Preventing Diabetes Complications

Diabetes can affect many parts of the body and can lead to serious complications such as blindness, kidney damage, and lower-limb amputations. Working together, people with diabetes, their support network, and their health care providers can reduce the occurrence of these and other diabetes complications by controlling the levels of blood glucose, blood pressure, and blood lipids and by receiving other preventive care practices in a timely manner.

Glucose Control

• Studies in the United States and abroad have found that improved glycemic control benefits people with either type 1 or type 2 diabetes. In general, every percentage point drop in A1C blood test results—for example, from 8.0 to 7.0 percent—can reduce the risk of microvascular complications—eye, kidney, and nerve diseases—by 40 percent.

• In patients with type 1 diabetes, intensive insulin therapy has long-term beneficial effects on the risk of cardiovascular disease.

Blood Pressure Control

• Blood pressure control reduces the risk of cardiovascular disease—heart disease or stroke—among persons with diabetes by 33 to 50 percent, and the risk of microvascular complications—eye, kidney, and nerve diseases—by approximately 33 percent.

• In general, for every 10 mm Hg reduction in systolic blood pressure, the risk for any complication related to diabetes is reduced by 12 percent.

Control of Blood Lipids

• Improved control of LDL cholesterol can reduce cardiovascular complications by 20 to 50 percent.

Preventive Care Practices for Eyes, Feet, and Kidneys

• Detecting and treating diabetic eye disease with laser therapy can reduce the development of severe vision loss by an estimated 50 to 60 percent.

• Comprehensive foot care programs can reduce amputation rates by 45 to 85 percent.

• Detecting and treating early diabetic kidney disease by lowering blood pressure can reduce the decline in kidney function by 30 to 70 percent. Treatment with angiotensin-converting enzyme (ACE) inhibitors and angiotensin receptor blockers (ARBs) are more effective in reducing the decline in kidney function than other blood pressure lowering drugs.

• In addition to lowering blood pressure, ARBs reduce proteinuria, a risk factor for developing kidney disease, by 35 percent—similar to the reduction achieved by ACE inhibitors.