Chronic Complications of Diabetes Major Cause of Morbidity, Mortality and Health Care Costs

Neil Fam, BSc, MSc

Diabetes is a common chronic disease characterized by metabolic abnormalities that have both acute and long term complications. In Canada, at least 1.5 million individuals (5% of the population) are afflicted by the disease, and this number is predicted to increase to 2.2 million by the year 2000. Diabetes has considerable associated morbidity and mortality. It is a major cause of coronary artery disease and stroke and is a leading cause of blindness and kidney disease in adults. Furthermore, individuals with diabetes have a shortened life expectancy when compared to those without the disease. Long-term complications occur in both type 1 and type 2 diabetes and result from the chronic hyperglycemia and hypertension associated with the disease. This article summarizes the chronic complications of diabetes, including effects on the vascular system, kidneys, eyes and nervous system.

The diabetic patient may develop one or all of a myriad of complications, including vascular disease, hypertension, retinopathy, nephropathy, neuropathy and foot disease.

Vascular Complications and Hypertension
The vascular complications of diabetes can be divided into microvascular and macrovascular disease.