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Complications of Diabetes in the United States

Heart Disease and Stroke

  • In 2004, heart disease was noted on 68 percent of diabetes-related death certificates among people aged 65 years or older.

  • In 2004, stroke was noted on 16 percent of diabetes-related death certificates among people aged 65 years or older.

  • Adults with diabetes have heart disease death rates about two to four times higher than adults without diabetes.

  • The risk for stroke is two to four times higher among people with diabetes.

High Blood Pressure

  • In 2003 to 2004, 75 percent of adults with self-reported diabetes had blood pressure greater than or equal to 130/80 millimeters of mercury (mm Hg) or used prescription medications for hypertension.

Blindness

  • Diabetes is the leading cause of new cases of blindness among adults aged 20 to 74 years.

  • Diabetic retinopathy causes 12,000 to 24,000 new cases of blindness each year.

Kidney Disease

  • Diabetes is the leading cause of kidney failure, accounting for 44 percent of new cases in 2005.

  • In 2005, 46,739 people with diabetes began treatment for end-stage kidney disease in the United States and Puerto Rico.

  • In 2005, a total of 178,689 people with end-stage kidney disease due to diabetes were living on chronic dialysis or with a kidney transplant in the United States and Puerto Rico.

Nervous System Disease

  • About 60 to 70 percent of people with diabetes have mild to severe forms of nervous system damage. The results of such damage include impaired sensation or pain in the feet or hands, slowed digestion of food in the stomach, carpal tunnel syndrome, erectile dysfunction, or other nerve problems.

  • Almost 30 percent of people with diabetes aged 40 years or older have impaired sensation in the feet—for example, at least one area that lacks feeling.

  • Severe forms of diabetic nerve disease are a major contributing cause of lower-extremity amputations.

Amputations

  • More than 60 percent of nontraumatic lower-limb amputations occur in people with diabetes.

  • In 2004, about 71,000 nontraumatic lower-limb amputations were performed in people with diabetes.

Dental Disease

  • Periodontal, or gum, disease is more common in people with diabetes. Among young adults, those with diabetes have about twice the risk of those without diabetes.

  • Persons with poorly controlled diabetes (A1C > 9 percent) were nearly three times more likely to have severe periodontitis than those without diabetes.

  • Almost one-third of people with diabetes have severe periodontal disease with loss of attachment of the gums to the teeth measuring 5 millimeters or more.

Complications of Pregnancy

  • Poorly controlled diabetes before conception and during the first trimester of pregnancy among women with type 1 diabetes can cause major birth defects in 5 to 10 percent of pregnancies and spontaneous abortions in 15 to 20 percent of pregnancies.

  • Poorly controlled diabetes during the second and third trimesters of pregnancy can result in excessively large babies, posing a risk to both mother and child.

Other Complications

  • Uncontrolled diabetes often leads to biochemical imbalances that can cause acute life-threatening events, such as diabetic ketoacidosis and hyperosmolar, or nonketotic, coma.

  • People with diabetes are more susceptible to many other illnesses and, once they acquire these illnesses, often have worse prognoses. For example, they are more likely to die with pneumonia or influenza than people who do not have diabetes.

  • Persons with diabetes aged 60 years or older are two to three times more likely to report an inability to walk a quarter of a mile, climb stairs, do housework, or use a mobility aid compared with persons without diabetes in the same age group.

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