Also called heart attacks; results from permanent damage to an area of the heart muscle. This happens when the blood supply to the area of the heart is interrupted because of narrowed or blocked blood vessels. In the majority of cases this is due to coronary artery disease.
In virtually every developed society, diabetes is ranked among the leading causes of blindness, renal failure and lower limb amputation. It is also now one of the leading causes of death through its effects on cardiovascular disease (70-80% of people with diabetes die of cardiovascular disease). The main relevance of diabetes complications in a public health perspective is the relationship to human suffering and disability, and the huge socio-economic costs through premature morbidity and mortality1American Diabetes Association: Economic consequences of diabetes mellitus in the U.S. in 1997. Diabetes Care 1998; 21:296-309..
Chronic elevation of blood glucose, even when no symptoms are present to alert the individual to the presence of diabetes, will eventually lead to tissue damage, with consequent, and often serious, disease. Whilst evidence of tissue damage can be found in many organ systems, it is the kidneys, eyes, peripheral nerves and vascular tree, which manifest the most significant, and sometimes fatal, diabetic complications. The mechanism by which diabetes leads to these complications is complex, and not yet fully understood, but involves the direct toxic effects of high glucose levels, along with the impact of elevated blood pressure, abnormal lipid levels and both functional and structural abnormalities of small blood vessels.
About half of all the money spent on diabetes care goes towards the costs of managing diabetic complications. Cardiovascular complications frequently account for the bulk of the costs as reflected in the patterns of hospital admissions for the treatment of complications, as shown in the figure below. The trend of escalating diabetes prevalence will no doubt lead to an immense financial burden in many countries unless action is taken to prevent both diabetes and its complications.
As part of its campaign to prevent diabetic complications, IDF has dedicated World Diabetes Day to a range of complications since 2001. An outcome of the campaigns has been the publication of a 'Time to Act' series on various topics including cardiovascular disease, kidney disease and the diabetic foot. These publications are available at the online IDF book shop: www.idf.org/bookshop.