Recent research provides clear evidence of the potential for adequate treatment to delay or even prevent the long term complications of diabetes, which include blindness, kidney failure, heart attacks and even gangrene and amputation of the limbs.

DIABETIC RETINOPATHY is the leading cause of blindness and visual disability in adults in economically developed societies. Findings, consistent from study to study, make it possible to suggest that, after 15 years of diabetes, approximately 2% of people become blind while about 10% develop severe visual handicap.

Diabetes mellitus is associated with damage to the small blood vessels in the retina, resulting in loss of vision.

Loss of vision due to certain types of glaucoma and cataract may also be more common in people with diabetes than in those without the disease.

Loss of vision and blindness in persons with diabetes can be prevented by early detection and treatment of vision-threatening retinopathy: regular eye examinations and timely intervention with laser treatment, or through surgery in cases of advanced retinopathy. A recent study has demonstrated that good metabolic control can also delay the onset and progression of diabetic retinopathy.

There is evidence that, even in developed countries, a large proportion of those in need is not receiving such care due to lack of public and professional awareness. In developing countries, in many of which diabetes is now common, such care is inaccessible to the majority of the population.
 

Diabetes is a leading cause of RENAL FAILURE, but its frequency varies between populations and is also related to the severity and duration of the disease. Several measures to slow down the progress of renal damage have been identified. They include control of hyperglycaemia, control of hypertension and restriction of dietary protein. Screening and early detection of diabetic kidney disease are an important means of prevention.

HEART DISEASE accounts for 75 % of all deaths among people with diabetes in industrialized countries. Risk factors for heart disease in people with diabetes include cigarette smoking, hypertension, hypercholesterolaemia and obesity. Diabetes negates the protection from heart disease which pre-menopausal women, without diabetes, experience. Recognition and management of these conditions may delay or prevent heart disease in people with diabetes.

DIABETIC NEUROPATHY is probably the most common complication of diabetes. Studies suggest that 50%, or more, of people with diabetes are affected to some degree. Major risk factors of this condition are the level and duration of hyperglycaemia. Neuropathy can lead to sensory loss and damage to the limbs. It is also a major cause of impotence in diabetic men. This fact is often under-recognized. Foot care is an important means of reducing the impact of diabetic neuropathy.
 

DIABETIC FOOT DISEASE ULCERATION FREQUENTLY LEADING TO AMPUTATION is one of the most costly complications of diabetes, especially in communities with inadequate footwear. It is a result of both vascular and neurological disease processes. Diabetes is the commonest cause of non-traumatic amputation of the lower limb, which may be prevented by regular inspection and good care of the foot.