TY - CHAP M1 - Book, Section TI - Diabetes Mellitus: Complications A1 - Powers, Alvin C. A1 - Stafford, John M. A1 - Rickels, Michael R. A2 - Jameson, J. Larry A2 - Fauci, Anthony S. A2 - Kasper, Dennis L. A2 - Hauser, Stephen L. A2 - Longo, Dan L. A2 - Loscalzo, Joseph PY - 2018 T2 - Harrison's Principles of Internal Medicine, 20e AB - Diabetes-related complications affect many organ systems and are responsible for the majority of morbidity and mortality associated with the disease. For many years in the United States, diabetes has been the leading cause of new blindness in adults, renal failure, and nontraumatic lower extremity amputation. More recently, diabetes has also emerged as a leading contributor to coronary heart disease (CHD). Diabetes-associated complications related to hyperglycemia usually do not appear until the second decade of hyperglycemia. In contrast, diabetes-associated CHD risk, related in part to insulin resistance, may develop before hyperglycemia is established. Because type 2 diabetes mellitus (DM) often has a long asymptomatic period of hyperglycemia before diagnosis, many individuals with type 2 DM have both glucose-related and insulin resistance-related complications at the time of diagnosis. Fortunately, many of the diabetes-related complications can be prevented or delayed with a focus on diet, fitness, early detection, aggressive glycemic control, and efforts to minimize the risks of complications. Recent studies show a decline in diabetes-related complications in individuals, but this is tempered by the increase in the number of individuals with diabetes. For example, the rate of myocardial infarction (MI) associated with diabetes declined by 67% between 1990 and 2010. SN - PB - McGraw-Hill Education CY - New York, NY Y2 - 2024/03/19 UR - accesspharmacy.mhmedical.com/content.aspx?aid=1183992628 ER -