CLINICAL REVIEW THE PREVENTION AND EARLY DETECTION OF THE VASCULAR COMPLICATIONS OF DIABETES Long (web) version

Diabetes is a common cause of reduced life expectancy and premature morbidity, primarily from vascular causes. It is also the commonest cause of blindness in the working age groups, renal failure and non-traumatic lower limb amputation. The risk of these complications can be reduced by good glucose and blood pressure control, prescription of statins and aspirin and life-style changes aimed at reducing cardiovascular risk. If complications do develop, they must be diagnosed early: prompt intervention may prevent, delay or minimize the impact of end-stage disease. Every individual with diabetes should be included in an annual screening programme designed to detect complications early and to assess cardiovascular risk factors. Intervention can be tightened to slow progression of complications and specific protective measures begun, such as prescription of inhibitors of the renin-angiotensin system in nephropathy and provision of special footwear in peripheral neuropathy. More aggressive management significantly reduces the impact of both cardiovascular and specific complications of diabetes.