Macrovascular disease: pathogenesis and risk assessment

Type 2 diabetes mellitus is characterized by obesity and insulin resistance. Macrovascular (cardiovascular) disease (CVD) encompasses myocardial infarction, stroke and peripheral arterial disease. It is caused by atherosclerosis, a complex pathological process that is accelerated in people with diabetes and therefore accounts for a higher proportion of total mortality. Risk is modified by established factors including hypertension and dyslipidaemia (which are linked to underlying insulin resistance), and microalbuminuria/renal impairment.