Diabetes Complications covers the long-term consequences of uncontrolled or long-standing diabetes — eye disease (retinopathy that can lead to blindness), kidney disease (nephropathy that can lead to dialysis), nerve damage (neuropathy with pain, numbness and foot ulcers), and accelerated vascular damage causing heart attack, stroke and non-healing wounds. Most of these develop silently over 5-15 years, usually well before symptoms show, which is why annual eye exams, kidney tests, and foot checks matter more than waiting for something to hurt. Our endocrinologists, ophthalmologists, nephrologists and podiatry teams explain what to screen for and when, what early signs to catch at home, and how tight sugar and blood pressure control, no smoking, and targeted therapies like ACE inhibitors and statins genuinely change the trajectory rather than merely tracking it.
Last reviewed: 11 August 2026
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Expert answers from our medical team
Chronically high sugar damages small and large blood vessels. Small-vessel damage causes retinopathy (eyes), nephropathy (kidneys), and neuropathy (nerves). Large-vessel damage speeds up atherosclerosis, causing heart attack, stroke, and poor blood flow to the legs. Complications develop silently over 5-15 years — usually before symptoms appear — which is why routine screening tests matter more than waiting for something to hurt.
Every diabetic adult needs a dilated retinal examination by an ophthalmologist within 5 years of type 1 diagnosis (or at diagnosis for type 2), then annually. Early diabetic retinopathy has no symptoms — by the time you notice blurred vision, damage is often advanced. Laser treatment and newer anti-VEGF injections prevent blindness when caught early. Don't skip the yearly eye check even if your vision feels fine.
Annually — a urine test for microalbumin (protein leak) and a blood test for creatinine (kidney filtration). Microalbumin appears years before creatinine rises, giving a warning window when ACE inhibitors or ARBs (a class of blood pressure medications) can slow damage significantly. Poor sugar control, high blood pressure, and smoking all speed nephropathy — controlling these three is the single most important thing to protect kidneys.
Diabetic neuropathy starts with numbness, tingling, or burning in the toes and feet, gradually working upward — 'stocking-and-glove' pattern. It's often worse at night. Once nerves are damaged, sensation is reduced, so small injuries (a stone in the shoe, ill-fitting sandals, a cut trimming a toenail) go unnoticed and become infected. Daily foot inspection, well-fitting footwear, moisturized skin, and prompt doctor visits for any wound are the pillars of preventing foot ulcers and amputations.
Yes — even people with diabetes for 20+ years often have no complications if they've maintained good control. The pillars: HbA1c under 7% (or your individualized target), blood pressure under 130/80, LDL cholesterol under 100, no smoking, annual eye/kidney/foot examinations, and prompt treatment when anything abnormal appears. Complications are largely a function of years of poor control — not diabetes itself.
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