Training modules (NHS England)

Complications of diabetes

It is essential that patients with diabetes are made aware of the complications that can occur as a result of having the condition.

Diabetes complications may occur over many different timescales, from the date of diagnosis, or many years after diabetes has developed.

The majority of diabetes complications occur due to fluctuations in blood glucose levels, particularly elevated blood sugar over a long period of time.

The long term complications of diabetes involve many different systems in the body. These may be found at time of diagnosis of diabetes, or many years after the onset of diabetes. Many of the long term complications of diabetes are thought to be due to persistently elevated levels of blood glucose and it has been shown, that controlling blood glucose levels and blood pressure may minimize or prevent the onset of these complications.

The complications of diabetes may be categorised as;

  • ‘Macro-vascular’ (involving large blood vessels) resulting in increased risk of Strokes, Heart attacks and Peripheral Arterial Disease (PAD)
  • ‘Micro-vascular’ (involving small blood vessels) resulting in increased risk of eye problems (diabetic retinopathy), disruption to nerves (neuropathy) and kidney problems (diabetic nephropathy)

It is difficult to predict who is likely to develop chronic complications of diabetes which may sometimes occur regardless of the level of control. Not everyone who has diabetes will develop complications. There is good evidence that good control of blood sugar, blood pressure, cholesterol lowering, a healthy lifestyle with plenty of exercise and not smoking will prevent complications in a lot of people.

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