The long-term health complications associated with diabetes can be divided between
microvascular and macrovascular complications. Microvascular complications affect
the small blood vessels and macrovascular complications affect the large arteries
in your body.
Macrovascular complications are also sometimes called cardiovascular complications.
The higher your blood glucose level rises, the greater your risk of experiencing
the health complications that have been linked to Type 2 diabetes. The good news
is that you can help minimise your risk by following the advice of your diabetes
healthcare team about your treatment and lifestyle.
The large arteries supply blood to your heart, legs, kidneys and brain. If these
become clogged up (thrombosed), you will be more at risk of developing heart disease,
which can lead to a heart attack. You will also be more at risk of kidney failure,
foot ulcers and strokes. Heart attack and stroke represent the major cause of death
(up to 75 per cent) in patients with Type 2 diabetes. It is therefore important
that you do everything possible to reduce your risk of macrovascular complications.
Reducing your risk of Macrovascular complications
Listed below are 1The long-term health complications associated with diabetes can
be divided between microvascular and macrovascular complications. Macrovascular
complications affect the large arteries and microvascular complications affect the
small blood vessels in your body. These microvascular complications can lead to
problems with your eyes (retinopathy), your kidneys (nephropathy) and nerve damage
(neuropathy). However, there is good evidence that if you control your blood pressure
and sustain a healthy blood glucose level, you can significantly reduce your risk
of developing microvascular complications.
Complications affecting the eyes (retinopathy)
Try not to worry if you have disturbed vision but seek the advice of your diabetes
healthcare team immediately. In most cases blurred vision results from changes in
your blood glucose affecting the shape of the lens in your eye and it is not associated
with future problems with your sight. Sometimes the disturbed vision can continue
for several weeks. However with good blood glucose control, your vision should return
to normal.
Modern eye care has considerably reduced the risk of eye damage for people with
diabetes. Blindness due to diabetes is very rare (one in 1000 people) in countries
where modern treatment methods are available. However, if you have had diabetes
for at least 15 years it is likely that you will have some degree of eye damage.
The best preventative measure and treatment for retinopathy is good control of blood
glucose and blood pressure levels. You should have annual screenings for retinopathy.
If you experience damage, you may be advised to have laser treatment.
Complications affecting the kidneys (nephropathy)
Your kidneys filter and clean your blood, turning some of your body's waste into
urine. They also release hormones and regulate the amount of fluid and salt in your
body, helping to control your blood pressure. Kidney disease progresses gradually
in people with diabetes and there are well-recognised ways of slowing down this
process before it leads to kidney failure.
To slow down the progression of kidney disease, it is very important to have good
control over your blood glucose and blood pressure. If you have a urinary tract
infection, it should be treated swiftly because this could also lead to kidney damage.
Your doctor may prescribe you medication to bring down your blood pressure and help
protect your kidneys against damage. If your kidneys are unable to function properly,
your diabetes healthcare team may advise you to adjust your diet. In rare cases,
people with diabetes experience severe kidney damage or kidney failure, which needs
to be treated with dialysis or a transplant.
Complications affecting the nerves (neuropathy)
If the blood vessels that supply your nerve fibres are damaged, your nerves may
be starved of oxygen. This can result in nerve injury, which can lead to loss of
sensation and pain. Your longest nerves are the most vulnerable, such as those in
your feet and hands. The loss of sensation in these areas can lead to foot damage
and an inability to pick up small objects or perform delicate tasks such as doing
up buttons. Neuropathy can also affect your digestive system, heart, eyes, sweat
glands, bladder and sexual functions.
The best way to reduce your risk of neuropathy is to maintain a healthy blood glucose
level. If neuropathy affects your feet, you should have regular foot checks. There
are also a number of medications that can ease any pain or discomfort you may feel.
If you experience pain or a loss of sensation, you should inform your doctor immediately.