Long-Term Diabetes Complications

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The long-term complications of diabetes can affect almost every organ in the body. But there is some good news for people who have diabetes. Keeping blood sugars under good control can slow down the rate of damage and help to prolong life.

What are Long-Term Complications of Diabetes?

The most common cause of death in a person with diabetes is heart disease. Almost three out of four people with diabetes die of heart-related complications. The risk of stroke and vascular disease of the blood vessels is also higher in people with diabetes. To make matters worse, diabetics are more likely to have hypertension than non-diabetics, which further increases their risk of heart disease and heart attack. In addition, diabetics more often have “silent ischemia” where they sustain heart damage without having the classic symptoms of a heart attack.

The heart isn’t the only organ touched by the harsh hand of diabetes. Type 2 diabetes is the most common cause of irreversible kidney disease, and the risk of kidney problems is even greater in diabetics who have hypertension.

The eyes and nerves are commonly affected by diabetes. Diabetics frequently develop a condition called diabetic retinopathy that can lead to blindness, and they’re more susceptible to cataracts as well. People with type 2 diabetes can develop neuropathy, or inflammation of the nerves in the extremities in addition to dysfunction of nerves that control digestion and the heart. This leads to slow digestion and positional drops in blood pressure and dizziness.

Because diabetics are prone to neuropathy and vascular disease of the legs and feet, their risk for serious foot infections requiring amputation is higher. They can also develop ulcers involving the feet that spread to the underlying skin and bone, and they’re more likely to develop skin infections and boils at other sites. In addition, women are more prone to vaginal infections and urinary tract infections when they have diabetes.

What Causes the Complications of Diabetes?

No one knows for sure what causes the long-term complications of diabetes, although there are some theories. The most compelling is that high levels of glucose damages the interior of cells - modifying proteins and genes and causing them to produce inflammatory chemicals called cytokines. When these cytokines are released from cells, they cause blood vessel damage that can lead to the complications of diabetes.

Because this whole pathway is initiated by high levels of glucose, it makes sense that lower blood sugar levels would prevent some of this damage. Indeed, studies show that tighter glucose control helps to lower the risk of “macrovascular” complications of diabetes such as heart disease and stroke, but may be less effective for preventing “microvascular” disease such as kidney and retinal disease.

How Can You Prevent the Long-Term Complications of Diabetes?

Controlling blood sugar and hemoglobin A1C levels under good control may help to reduce the risk of diabetic heart disease and stroke. Other ways to reduce the risk of complications is to stop smoking and keep blood pressures well-controlled since this also damages blood vessels that supply the heart and other organs of the body.

Eating a healthy diet with lots of antioxidant-rich fruits and vegetables may help to protect cells from damage that comes from hyperglycemia. Regular exercise, such as walking, helps to lower the risk of blood vessel disease that leads to amputations. It’s also important for diabetics to be aware of any foot ulcers or sores, so they can be promptly treated to avoid future complications.

The Bottom Line?

Some of the long-term complications can be prevented by leading a healthy lifestyle and keeping blood sugars under good control. Make a commitment to do this if you have diabetes.


Emedicine. “Diabetes Type 2 – A Review”.

Merck Manual. Eighteenth edition. 2006.