DIABETES LONG TERM COMPLICATIONS

Long-term complications are the effects on the body of prolonged exposure to ele­vated glucose levels. People with diabetes are understandably fearful of these long-term complications. It is, however, important to emphasize that with good glucose control and treatment of high lipid levels and blood pressure, almost all of these complications can be prevented or their progression arrested. Also, there is a genetic component to complications—even in the presence of poor glucose control, only 40 percent of people with diabetes develop severe complications.

Following are the long term complications of the diadetes

Long-term complications are categorized into two types: microvascular and mac­rovascular. This division does not mean that one gets only one or the other—many times people have a little bit of both.

• Microvascular complications relate to the small blood vessels and capillaries and lead to kidney, eye, and nerve disease. In people with type 1 diabetes, where the problem is principally of glucose control, microvascular complications are initially more prominent, but once these develop, or with long duration of diabetes, macrovascular complications may also occur.

• Macrovascular complications relate to disease of medium-sized and large blood vessels and lead to heart attacks, circulation problems in the legs, and strokes. Generally speaking, people with type 2 diabetes are more prone to the macrovascular complications, because in addition to having elevated glucose values, they often have high blood pressure (hypertension), high cholesterol and triglycerides, and low HDL cholesterol. They may develop microvascular disease with time if their glucose levels remain elevated.

Another point to remember is that some of the complications that are seen in people with diabetes (for example cataracts, glaucoma, heart disease) also occur in the absence of diabetes. The difference is that these complications are more fre­quent in people with diabetes.