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3: Preventing complications of diabetes

Med J Aust 2003; 179 (9): 498-503.

Summary

  • Diabetes complications are common and almost triple the annual cost of managing diabetes.

  • Microvascular complications are the major risk in type 1 diabetes, while macrovascular complications are the major cause of morbidity and mortality in type 2 diabetes.

  • Control of hyperglycaemia (target HbA1c level ≤ 7%) and hypertension (target blood pressure ≤ 130/80 mmHg) prevents microvascular complications in both types of diabetes; a multifactorial approach, comprising behaviour modification and pharmacological therapy for all risk factors, reduces the development of micro- and macrovascular complications in type 2 diabetes.

  • The benefit of treating dyslipidaemia is at least as great in the diabetic population as in the non-diabetic population.

  • Angiotensin-converting enzyme inhibitors and low-dose aspirin are indicated in people with diabetes and other cardiovascular risk factors.

  • Regular annual screening for diabetes complications allows treatable disease to be identified.

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  • Katherine L Bate1
  • George Jerums2

  • Endocrinology Unit, Austin Health, Melbourne, VIC.

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