prescribe include:

• Antiplatelets. These drugs, such as aspirin, reduce the likelihood that blood factors called platelets will clump together on the walls of an artery. In the case of atherosclerosis, antiplatelets prevent the formation of blood clots that can cause further blockage.
  
  
• Cholesterol drugs. These medications can improve a patient's cholesterol profile, which may help slow, stop or reverse the buildup of plaque on the artery walls.
  
  
• Anticoagulants. In certain instances, a physician may prescribe these drugs to help prevent clots from forming in the arteries and blocking the blood flow to the tissues.
  
  
• Antihypertensives. Blood pressure drugs such as ACE inhibitors, angiotensin-II receptor blockers (ARBs) and calcium channel blockers prevent the muscles in the walls of the arteries from tightening, which narrow the arteries.
  
  
• Other medications. In some cases, the physician may prescribe medications for other complications, such as nitrates to relieve angina or folic acid for high levels of homocysteine. If glucose control is a problem in diabetes patients, medications may be changed to improve the condition. Recent studies suggest that antidiabetic agents such as thiazolidinediones (TZDs) might help fight atherosclerosis, though TZDs have also been found to have some other cardiac risks.

It is important for the physician to consider any interactions between these drugs and insulin or other medications. Individuals with diabetes should inform the physician of the exact type and strength of insulin they are taking, as well as their schedule.

If a physician notes severe symptoms, a serious blockage may be present. This blockage can cause damage to tissue or organs and may require surgical intervention. Surgeries that may be used to correct the condition include:

• Angioplasty. A thin balloon-tipped catheter is inserted into the blocked or narrowed part of the artery. The balloon is inflated, pressing the plaques against the artery walls. This procedure opens the artery to allow increased blood flow. A mesh tube (stent) may be left in the artery to help keep it open.
  
  
• Embolectomy. A catheter is inserted into the artery to remove a blood clot.
  
  
• Endarterectomy. In this procedure, a surgeon makes an incision in the artery, removes the plaques and closes the artery.
  
  
• Vascular surgery. A bypass operation takes a graft from another part of the body or from a synthetic tube and places it in a blocked or narrowed artery. This graft allows the blood to flow around the blocked or narrowed artery and is often used in the legs. It also can be used to repair a large or leaking aneurysm in the aorta.
  
  
• Thrombolytic therapy. A physician may insert a clot-dissolving drug (“clot buster”) into a blood clot to break up the blockage.

If the atherosclerosis is present in the arteries of the heart, coronary artery bypass surgery may be recommended by the physician. If the disease affects the carotid arteries of the neck, the physician may recommend surgical procedures such as carotid endarterectomy to remove the plaque buildup. The carotid arteries supply the brain, and it is crucial to keep them as free from plaques as possible to avoid a stroke.

Because individuals with diabetes have an increased risk of atherosclerosis, it is important that they be closely monitored for any symptoms. If the disease is detected early, treatment may slow or possibly reverse its effects. If atherosclerosis goes undetected, however, the result can be an emergency such as a heart attack or stroke.