Hi-R-Ed Online

In people with diabetes, damage to small blood vessels (microvascular complications) and nerves (neuropathy) can occur, increasing the risk of eye disease, kidney disease, sexual dysfunction, and other serious medical problems.

Hyperglycemia, often acting in concert with hypertension, can lead to small blood vessel damage. Microvascular complications include:

— Eye disease. Eye disease is 25 times more common in people with diabetes than in the general population. Diabetic retinopathy (a term for disorders of the retina associated with diabetes) is the leading cause of blindness in the United States for people between 20 and 74. In addition, people with diabetes are twice as likely to develop glaucoma and cataracts as those without diabetes.

Hyperglycemia can also lead to nerve damage. Diabetes is the most common cause of peripheral neuropathy. Peripheral neuropathy of the sensory nerves contributes to the development of foot ulcers, which can lead to amputation. Lower extremities tend to be more seriously affected than upper extremities, but neuropathy also can affect the hands and arms. Diabetes-related damage to nerves that supply internal body organs (autonomic neuropathy) also may occur. Autonomic neuropathy can lead to problems with the regulation of blood pressure, heart rate, bladder emptying, and digestion. Sexual dysfunction, including erectile dysfunction in men and a number of female sexual problems, is another common long-term complication of diabetes.

In people with diabetes, damage to large blood vessels (macrovascular disease) can occur, increasing the risk of heart attack, stroke, and poor circulation in the hands and feet.

Diabetes is considered to be the leading risk factor for cardiovascular disease, more significant than smoking, high blood pressure, elevated cholesterol, or obesity. Although cardiovascular disease is the leading cause of death for people with diabetes, the majority (more than two thirds) are unaware of their increased risk for heart disease.

Diabetes accelerates the development of atherosclerosis, which narrows the arteries and increases the risk of a heart attack or stroke. Hyperglycemia, dyslipidemia, and hypertension all may contribute to the development of atherosclerosis and cardiovascular disease in people with diabetes. Recent evidence suggests that inflammation also plays an important part in atherosclerosis.

Cardiovascular disease is the leading cause of death in people with diabetes.[1] Coronary artery disease and stroke account for approximately 65% of all deaths in people with diabetes. Peripheral vascular disease (poor circulation in the extremities, such as hands and feet) is a major risk factor for lower extremity amputations.