Long-term complications of diabetes
Diabetes (Type 1 or 2) – whether controlled by insulin, tablets or diet – has many long-term complications. They can be divided up into 5 groups.
Most of the complications start 10 years or more after the onset of the disease.
1. Microvascular
- Diabetic retinopathy (eye damage): Damaged blood vessels in the eyes can lead to permanent visual loss.
- Diabetic nephropathy (kidney damage): Damaged small blood vessels within the kidney can lead to chronic kidney disease (CKD), ESRF (need for dialysis, a kidney or kidney-pancreas transplant) or nephrotic syndrome.
- Diabetic neuropathy (nerve damage): Nerve damage can cause pain, burning, tingling, and loss of feeling in the hands and feet. It can also make it harder for men to have an erection.
2. Macrovascular
- Atheroma (blood vessel damage): Damaged large blood vessels around the heart or within the brain, increase the risk of myocardial infarction (MI; heart attack) or stroke.
- Renovascular disease (RVD): This is damage to the large blood vessels within the kidney. It can can also cause CKD/ESRF. Patients with diabetes (especially Type 2) often have both diabetic nephropathy and RVD.
3. Autonomic neuropathy
- Diabetic gastroparesis: Diabetes can cause nausea, vomiting, constipation or diarrhoea.
- Low blood pressure: Though high blood pressure (hypertension) is more common.
4. Other complications
- Immunosuppression: Diabetes can weaken the immune system.
- Mental health: People with diabetes often have depression.
- Bone and joint problems: Diabetes increases the risk of bone diseases, including osteoporosis and osteomyelitis.
- Teeth and gum infections: Diabetes can cause teeth and gum infections.
5. Complex complications
- Diabetic foot disease: This is often due to a combination of neuropathy, peripheral vascular disease (PVD) and immunosuppression leading to leg and foot ulcers, infection (including osteomyelitis), and in some cases, amputation.
Prevention of diabetes (and prediabetes)
Preventing diabetes (and prediabetes), by screening, weight loss and NHS programmes like OVIVA is very important – as complications of diabetes can then be prevented.
