The prevalence of multiple diabetes-related complications

Aims To determine the prevalence of the complications of diabetes and the i nterrelationship between them within a United Kingdom district health autho rity population. Methods Data extracted from a general practice diabetes audit were combined with data for patients with diabetes derived from a patient index construc ted using record linkage techniques. Results A total of 10 709 patients were identified as having diabetes (prev alence 2.47%). Coronary heart disease was present in 25.2%, cerebrovascular disease in 9.6%, complications of the 'diabetic foot' in 18.1%, retinopath y in 16.5% and nephropathy in 2.0%. Over a half of the patients (52.1%) had none of the studied complications, 30.2% had one, 12.7% had two, 4.1% had three, 0.8% had four and 0.1% had all five. All complications were related to both age and duration of diabetes but duration was particularly apparent for the microvascular complications (retinopathy and nephropathy). Macrova scular complications in the Type 2 diabetic population appear advanced in o nset compared with Type 1. Conclusions Multiple complications are apparent in almost one fifth of pati ents with diabetes. Macrovascular morbidity in Type 2 diabetes of early ons et indicates that a targeted approach to treatment may prove most beneficia l in both patient and health service terms.