Diabetes mellitus and its many complications
S. Sethu K. Reddy, MengHee Tan
Abstract
Diabetes mellitus is a chronic endocrine/metabolic disease with heterogeneous etiologies (mainly via insulin deficiency and/or insulin resistance) and varied clinical presentations. “He who knows syphilis knows medicine” said Sir William Osler, over a century ago. In 2020, we can say the same about diabetes and its many complications, including the well-known classic microvascular (retinopathy, nephropathy, and neuropathy), and macrovascular (coronary artery disease, cerebrovascular disease, peripheral arterial disease) complications. There are lesser known complications involving bone (osteoporosis, increased fracture risk, impaired fracture healing, and increased bone infections), dental (periodontal disease, gingivitis, and possibly osteonecrosis), and musculoskeletal (sarcopenia, cheiroarthropathy, diabetic myonecrosis, trigger finger, frozen shoulder, rotator cuff tendinopathy, Charcot arthropathy, diffuse idiopathic skeletal hyperostosis, and others) systems. All diabetes complications add a burden to the affected individual and to society. Both the direct and indirect costs (healthcare and related loss of productivity), impact families, friends, and public health programs.