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.