What Are the Microvascular Complications of Diabetes?

What Are the Microvascular Complications of Diabetes?

Diabetes is a chronic metabolic disorder characterized by persistently elevated blood glucose levels (ie, hyperglycemia) resulting from impaired insulin production or utilization.1 The disease affects millions of people worldwide and can lead to both acute and chronic complications. Among the most common debilitating long-term complications of diabetes are its microvascular (ie, small blood vessels) complications. They arise due to chronic hyperglycemia causing damages to the tiny blood vessels, particularly in the eyes, kidneys, and nerves, leading to severe health consequences. The three main types of microvascular complications of diabetes include: diabetic retinopathy, diabetic nephropathy, and diabetic neuropathy. 

Diabetic Retinopathy

Diabetic retinopathy is an eye condition marked by vision loss and is one of the leading causes of blindness in adults worldwide.2,3 Prolonged hyperglycemia in diabetes can cause damages to the tiny blood vessels in the retina, developing hemorrhages (ie, bleeding), microaneurysms (ie, tiny outpouchings of blood from blood vessels), and neovascularization (ie, growth of new blood vessels). Overtime, this may lead to retinal detachment, macular edema (ie, swelling), and vision loss. Managing blood glucose levels, having regular eye examinations, and receiving timely treatment are critical in preventing and managing diabetic retinopathy. 

Diabetic Nephropathy

Diabetic nephropathy is also known as diabetic kidney disease.4 Uncontrolled hyperglycemia, insulin resistance, and high blood pressure (ie, hypertension) can cause structural and functional changes to the kidney, leading to progressive worsening of kidney function marked by proteinuria (protein found in urine) and hypertension.5 Intensive management of blood glucose levels, blood pressure, and blood lipids with lifestyle modifications and pharmacological interventions can delay progression of diabetic nephropathy.6 Without appropriate management, diabetic nephropathy can progress to end-stage renal disease that may require dialysis or kidney transplantation. 

Diabetic Neuropathy

Diabetic neuropathy includes various nerve disorders that result from damages to the peripheral nerves, leading to numbness, pain, and loss of sensation in the extremities.7 Although most commonly present in the extremities, autonomic neuropathy can also affect the gastrointestinal, cardiovascular, and genitourinary systems. Maintaining glycemic control, receiving regular foot care, and managing symptoms are important to prevent the development of foot ulcers and to reduce risk of amputations.


1. Fowler MJ. Microvascular and Macrovascular Complications of Diabetes. Clinical Diabetes. 2008;26(2):77-82. doi:10.2337/diaclin.26.2.77
2. Cheung N, Mitchell P, Wong TY. Diabetic Retinopathy. Lancet. 2010;376(9735):124-136. doi:10.1016/S0140-6736(09)62124-3
3. Wang W, Lo ACY. Diabetic Retinopathy: Pathophysiology and Treatments. Int J Mol Sci. 2018;19(6):1816. doi:10.3390/ijms19061816
4. Alicic RZ, Rooney MT, Tuttle KR. Diabetic Kidney Disease. Clin J Am Soc Nephrol. 2017;12(12):2032-2045. doi:10.2215/CJN.11491116
5. Varghese RT, Jialal I. Diabetic Nephropathy. In: StatPearls. StatPearls Publishing; 2022. Accessed December 13, 2022. http://www.ncbi.nlm.nih.gov/books/NBK534200/
6. Thomas MC, Brownlee M, Susztak K, et al. Diabetic Kidney Disease. Nat Rev Dis Primers. 2015;1(1):1-20. doi:10.1038/nrdp.2015.18
7. Pop-Busui R, Boulton AJM, Feldman EL, et al. Diabetic Neuropathy: A Position Statement by the American Diabetes Association. Diabetes Care. 2017;40(1):136-154. doi:10.2337/dc16-2042



The content of this article is intended to provide a general information and knowledge on the subject matter. The views expressed in newsletters, articles, and blogs in the i-SENS USA website are not necessarily those of i-SENS Incorporated, i-SENS USA Incorporated or our publishers. Medical or nutritional information on i-SENS USA website is not intended to replace professional medical advice – you should always consult a specialist with any questions about your specific circumstances.

Add a comment