What is the Difference Between Microvascular and Macrovascular

Diabetes is a group of chronic diseases characterized by hyperglycemia. However, it involves many other complications in addition to hyperglycemia. Some other common diabetic mellitis complications include eye problems, heart disease, chronic kidney disease, nerve damage and other problems such as feet, oral, vision, hearing and mental health. Microvascular and macrovascular are also two different types of diabetic complications.

The key difference between microvascular and macrovascular is their effect on blood vessels. Microvascular is a type of diabetic complication that affects small blood vessels, while macrovascular is a type of diabetic complication that affects larger blood vessels.

CONTENTS

1. Overview and Key Difference
2. What is Microvascular  
3. What is Macrovascular
4. Similarities – Microvascular and Macrovascular
5. Microvascular vs Macrovascular in Tabular Form
6. Summary – Microvascular vs Macrovascular
7. FAQ – Microvascular and Macrovascular

What is Microvascular?

Microvascular complications of diabetes are long-term issues that affect small blood vessels. These typically include retinopathy, nephropathy, and neuropathy. Microvascular complications are very common in patients with type 2 diabetes. Microvascular complications are associated with pain, numbness, and dysfunction of the motor and autonomic nervous system, which lead to serious problems in the quality of life.

Figure 01: Proliferative Diabetic Retinopathy

Retinopathy is usually divided into two main types as nonproliferative and proliferative retinopathy. Diabetic nephropathy is defined as persistent proteinuria, which progresses to a decline of renal function. On the other hand, neuropathy involves nerve damage and can manifest as focal, diffuse, sensory, motor, or autonomic neuropathy. Furthermore, preventing and reducing the progression of microvascular complications of diabetes mellitus requires intensive management of glucose levels, blood pressure, and lipids.

What is Macrovascular?

Macrovascular complications of diabetes are long-term issues that affect larger blood vessels involving large vessels, such as arteries and veins. These complications include ischaemic heart disease (IHD), cerebrovascular accident (CVA), and peripheral vascular disease (PVD).

Figure 02: Coronary Artery Disease

Generally, in the early stages, these complications involve atherosclerotic plaques in the vasculature, which partially obstruct the blood supply to the heart, brain, limbs, and other organs. In later stages, these complications cause complete obstruction of these vessels, leading to cardiovascular disease. Furthermore, macrovascular complications can be treated through proper nutritional intake, control of blood glucose, lifestyle and activity, blood pressure and lipids, and specific surgeries.

Similarities Between Microvascular and Macrovascular

1. Microvascular and macrovascular are two different types of complications involved in diabetes mellitus.
2. Microvascular and macrovascular complications are present in both type 1 and type 2 diabetes patients.
3. Both are due to obstruction of blood vessels.
4. They can be managed by controlling blood sugar, pressure, and lipids.

Difference Between Microvascular and Macrovascular

Definition

1. Microvascular is a type of diabetic complication that affects small blood vessels.
2. Macrovascular is a type of diabetic complication that affects larger blood vessels.

Types of Blood Vessels Affected

1. Microvascular complications affect capillaries.
2. Macrovascular complications affect large vessels such as arteries and veins.

Examples

• Microvascular complications include retinopathy, nephropathy, and neuropathy.
• Macrovascular complications include ischemic heart disease (IHD), cerebrovascular accidents (CVAs), and peripheral vascular disease (PVD).

Treatment

• Managing glucose, blood pressure, and lipids intensively can help treat microvascular complications.
• Proper nutrition, blood glucose control, lifestyle changes, activity levels, blood pressure management, lipid control, and specific surgeries can help treat macrovascular complications.

The following table summarizes the difference between microvascular and macrovascular.

Summary – Microvascular vs Macrovascular

Microvascular and macrovascular are two different types of complications involved in diabetes mellitus. Microvascular diabetic complications affect small blood vessels, such as capillaries, while macrovascular diabetic complications affect larger blood vessels, such as arteries and veins. This summarizes the difference between microvascular and macrovascular.

FAQ: Microvascular and Macrovascular

1. What are the 4 stages of diabetes?

• Diabetes mellitus occurs in four stages: insulin resistance, prediabetes, diabetes, and diabetes with vascular complications. People are at higher risk for these conditions if they are older than 45, have close biological relatives with diabetes, are physically inactive, and have extra weight.

2. What is an example of a microvascular disease?

• The microvascular complications of diabetes include retinopathy, nephropathy and neuropathy unique to diabetes. Most patients with diabetes will have one or more of these microvascular complications.

3. Can people be cured of microvascular disease or microvascular complications of diabetes?

• It may be possible to reverse some of the brain changes in the early stage of microvascular complications. Prevention and reduction in the progression of microvascular complications of diabetes mellitus requires intensive management of glucose, blood pressure and lipids.

4. What are macrovascular diseases or macrovascular complications of diabetes?

• Macrovascular disease is a disease of any large blood vessels in the body. It is a disease of the large blood vessels which include coronary arteries, aorta, and the sizable arteries in the brain and in the limbs.

5. What are the microvascular and macrovascular complications of diabetes mellitus?

• Microvascular complications are such as retinopathy, neuropathy and nephropathy while macrovascular complications include cardiovascular, cerebrovascular, and peripheral vascular disease.

Reference:

1. Vithian, Karunakaran, and Steven Hurel. “Microvascular Complications: Pathophysiology and Management.” Clinical Medicine (London, England), U.S. National Library of Medicine.
2. Viigimaa M;Sachinidis A;Toumpourleka M;Koutsampasopoulos K;Alliksoo S;Titma T; “Macrovascular Complications of Type 2 Diabetes Mellitus.” Current Vascular Pharmacology, U.S. National Library of Medicine.

Image Courtesy:

1. “Blausen 0257 CoronaryArtery Plaque” By Blausen.com staff (2014). “Medical gallery of Blausen Medical 2014”. WikiJournal of Medicine 1 (2). DOI:10.15347/wjm/2014.010. ISSN 2002-4436. – Own work (CC BY 3.0) via Commons Wikimedia
2. “Proliferative diabetic retinopathy” By Community Eye Health (CC BY-NC 2.0 DEED) via Flickr

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