Long term complications: Microvascular

The long-term health complications associated with diabetes can be divided between microvascular and macrovascular complications. Microvascular complications affect the small blood vessels and macrovascular complications affect the large arteries in your body. Macrovascular complications are also sometimes called cardiovascular complications. The higher your blood glucose level rises, the greater your risk of experiencing the health complications that have been linked to Type 2 diabetes. The good news is that you can help minimise your risk by following the advice of your diabetes healthcare team about your treatment and lifestyle.

The large arteries supply blood to your heart, legs, kidneys and brain. If these become clogged up (thrombosed), you will be more at risk of developing heart disease, which can lead to a heart attack. You will also be more at risk of kidney failure, foot ulcers and strokes. Heart attack and stroke represent the major cause of death (up to 75 per cent) in patients with Type 2 diabetes. It is therefore important that you do everything possible to reduce your risk of macrovascular complications.

Reducing your risk of Macrovascular complications

Listed below are 1The long-term health complications associated with diabetes can be divided between microvascular and macrovascular complications. Macrovascular complications affect the large arteries and microvascular complications affect the small blood vessels in your body. These microvascular complications can lead to problems with your eyes (retinopathy), your kidneys (nephropathy) and nerve damage (neuropathy). However, there is good evidence that if you control your blood pressure and sustain a healthy blood glucose level, you can significantly reduce your risk of developing microvascular complications.

Complications affecting the eyes (retinopathy)

Try not to worry if you have disturbed vision but seek the advice of your diabetes healthcare team immediately. In most cases blurred vision results from changes in your blood glucose affecting the shape of the lens in your eye and it is not associated with future problems with your sight. Sometimes the disturbed vision can continue for several weeks. However with good blood glucose control, your vision should return to normal.

Modern eye care has considerably reduced the risk of eye damage for people with diabetes. Blindness due to diabetes is very rare (one in 1000 people) in countries where modern treatment methods are available. However, if you have had diabetes for at least 15 years it is likely that you will have some degree of eye damage. The best preventative measure and treatment for retinopathy is good control of blood glucose and blood pressure levels. You should have annual screenings for retinopathy. If you experience damage, you may be advised to have laser treatment.

Complications affecting the kidneys (nephropathy)

Your kidneys filter and clean your blood, turning some of your body's waste into urine. They also release hormones and regulate the amount of fluid and salt in your body, helping to control your blood pressure. Kidney disease progresses gradually in people with diabetes and there are well-recognised ways of slowing down this process before it leads to kidney failure.


To slow down the progression of kidney disease, it is very important to have good control over your blood glucose and blood pressure. If you have a urinary tract infection, it should be treated swiftly because this could also lead to kidney damage. Your doctor may prescribe you medication to bring down your blood pressure and help protect your kidneys against damage. If your kidneys are unable to function properly, your diabetes healthcare team may advise you to adjust your diet. In rare cases, people with diabetes experience severe kidney damage or kidney failure, which needs to be treated with dialysis or a transplant.

Complications affecting the nerves (neuropathy)

If the blood vessels that supply your nerve fibres are damaged, your nerves may be starved of oxygen. This can result in nerve injury, which can lead to loss of sensation and pain. Your longest nerves are the most vulnerable, such as those in your feet and hands. The loss of sensation in these areas can lead to foot damage and an inability to pick up small objects or perform delicate tasks such as doing up buttons. Neuropathy can also affect your digestive system, heart, eyes, sweat glands, bladder and sexual functions.

The best way to reduce your risk of neuropathy is to maintain a healthy blood glucose level. If neuropathy affects your feet, you should have regular foot checks. There are also a number of medications that can ease any pain or discomfort you may feel. If you experience pain or a loss of sensation, you should inform your doctor immediately.


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