Microvascular Complications of Diabetes

Persistent hyperglycemia damages the smallest vessels that nourish the retina, glomeruli, and peripheral nerves. Endothelial dysfunction, capillary basement-membrane thickening, inflammation, and impaired blood flow leave these tissues vulnerable to leakage, ischemia, and progressive cell injury. The clinical consequences differ by organ: - In the retina, leaking and occluded capillaries cause retinopathy, macular edema, ischemia, and abnormal new-vessel growth. - In the peripheral nerves, metabolic injury and reduced microvascular perfusion impair sensory fibres, producing pain, numbness, and loss of protective sensation. - In the kidneys, glomerular injury permits albumin to enter the urine before filtration necessarily declines. Glycemic control matters, but it is not the only target. Elevated blood pressure accelerates capillary injury, and dyslipidemia contributes to retinal and vascular disease. Effective prevention therefore combines glycemic, blood-pressure, lipid, kidney, and foot-risk management.