Heart Disease and Stroke

• Heart disease is the leading cause of diabetes-related deaths. Adults with diabetes have heart disease death rates about 2 to 4 times higher than adults without diabetes.
  
• The risk for stroke is 2 to 4 times higher among people with diabetes.
  
• About 65% of deaths among people with diabetes are due to heart disease and stroke.

High Blood Pressure

• About 73% of adults with diabetes have blood pressure greater than or equal to 130/80 millimeters of mercury (mm Hg) or use prescription medications for hypertension.

Blindness

• Diabetes is the leading cause of new cases of blindness among adults 20-74 years old.
  
• Diabetic retinopathy causes from 12,000 to 24,000 new cases of blindness each year.

Kidney Disease

• Diabetes is the leading cause of treated end-stage renal disease, accounting for 43% of new cases.
  
• In 2000, 41,046 people with diabetes began treatment for end-stage renal disease.
  
• In 2000, a total of 129,183 people with diabetes underwent dialysis or kidney transplantation.

Nervous System Disease

• About 60% to 70% 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, and other nerve problems.
  
• Severe forms of diabetic nerve disease are a major contributing cause of lower-extremity amputations.

Amputations

• More than 60% of nontraumatic lower-limb amputations in the United States occur among people with diabetes.
  
• From 2000 to 2001, about 82,000 nontraumatic lower-limb amputations were performed each year among people with diabetes.

Dental Disease

• Periodontal or gum diseases are more common among people with diabetes than among people without diabetes. Among young adults, those with diabetes are often at twice the risk of those without diabetes.
  
• Almost one-third of people with diabetes have severe periodontal diseases 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 can cause major birth defects in 5% to 10% of pregnancies and spontaneous abortions in 15% to 20% of pregnancies.
  
• Poorly controlled diabetes during the second and third trimesters of pregnancy can result in excessively large babies, posing a risk to the mother and the child.

Other Complications

• Uncontrolled diabetes often leads to biochemical imbalances that can cause acute life-threatening events, such as diabetic ketoacidosis and hyperosmolar (nonketotic) coma.
  
• People with diabetes are more susceptible to many other illnesses and, once they acquire these illnesses, often have worse prognoses than people without diabetes. For example, they are more likely to die with pneumonia or influenza than people who do not have diabetes.

Data Source: Heart disease and stroke Geiss LS, Herman WH, Smith PJ. Mortality in non-insulin-dependent diabetes. In: National Diabetes Data Group, editors. Diabetes in America , 2nd ed. Washington , DC : U.S. Department of Health and Human Services, National Institutes of Health, National Institute of Diabetes and Digestive and Kidney Diseases, 1995. NIH Publication No. 95-1468. p. 233-57. Kuller LH. Stroke and diabetes. In: National Diabetes Data Group, editors. Diabetes in America , 2nd ed. Washington , DC : U.S. Department of Health and Human Services, National Institutes of Health, National Institute of Diabetes and Digestive and Kidney Diseases, 1995. NIH Publication No. 95-1468. p. 449-56. High blood pressure Geiss LS, Rolka DB, Engelgau MM. Elevated blood pressure among U.S. adults with diabetes, 1988-1994. Am J Prev Med 2002; 22:43 -9. Blindness Klein R, Klein BEK. Vision disorders in diabetes. In: National Diabetes Data Group, editors, Diabetes in America, 2nd ed. Washington, DC: U.S. Department of Health and Human Services, National Institutes of Health, National Institute of Diabetes and Digestive and Kidney Diseases, 1995. NIH Publication No. 95-1468. p. 293-336. Will JC, Geiss LS, Wetterhall SF. Diabetic retinopathy [letter]. N Engl J Med 1990;323:613. Kidney disease U.S. Renal Data System. USRDS 2003 Annual Data Report: Atlas of End-Stage Renal Disease in the United States . Bethesda , MD : National Institutes of Health, National Institute of Diabetes and Digestive and Kidney Diseases, 2003 Nervous system disease Eastman RC. Neuropathy in diabetes. In: National Diabetes Data Group, editors. Diabetes in America , 2nd ed. Washington , DC : U.S. Department of Health and Human Services, National Institutes of Health, National Institute of Diabetes and Digestive and Kidney Diseases, 1995. NIH Publication No. 95-1468. p. 339-48. Amputations Unpublished data from the 2000-2001 National Hospital Discharge Survey, National Center for Health Statistics, Centers for Disease Control and Prevention. Dental disease Personal communication from R. H. Selwitz, DDS, National Institute of Dental and Craniofacial Research, Bethesda, MD, concerning unpublished data from the third National Health and Nutrition Examination Survey, 1988-1994. Complications of pregnancy Personal communication from Thomas A. Buchanan, MD, Professor, Medicine, Obstetrics and Gynecology, and Physiology and Biophysics, USC Keck School of Medicine, Los Angeles, CA. Other complications Fishbein H, Palumbo PJ. Acute metabolic complications in diabetes. In: National Diabetes Data Group, editors. Diabetes in America , 2nd ed. Washington , DC : U.S. Department of Health and Human Services, National Institutes of Health, National Institute of Diabetes and Digestive and Kidney Diseases, 1995. NIH Publication No. 95-1468. p. 283-91. Valdez R, Narayan KM, Geiss LS, Engelgau MM. Impact of diabetes mellitus on mortality associated with pneumonia and influenza among non-Hispanic black and white US adults. Am J Public Health 1999;89:1715-21.