The incidence of diabetic atherosclerosis is three to five fold compared to non-diabetics. Atherosclerosis is a disease characterized by the formation of complex plaques, which ultimately reduces the lumen diameter of the artery wall, and leads to cardiovascular disease.

The earliest form of a lesion within the artery wall is a fatty streak caused by the aggregation of lipid-laden (LDL) foam cells, derived from macrophages, smooth muscle cells, T-lymphocytes, fibroblasts and endothelial cells.

The clinical manifestations of atherosclerosis include:

	Coronary Heart Disease (CHD) - Caused by restriction of blood flow to the coronary arteries and can present as angina, congestive heart failure or myocardial infarction.
	Cerebrovascular Disease - Caused by narrowing of the carotid, vertebral and cerebral arteries leading to stroke.
	Peripheral Artery Disease (PAD) - The lumen of the femoral and iliac arteries supplying to the legs become stenosed causing cramping, leg and foot ulcers, which in some cases may lead to amputation.

IDD has defined a target for the treatment of atherosclerosis for people with diabetes.