Complications of Diabetes in the United States
Heart Disease and Stroke
- In 2004, heart disease was noted on 68 percent of diabetes-related death certificates among people ages 65 years or older.
- In 2004, stroke was noted on 16 percent of diabetes-related death certificates among people ages 65 years or older.
- 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.
- In 2005–2008, of adults ages 20 years or older with self-reported diabetes, 67 percent had blood pressure greater than or equal to 140/90 millimeters of mercury (mmHg) or used prescription medications for hypertension.
Blindness and Eye Problems
- Diabetes is the leading cause of new cases of blindness among adults ages 20–74 years.
- In 2005–2008, 4.2 million—28.5 percent—people with diabetes ages 40 years or older had diabetic retinopathy, and of these, 655,000—4.4 percent of those with diabetes—had advanced diabetic retinopathy that could lead to severe vision loss.
- Diabetes is the leading cause of kidney failure, accounting for 44 percent of all new cases of kidney failure in 2008.
- In 2008, 48,374 people with diabetes began treatment for end-stage kidney disease.
- In 2008, a total of 202,290 people with end-stage kidney disease due to diabetes were living on chronic dialysis or with a kidney transplant.
Nervous System Disease
- About 60 to 70 percent 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, erectile dysfunction, or other nerve problems.
- Almost 30 percent of people with diabetes ages 40 years or older have impaired sensation in the feet, for example, at least one area that lacks feeling.
- Severe forms of diabetic nerve disease are a major contributing cause of lower-extremity amputations.
- Periodontal, or gum, disease is more common in people with diabetes. Among young adults, those with diabetes have about twice the risk of those without diabetes.
- Adults ages 45 years or older with poorly controlled diabetes—A1C above 9 percent—were 2.9 times more likely to have severe periodontitis than those without diabetes. The likelihood was even greater—4.6 times—among smokers with poorly controlled diabetes.
- About one-third of people with diabetes have severe periodontal disease consisting of loss of attachment—5 millimeters or more—of the gums to the teeth.
Complications of Pregnancy
- Poorly controlled diabetes before conception and during the first trimester of pregnancy among women with type 1 diabetes can cause major birth defects in 5 to 10 percent of pregnancies and spontaneous abortions in 15 to 20 percent of pregnancies. On the other hand, for a woman with pre-existing diabetes, optimizing blood glucose levels before and during early pregnancy can reduce the risk of birth defects in their infants.
- Poorly controlled diabetes during the second and third trimesters of pregnancy can result in excessively large babies, posing a risk to both mother and child.