Which macrovascular complication is commonly associated with type 2 diabetes mellitus?

• A. Nephropathy
• B. Atherosclerosis leading to CAD, PVD, and stroke
• C. Retinopathy
• D. Neuropathy

Answer: (B)

Macrovascular disease refers to problems in the large blood vessels, and in type 2 diabetes the risk of accelerated atherosclerosis is high. This long-standing hyperglycemia and insulin resistance promote endothelial dysfunction, inflammation, and plaque formation, leading to coronary artery disease, peripheral arterial disease, and strokes. The combination of diabetes with lipid abnormalities (high triglycerides, low HDL), hypertension, and a pro-thrombotic state further drives this process, making atherosclerosis the most common macrovascular complication in type 2 diabetes.

In contrast, nephropathy, retinopathy, and neuropathy involve small vessels and are microvascular complications, which is why they’re not the macrovascular focus here.