Overview of Clinical Complications of Diabetes

What are the clinical complications associated with diabetes?

Clinical complications associated with diabetes may include the following:

• Cardiovascular disease. Cardiovascular disease, in many cases, is caused by atherosclerosis. This is an excess buildup of plaque on the inner wall of a blood vessel that restricts the flow of blood. Heart attack and stroke are 2 to 4 times more common in people with diabetes. In addition to high glucose, the other risk factors for cardiovascular disease that can be improved include smoking, high blood pressure, diabetic kidney disease, and high cholesterol.

• Hypertension. High blood pressure affects as many as 2 out of 3 people who have diabetes. It dramatically increases the risk of diabetes-related complications. This includes heart attack, stroke, renal failure, and blindness. 

• Dental disease. Periodontal (gum) disease happens with greater frequency in people with diabetes.

• Retinopathy or glaucoma (eye disease or blindness). Diabetes is the leading cause of new cases of blindness among adults between ages 20 and 74. In addition to high glucose, the other risk factors for blindness from diabetes that can be improved include smoking, high blood pressure, and diabetic kidney disease. People with diabetes have an increased risk of developing cataracts and of developing them at an earlier age. 

• Renal disease (kidney/urinary tract disease). Diabetes is the leading cause of end-stage renal disease (ESRD). This is a condition in which the patient needs dialysis or a kidney transplant in order to live. In addition to high glucose, the other risk factors for kidney failure from diabetes that can be improved include smoking, high blood pressure, and the use of certain medicines (like pain pills). 

• Neuropathy (nerve disease). Approximately half of all people with diabetes have some form of nerve damage. This can cause disabling pain requiring medicines. Severe forms of diabetic nerve disease are the major contributing cause of lower-extremity amputations.

• Amputation. More than 60% of nontraumatic lower-limb amputations in the U.S. happen among people with diabetes. In addition to high glucose, the other risk factors that increase the risk of amputation and can be improved include smoking, high blood pressure, diabetic kidney disease, high cholesterol, and injuries to the feet. 

• Diabetic ketoacidosis (DKA). DKA is one of the most serious outcomes of poorly controlled diabetes. It primarily happens in people with type 1 diabetes. DKA is marked by high blood glucose levels along with ketones in the urine and blood.

What can prevent diabetes complications?

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

• Get regular checkups. Finding problems early is the best way to keep complications from becoming serious.

• Keep appointments with your healthcare provider, even when you are feeling well

• Be aware of symptoms and warning signs. These include 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, or constant headaches.

• Carefully self-monitor blood sugar levels several times a day, as directed by your healthcare provider

• Control weight

• Eat a healthy, well-balanced diet

• Get regular exercise

• Check your feet every day for even minor cuts or blisters

• Quit smoking

• Taking appropriate medicines for good blood pressure and cholesterol control. Avoid certain pain medicines that can injury your kidneys.