Diabetes complications: why good values pay off

Why does too much sugar in the blood cause harm at all? Put simply, over years excess sugar “gums up” fine structures in vessels and nerves. Two areas are affected: the small and the large blood vessels.

The two groups: small and large vessels

In the small vessels (microvascular), three organs are mainly affected: the eyes (retina, retinopathy), the kidneys (nephropathy) and the nerves (neuropathy, often first in the feet). In the large vessels (macrovascular), the risk rises for heart attack, stroke and circulatory problems in the legs and feet.

The lever: good values work measurably

That good control pays off is impressively documented. In the large UKPDS study, each 1-percentage-point improvement in the long-term marker HbA1c markedly lowered the risk of microvascular complications (on the order of about a third fewer).¹ Notable is the so-called legacy effect: early good control keeps having an effect years later. As a rough guide, an HbA1c around 7% applies for many – but the exact target is always set individually.

Detect early: the preventive checks

Many complications develop unnoticed for a long time – which is why regular checks are so valuable: the eyes (retinal examination), the kidneys (urine and blood values such as eGFR) and the feet (skin, sensation, circulation). When changes are found early, a lot can usually be done before symptoms arise.

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