Prevention and early detection of vascular complications of diabetes

doi:10.1136/bmj.38922.650521.80

BMJ 2006;333:475-480 (2 September), doi:10.1136/bmj.38922.650521.80

Clinical review

Prevention and early detection of vascular complications of diabetes

Sally M Marshall, professor of diabetes¹, Allan Flyvbjerg, professor in experimental medical research²

¹ Diabetes Research Group, Medical School, University of Newcastle upon Tyne, Newcastle upon Tyne NE2 4HH, ² University of Aarhus, Denmark, DK 8000

Correspondence to: S M Marshall s.m.marshall@ncl.ac.uk

The first 150 words of the full text of this article appear below.

Introduction

Diabetes reduces life expectancy by five to 10 years. Prematurecardiovascular disease is the most common cause of morbidityand mortality, but the microvascular complications specificto diabetes (box 1) are also contributory factors. Diabetesis the most common reason for renal replacement therapy worldwide,the most common cause of blindness in the under 65s, and themost common cause of non-traumatic amputation. With our currentknowledge, most of these devastating events could be preventedor delayed, or their impact minimised. This review focuses onthe prevention, early detection, and initial management of thevascular complications of diabetes in adults.

Why are the complications of diabetes important?

Complications are common and the cost to the individual andsociety is enormous. The onset of complications reduces qualityof life, particularly when both microvascular and macrovasculardisease are present.^w1 The CODE-2 study gathered data on 7000people with type 2 diabetes from eight European studies—72%had at least one . . . [Full text of this article]

Who develops complications?

Pathophysiology

How do I prevent complications?

How do I detect and screen for complications?

How do I manage early complications?

How well are we doing?

How can we improve?

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