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IntroductionThe World Health Organization defines Diabetes mellitus as a chronic disease caused by inherited and/or acquired deficiency in production of insulin by the pancreas or by the ineffectiveness of the insulin produced. The pancreas is a large gland behind the stomach which secretes digestive enzymes into the duodenum. Embedded in it are the islets of Langerhans, which secrete into the blood the hormones insulin and glucagon.

A more simplified definition by the Indian journal of endocrinol metabolism; Diabetes mellitus (DM) is described as a metabolic disorder characterized by hyperglycaemia that develops as a consequence of defects in insulin secretion, insulin action, or both.
As the disease progresses in the system, certain complications may arise, but this differ with individuals.

Categories of complications of Diabetes Mellitus

There are two broad categories of diabetes mellitus and they include;
1. Macrovascular
2. Microvascular

Macrovascular Complications of Diabetes Mellitus

These are diseases and conditions of the large blood vessels caused by diabetes, they can occur in blood vessels in any part of the body. Risk factors such as abnormalities in blood clotting, high cholesterol levels, high blood pressure, blood sugar, insulin resistance and smoking can contribute to macrovascular complications.
The three known macrovascular complications include heart disease, stroke, and peripheral arterial disease.

a. Stroke: Most diabetic patients have high blood pressure, and this can cause abnormalities in the small vessel of the brain leading to stroke.
b. Heart Disease: Patients with diabetes are at risk of heart disease and other heart related problems especially if diabetic neuropathy (microvascular complication) has set in.
c. Peripheral Arterial Disease: Diabetic patients are at higher risk for narrowing of the large vessels of their legs leading to poor circulation. This leads to poor circulation, impaired healing and serious infection.

Microvascular Complications of Diabetes Mellitus
These are diseases and conditions of the small blood vessels caused by diabetes. They include;

1. Diabetic Retinopathy: This is a complication of diabetes mellitus that affects the eye. It is caused by damage to the blood vessels in the tissue at the back of the eye (retina). Symptoms such as blurring vision, difficulty in identifying colours and eventually blindness can occur.
2. Diabetic Neuropathy: A type of nerve damage that can occur with diabetes mellitus. In Nigeria, more than 100 thousand cases per year are identified.
3. Diabetic Nephropathy: This is damage to the kidneys of diabetic patients and if critical can lead to kidney failure.

Management of Complications
Managing these complications include;
1. Nutrition
2. Control of blood glucose
3. Lifestyle and activity such as alcohol intake and smoking should be curbed.
4. Blood pressure should be checked regularly
5. Occasional laboratory analysis of fasting lipid profile and renal function tests

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