When diabetes is not well managed, complications develop that threaten health and endanger life. Acute complications are a significant contributor to mortality, costs and poor quality of life.
Over time diabetes can damage the heart, blood vessels, eyes, kidneys and nerves, and increase the risk of heart disease and stroke. Such damage can result in reduced blood flow, which – combined with nerve damage (neuropathy) in the feet – increases the chance of foot ulcers, infection and the eventual need for limb amputation. Diabetic retinopathy is an important cause of blindness and occurs as a result of long-term accumulated damage to the small blood vessels in the retina. Diabetes is among the leading causes of kidney failure.
The most common long-term complications of diabetes mellitus are:
Cardiovascular disease - affects the heart and blood vessels and may cause fatal complications such as coronary heart disease (leading to a heart attack) and stroke (a common cause of disability and death in people with diabetes). People with diabetes are two to four times more likely to develop cardiovascular disease than people without diabetes.
Diabetic neuropathy (nerve disease) - damage to the nerve fibres primarily affecting the legs and feet. Foot ulcers are common symptoms. Infections in these wounds may ultimately result in amputation of the foot and lower leg. It is estimated that up to 70% of all lower limb amputations are related to diabetes.
Diabetic nephropathy (kidney disease) - may result in total kidney failure and in the need for dialysis or kidney transplant. Diabetes is the leading cause of kidney failure in the developed world and accounts for approximately 35 to 40 % of new cases of End Stage Renal Disease (ESRD) each year.
Diabetic retinopathy (eye disease) - damage to the retina of the eye which can lead to vision loss. The incidence of blindness is 25 times higher in people with diabetes than in the general population.