Chapter 1 Diabetes

Complications

The complications of diabetes are strongly related to high blood sugar levels and are mostly correlated with the duration of diabetes. Long-term complications may occur in both type 1 and type 2 diabetes. Complications of diabetes may include microvascular changes, resulting in retinopathy, nephropathy and neuropathy. After 20 years of diabetes, nearly all patients with type 1 diabetes and over 60% of patients with type 2 diabetes have some degree of retinopathy¹².

The long-term complications of diabetes affect many parts of the body, decrease quality of life for the individual with diabetes and increase the use of health services. Table 1-1 gives a description of the most common complications and their related outcomes.

Individuals with diabetes may face shortened life expectancy due to complications from the disease. Life expectancy is influenced by the age at the onset of diabetes. Good control of blood sugar, blood pressure and blood lipids through the adoption of a healthy diet, weight management, regular physical activity, and/or medication can decrease the risk of diabetes complications and increase life expectancy.

Table 1-1 Diabetes Complications

Complication Type	Description	Possible Outcomes
Microvascular (or peripheral vascular disease) small blood vessel damage	Small blood vessel damage that contributes to a decrease in blood circulation	Retinopathy (eye disease) Nephropathy (kidney disease that leads to renal failure requiring dialysis) Periodontal disease
Macrovascular large blood vessel damage	Large blood vessel damage that contributes to a decrease in blood circulation	Cardiovascular disease Cerebrovascular disease Stroke Ischemic heart disease Lower limb amputation
Neuropathy nervous system disease	Diabetic neuropathy is a group of nerve diseases. All these disorders affect the peripheral nerves. There are three types of peripheral nerves: motor, sensory, and autonomic.	Foot infections and ulceration Decreased sensation Increased sensitivity Muscle wasting Sexual dysfunction
Retinopathy eye disease	Diabetic retinopathy is a general term for all disorders of the retina caused by diabetes. There are two major types of retinopathy: nonproliferative and proliferative.	Glaucoma Cataracts and blindness

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