Vascular Health
Last updated: 13 Aug 2025
The Impact of Long T1D on Vascular Health
In people living with T1D, the risk of a Transient Ischaemic Attack or Stroke is 1.5 to 2 times higher compared to individuals without diabetes. This risk is not static; it grows with the duration of the disease. Diabetes acts as a powerful “accelerant” for the atherosclerotic process through multiple interconnected pathways:
- Hyperglycemia (High Blood Sugar): Chronically elevated blood glucose levels are directly toxic to the inner lining of blood vessels. This damage makes the artery walls “stickier” and more permeable, creating an environment where cholesterol and inflammatory cells can easily invade and initiate plaque formation.
- Chronic Inflammation and Oxidative Stress: Diabetes fosters a state of persistent, low-grade inflammation throughout the body. It also leads to an overproduction of harmful reactive molecules, a condition known as oxidative stress. This inflammatory and oxidative environment not only promotes the growth of atherosclerotic plaques but also makes them more unstable and likely to rupture.
- Associated Risk Factors: Type 1 Diabetes is often accompanied by other conditions that are themselves major risk factors for atherosclerosis, including high blood pressure (hypertension) and abnormal blood lipid levels (dyslipidemia), such as high LDL cholesterol.
The Aging Factor: How Blood Vessels Change Over Time
Independently of any disease, aging is the single most potent non-modifiable risk factor for TIA and stroke. The risk increases markedly after the age of 55, doubling with each subsequent decade. This is due to natural, age-related changes in the vascular system:
- Arteries naturally become less flexible and stiffer.
- The lining of blood vessels deteriorates, making it less able to protect artery walls.
- The body’s systems for regulating blood pressure and flow becomes less efficient.
A Convergence of Risks: How Age and T1D Compound the Threat
For an older adult with long-standing Type 1 Diabetes, these risks reinforce one another. Pre-existing, diabetes-related damage is superimposed on the natural, age-related decline in vascular health. The result is a vascular system that is exceptionally vulnerable.