Angiopathy is any disease of the blood vessels or lymph vessels. When caused by diabetes, it may be referred to as diabetic angiopathy or diabetic vascular disease.

A complication of type 1 diabetes, type 2 diabetes and other forms of diabetes, diabetic angiopathy is the process that strongly links diabetic individuals to an increased risk of cardiovascular diseases, including heart attack and stroke – the leading causes of death for people with diabetes. Heart disease occurs earlier, is two to four times more common, and is more often fatal in people with diabetes than nondiabetics.

Angiopathy can also affect the rest of the body. Poor circulation is related to higher risk of limb infections and amputation, vision problems and blindness, and kidney disease and kidney failure. People who keep their glucose (blood sugar), cholesterol and blood pressure levels close to normal may prevent or minimize the development of these complications.

Like most other diabetes complications, vascular disease is largely the result of high glucose (hyperglycemia). Increased glucose can exacerbate unhealthy cholesterol levels. Cholesterol is a fatty substance that can stick to blood vessel walls, narrowing the opening through which blood can flow. Unhealthy levels of cholesterol increase the risk of atherosclerosis, a disease in which the arteries are hardened and narrowed by the gradual buildup of plaque on the inner walls.

During circulation, the heart pumps blood through the body to deliver oxygen and nutrients that cells need and take away waste products that can harm cells. When blood flow through these vessels is lessened, cells do not receive the oxygen and nutrients they need. Over time, these body cells can become damaged or die.

Diabetes can upset the balance of HDL (“good”) and LDL (“bad”) cholesterol. Diabetic patients tend to have LDL particles that stick to arteries and damage arterial walls more easily. When glucose latches onto LDL, it remains in the bloodstream longer and may lead to plaque. People with diabetes also tend to have low HDL and high triglyceride levels, which increase the risk of heart and artery disease.

Scientists in 2006 reported showing for the first time that insulin is needed for the creation of blood vessels. They found that this glucose-controlling hormone is what alerts heart cells when to make more VEGF (vascular endothelial growth factor). VEGF stimulates production of blood vessels, such as when new arteries are needed because of coronary artery disease. This response appears to be impaired in people with insulin resistance. The next step in this line of research is to improve treatments for diabetic vascular conditions by enhancing the actions of VEGF and insulin in the heart.