Ask the doctor: Why does diabetes raise heart disease risk?

The reasons why aren't completely clear, but high blood sugar (the hallmark of diabetes) seems to harm blood vessels in several different ways. It damages the tissue that lines the inner walls of the arteries, a process that encourages the buildup of cholesterol-laden plaque. And that plaque seems to be more prone to rupture, potentially triggering a blockage that leads to a heart attack. Excess sugar also coats circulating cells in the blood, making them sticky and more likely to form clots. Finally, high sugar levels lower levels of nitric oxide, a powerful blood vessel–widening chemical made naturally by the body. If your blood vessels stay constricted rather than relaxed, you're more likely to have blood flow problems.
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