Microvascular Disease Due to Diabetes

You are at greater risks for eye and kidney complications with this condition

Retinopathy

Diabetic retinopathy, the most common diabetic eye complication and the leading cause of blindness among U.S. adults, damages the retina, the light-sensitive nerve tissue at the back of the eye that transmits visual images to the brain. This damage is caused by changes in the tiny blood vessels that supply the retina.

In the early stages of retinopathy, called nonproliferative retinopathy, the retinal vessels weaken and develop bulges (microaneurysms) that may leak blood (hemorrhage) or fluid (exudate) into the surrounding tissue. Vision is rarely affected during this stage of retinopathy, but annual eye examinations should be performed by an ophthalmologist to ensure that the condition has not progressed. Later on, however, patients can develop proliferative retinopathy, when fragile new blood vessels begin to grow on the retina and into the vitreous humor, the jelly-like substance inside the back of the eye. These abnormal vessels are prone to rupture and bleed into the vitreous humor, causing blurred vision or temporary blindness.

Research studies show that maintaining good blood sugar control can reduce both the incidence and progression of retinopathy. Should proliferative retinopathy develop, it can be treated with laser surgery and vision can be preserved, if the retinopathy is detected early. About half of those with untreated proliferative retinopathy will become blind within five years, compared to just five percent of those who receive laser treatment. Regular eye exams offer the best chance of detecting retinopathy in its treatable stages.

Nephropathy

About 30 percent to 40 percent of people with Type 1 diabetes and 20 percent of those with Type 2 diabetes develop nephropathy (kidney damage) that can lead to kidney failure. The rate of nephropathy is decreasing, however, due to wide recognition of the benefits of intensive diabetes management, which can reduce the risk of kidney damage by 50 percent. Kidney damage can also be arrested with the use of ACE inhibitor medications.

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