Atherosclerosis, the Major Complication of Diabetes

  • George Steiner
Part of the Advances in Experimental Medicine and Biology book series (AEMB, volume 189)


Atherosclerosis accompanies diabetes so commonly that it is almost not considered when discussing the complications of diabetes mellitus. While approximately one-third of the general North American population will die of atherosclerosis, this or a related disorder will underlie the death of three-quarters of the diabetics in North America.1 This picture is very different from that which was seen before the discovery of insulin, when only about one-fifth of diabetic deaths were due to vascular disease.2 This change has often been attributed to the discovery of insulin and the consequent increase in the survival of diabetics. The problem with such a facile explanation is that approximately 80% of diabetics are type 2 (NIDDM) diabetics, most of whom would not have died of ketoacidosis even before the discovery of insulin and most of whom do not depend on insulin for their survival. Hence, if the change in mortality pattern were to be explained by prolonged survival due to the discovery of insulin, one would expect that almost all of the cardiovascular disease in diabetics should be found in type 1 (IDDM) and/or in insulin-treated type 2 diabetics. This is probably not the case. Therefore one must look to other explanations, such as changing diagnostic criteria, changing general disease patterns, changing treatment methods in general, etc.


Coronary Heart Disease Peripheral Vascular Disease Lipoprotein Lipase Macrovascular Disease Arterial Smooth Muscle Cell 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.


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© Springer Science+Business Media New York 1985

Authors and Affiliations

  • George Steiner
    • 1
    • 2
  1. 1.Departments of Medicine and PhysiologyUniversity of TorontoCanada
  2. 2.Division of Endocrinology and MetabolismToronto General HospitalCanada

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