Diabetes is associated with serious tissue complications resulting from disease of larger (macrovascular) and smaller (microvascular) blood vessels.
Microvascular complications occur due to disease of smaller blood vessels, principally affecting the eye (retinopathy), the kidney (nephropathy) and nerves (neuropathy). These strongly relate to the duration of diabetes and the severity of hyperglycaemia.
In the developed world, diabetic retinopathy is the most common cause of blindness in those aged <65 years. Diabetic nephropathy is a common cause of renal failure. Peripheral and autonomic neuropathy can both contribute to the development of foot ulceration and increase the risk of amputation. It can also
lead to impotence, diarrhoea and vomiting, postural hypotension and collapse.
Macrovascular complications relate to disease of cardiac, disease of cerebral and peripheral arteries and is significantly more common in those with diabetes. An increased rate of atherosclerotic disease leads to an excess of ischaemic heart disease, strokes and lower limb amputation.
The increased morbidity associated with diabetes accounts for more than 5% of total health care costs in Europe. The bulk of this cost relates to the long- term complications rather than the management of the condition itself. It is likely that 90% of the cost relates to disease in patients with Type 2 diabetes.
Life expectancy for a diabetes sufferer is reduced by about 25%. In developed countries, the age- specific mortality rates for those with Type 2 diabetes are approximately twice those of non-diabetic individuals. Most die from cardiovascular disease although nephropathy contributes largely to death rates in Type 1 diabetes.
Type 2 diabetes is increasingly affecting children. In Japan, 80% of childhood diabetes is now due to Type 2 diabetes. In the US this figure is approaching 40%.
E233 – Diabetes Serious Complications – www.diabetic.today