An Introduction Diabetic complications

Patients with long-standing diabetes may develop complications

affecting the eyes, kidneys or nerves (microvascular
complications) or major arteries. 

The major arteries areaffected in people with diabetes, causing a substantial increase
in both in coronary artery disease and strokes as well as
peripheral vascular disease.

The greatest risk of large vesseldisease occurs in those diabetic patients who develop
proteinuria or microalbuminuria, which are associated with
widespread vascular damage. 

These complications are often
discovered at presentation in Type 2 diabetic patients who must
have had diabetes for many years before it has been diagnosed.

During the last two decades, there has been a considerable
increase in understanding the mechanisms underlying the
development of the long-term diabetic microvascular
complications (retinopathy, nephropathy, and neuropathy)
and macrovascular disease, accompanied by major
developments in preventing them. 

The United Kingdom
Prospective  Diabetes Survey (UKPDS) in particular
demonstrated quantitatively the long-term harmful effects of
hyperglycaemia and hypertension in the development of both
microvascular and macrovascular complications in Type 2
diabetes. 

Both UKPDS and the Diabetes Complications and
Control Trial (DCCT) of Type 1 diabetes demonstrated the
benefits of optimal control.