Overview of Clinical Complications of Diabetes

What are the clinical complications associated with diabetes?
Clinical complications associated with diabetes may include:

• Cardiovascular disease
  Cardiovascular disease, in many cases, is caused by atherosclerosis -- an excess build-up of plaque on the inner wall of a large blood vessel, which restricts the flow of blood.
  • Heart disease is the leading cause of diabetes-related deaths.
  • Heart disease and stroke are 2 to 4 times more common in persons with diabetes.
  • Persons with diabetes have heart disease death rates nearly 2 to 4 times higher than in persons without diabetes.
    
    
• Hypertension
  High blood pressure affects 60-65 percent of people with diabetes.
  
  
• Dental disease
• Periodontal (gum) disease occurs with greater frequency in persons with diabetes. Periodontal disease occurs among 30 percent of people 19 years old or older with type 1 diabetes.
  
  
• Retinopathy or glaucoma (eye disease or blindness)
• Blindness due to diabetic retinopathy is a more important cause of visual impairment in younger-onset people than in older-onset people. Males with younger-onset diabetes develop retinopathy more rapidly than females with younger-onset diabetes.
  • Diabetic retinopathy causes from 12,000 to 24,000 new cases of blindness each year.
  • Diabetes is the leading cause of blindness among adults 20-74 years of age.
    
    
• Renal disease (kidney/urinary tract disease)
• Ten to twenty-one percent of all people with diabetes develop kidney disease.
  • Diabetes is the leading cause of end-stage renal disease (ESRD), a condition in which the patient requires dialysis or a kidney transplant in order to live.
  • According to the latest recorded statistics from the National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK), in 1995, 98,872 persons with diabetes underwent dialysis or transplantation.
    
    
• Neuropathy (nerve disease)
  • Approximately 60-70 percent of people with diabetes have mild to severe forms of diabetic nerve damage.
  • Severe forms of diabetic nerve disease are the major contributing cause of lower-extremity amputations.
    
    
• Amputation
  More than half the amputations in the US occur among people with diabetes.
  
  
• Diabetic ketoacidosis (DKA)
  DKA is one of the most serious outcomes of poorly controlled diabetes, and primarily occurs in persons with type 1 diabetes. DKA is marked by high blood glucose levels along with ketones in the urine. DKA is responsible for about 10 percent of diabetes-related deaths in individuals with diabetes under age 45.

Preventing diabetes complications:
Persons with diabetes must stay alert for symptoms that can lead to clinical complications. The best way to do this is:

• get regular checkups -- finding problems early is the best way to keep complications from becoming serious.
  
  
• keep appointments with your physician -- even when you are feeling well.
  
  
• be aware of symptoms and warning signs of potential problems, including:
  • vision problems (blurriness, spots)
  • fatigue
  • pale skin color
  • obesity (more than 20 pounds overweight)
  • numbness or tingling feelings in hands or feet
  • repeated infections or slow healing of wounds
  • chest pain
  • vaginal itching
  • constant headaches
    
    
• keep blood-sugar levels close to normal
  
  
• control weight
  
  
• eat a healthy, well-balanced diet
  
  
• get regular exercise
  
  
• check your feet every day for even minor cuts or blister
  
  
• do not smoke