Diabetes Complications

Diabetes can cause serious health complications including heart disease, blindness, kidney failure, and lower-extremity amputations.

Some of the complications that can arise from diabetes are:

Heart disease and stroke
· Heart disease and stroke account for about 65% of deaths in people with diabetes.
· Adults with diabetes have heart disease death rates about 2 to 4 times higher than adults without diabetes.
· The risk for stroke is 2 to 4 times higher among people with diabetes.

High blood pressure
· About 73% of adults with diabetes have blood pressure greater than or equal to 130/80 millimeters of mercury (mm Hg) or use prescription medications for hypertension.

Blindness
· Diabetes is the leading cause of new cases of blindness among adults aged 20-74 years.
· Diabetic retinopathy causes 12,000 to 24,000 new cases of blindness each year.

Kidney disease
· Diabetes is the leading cause of kidney failure, accounting for 44% of new cases in 2002.
· In 2002, 44,400 people with diabetes began treatment for end-stage kidney disease in the United States and Puerto Rico.
· In 2002, 153,730 people with end-stage kidney disease due to diabetes were living on chronic dialysis or with a kidney transplant in the United States and Puerto Rico.

Nervous system disease
· About 60% to 70% of people with diabetes have mild to severe forms of nervous system damage. The results of such damage include impaired sensation or pain in the feet or hands, slowed digestion of food in the stomach, carpal tunnel syndrome, and other nerve problems.
· Almost 30% of people with diabetes aged 40 years or older have impaired sensation in the feet (i.e., at least one area that lacks feeling).
· Severe forms of diabetic nerve disease are a major contributing cause of lower-extremity amputations.

Amputations
· More than 60% of nontraumatic lower-limb amputations occur in people with diabetes.
· In 2002, about 82,000 nontraumatic lower-limb amputations were performed in people with diabetes.

Dental disease
· Periodontal (gum) disease is more common in people with diabetes. Among young adults, those with diabetes have about twice the risk of those without diabetes.
· Almost one-third of people with diabetes have severe periodontal disease with loss of attachment of the gums to the teeth measuring 5 millimeters or more.

Complications of pregnancy
· Poorly controlled diabetes before conception and during the first trimester of pregnancy can cause major birth defects in 5% to 10% of pregnancies and spontaneous abortions in 15% to 20% of pregnancies.
· Poorly controlled diabetes during the second and third trimesters of pregnancy can result in excessively large babies, posing a risk to both mother and child.

Other complications
· Uncontrolled diabetes often leads to biochemical imbalances that can cause acute life-threatening events, such as diabetic ketoacidosis and hyperosmolar (nonketotic) coma.
· People with diabetes are more susceptible to many other illnesses and, once they acquire these illnesses, often have worse prognoses. For example, they are more likely to die with pneumonia or influenza than people who do not have diabetes.