Diabetic vasculopathy Diabetic vasculopathy is one of the common diabetic complications, which is also one of the main causes of death in diabetic patients. The most common vasculopathies include lower limb vasculopathy, cardiovascular lesions, cerebrovascular lesions, microvascular lesions of the kidney, retina and skin, etc. Classification of diabetic vasculopathy (1) Diabetic complications of macroangiopathy Diabetic patients are more prone to atherosclerosis than normal people, and it develops rapidly, leading to coronary heart disease, cerebrovascular accidents and lower limb gangrene. It has been reported that 20% of patients with peripheral vascular disease in the past were found to have combined diabetes, and those with intermittent claudication, muscle and skin atrophy, and gangrene of the lower extremities were also found to be higher in diabetic patients than in normal people. Therefore, patients with confirmed peripheral vascular disease should be further examined for the presence of diabetes mellitus. The occurrence of macroangiopathy is currently considered to be related to the patient’s age, the duration of diabetes and the degree of diabetes control. (2) Diabetic microangiopathy The main sites of microangiopathy in diabetic patients are the microvasculature of the retina, kidney, skin, etc. The pathological changes are mainly capillary basement membrane thickening. Retinal microangiopathy is most often seen in diabetic patients with youth onset and is the main cause of subsequent blindness. Diabetic nephropathy is often found in conjunction with diabetic retinopathy and diabetic neuropathy. Diabetic cutaneous microangiopathy can be seen anywhere in the body, but localized cyanosis and cutaneous ischemic ulcers are more common in the lower extremities with pretibial and foot skin microvascular involvement. These ulcers are superficial and painful, and the dorsalis pedis artery is well pulsed. Dangers of diabetic vasculopathy (1) Diabetic lower extremity arterial disease Lower extremity atherosclerosis can cause intermittent claudication, resting pain, gangrene, and other diabetic foot disease. (2) Diabetic nephropathy The thickening of the microvascular basement membrane of the kidney causes diffuse and nodular glomerulosclerosis, or complete glass-like changes, leading to nephropathy, renal failure, and death from uremia. (3) Extensive sclerosis of the vessels that nourish the nerves Causes diabetic neuropathy, such as damage to the peripheral nervous system. (4) Microangiopathy of the heart Diabetic cardiomyopathy can occur and induce heart failure and even sudden death. (5) Diabetic retinopathy The manifestations of retinopathy include microangiomas, cotton wool-like white spots, hemorrhage, and hard exudate. Neovascularization, fibrosis, and retinal detachment can lead to visual impairment and subsequent blindness. (6) Others The microcirculatory changes in diabetes are not only reflected mainly in the microvascular beds of the kidney and retina, but also involve other terminal microvascular beds as well, such as the extremities, skin, subcutaneous tissue, and skeletal muscle. In the early stages of diabetes, when the disease is not well controlled, microvascular changes may appear, and disappear when the metabolic abnormalities are corrected, and these changes are reversible. If the disease is poorly controlled for a long time, it can cause irreversible lesions, especially the eyes and kidneys that cause serious harm to the body.