Complications

Mortality in diabetic adults with heart disease is two to four times higher than in nondiabetic persons, and strokes occur two to four times more often in diabetic patients. Approximately three quarters of diabetic adults have high blood pressure. Diabetic retinopathy is now the leading cause of blindness in adults, and DM is also the leading cause of endstage renal disease (44% of all cases). About two thirds of diabetic patients have some form of neural damage (e.g., peripheral neuropathy, gastroparesis, carpal tunnel syndrome, erectile dysfunction). Younger diabetic adults are twice as likely to have periodontal disease, and all those with poorly controlled diabetes are three times more likely to have gum disease. GDM poorly controlled in the first trimester can cause major birth defects (5%-10% of pregnancies) and spontaneous abortions (15%-20%).

The total direct costs (costs of medical care and services) and indirect costs (disability, work loss, premature mortality) of diabetes in 2007 were an estimated $174 billion ($116 billion for direct, $58 billion for indirect).

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