Impact of Diabetes Complications

Smokovski, Ivica

Diabetic ketoacidosis, an acute diabetes complication, is associated with up to 40–80 times higher risk for mortality in developed compared to developing countries. Diabetes is a major risk factor for increased morbidity and mortality in people infected in the recent pandemic of COVID-19, especially in presence of diabetes complications. People with diabetes in developing countries have higher prevalence of cardiovascular diseases due to the higher prevalence of smoking, uncontrolled hypertension and uncontrolled dyslipidemia. Healthcare systems in developing countries that do not include routine screening for diabetic retinopathy face the burden of proliferative retinopathy and blindness, taking a huge toll on the limited resources. The prevalence of end stage renal disease requiring dialysis is ten times higher in diabetes compared to non-diabetes population. Diabetic foot ulcers and amputations are more common in low- and middle-income countries. Direct and indirect costs related to diabetes and its complications exert enormous burden on the budgets, threatening to bankrupt the healthcare systems and countries. Frequent screening for diabetes complications results in early diagnosis and treatment, and is a cost-effective approach compared to treatment of advanced complications, particularly under conditions with limited resources.