What are the long-term vascular complications of diabetes?

Written by: Professor Luigi Gnudi
Edited by: Carlota Pano

In this article, Professor Luigi Gnudi, renowned consultant diabetologist and endocrinologist, provides an expert insight into the major chronic vascular complications of diabetes. The London-based specialist discusses symptoms, prevention and treatment, among other important points.



What are the major chronic vascular complications of diabetes?


Sugar is not always sweet, and diabetes can damage your vessels, both the big and the small ones. Once the damage to the vessel has occurred, it is very difficult (if not impossible) to repair it, so prevention is key.


Vascular complications of diabetes manifest in two ways:

  • Microvascular complications involving the eyes, kidney and nerves.
  • Macrovascular complications affecting bigger vessels, which manifest with: peripheral vascular disease, heart disease, strokes, claudication (pain in the legs while walking); and feet ischaemia / non-healing ulcers.


How can patients prevent vascular complications?


Apart from good lifestyle habits (exercise, not smoking, moderate alcohol, being normoweight), glycaemic, blood pressure, and lipid control are crucial. Further, specific types of drugs have also proven to offer particular benefits for the prevention of chronic vascular complications.


What should patients do to ensure they are reviewed regularly?


Patients who have diabetes should be reviewed regularly to prevent and/or delay the progression of vascular complications if these are present.


Diabetes is the major cause of blindness, end stage renal disease (and renal replacement therapy, e.g. dialysis), and poses a significant increase in cardiovascular morbidity and mortality.


How can patients manage diabetic chronic vascular complications with their doctor?


Regular reviews will allow your doctor to:

  • Assess the progression of vascular complications
  • Support you in the engagement with the disease
  • Help you with the management of diabetes
  • Choose the best treatment for you


Have there been recent advancements in the treatment of chronic vascular complications?


In the last five years, there has been a tremendous advancement in the treatments available for the prevention and the delay in progression of chronic vascular diabetic complications.


These treatments have been shown to be extremely useful for the treatment of cardio-renal vascular disease in patient who have diabetes.



Professor Luigi Gnudi is an award-winning consultant diabetologist and endocrinologist with over 35 years’ experience.


If you have developed chronic vascular complications of diabetes, do not hesitate to book an appointment with Professor Gnudi via his Top Doctors profile today to receive expert treatment and management.

By Professor Luigi Gnudi
Endocrinology, diabetes & metabolism

Professor Luigi Gnudi is a leading, award-winning consultant diabetologist and endocrinologist based in central London who specialises in diabetes, hypothyroidism and hyperthyroidism alongside obesity, amenorrhoea and lipid disorders. He privately practises at The Lister Hospital, London Claremont Clinic and Italian Doctors clinic while his NHS base is Guy's and St Thomas' NHS Foundation Trust. 

Professor Gnudi, who further treats an extensive list of endocrinology conditions including menopause, Graves' disease and polycystic ovary syndrome (PCOS), is highly qualified with MD and PhD awards. He also has FRCP FASN and FICP fellowships from London, Italy and the United States. He obtained his MD with Honours from the University of Parma and then joined the residency programme at the School of Diabetes and Endocrinology at the University of Padua where he completed his specialist training in 1993.

Professor Gnudi also worked as a postdoctoral fellow at Beth Israel Hospital at Harvard Medical School in Boston, USA, from 1992 to 1995. In 1999, he obtained his PhD in Endocrinological Sciences from Milan University in Italy, and in 2005 he became a Fellow of the Royal College of Physicians and the American Society of Nephrology. 

Professor Gnudi, who is the head of the Metabolic Medicine, Professor of Diabetes and Metabolic Medicine within the School of Cardiovascular and Metabolic Medicine & Sciences at King's College London, speaks frequently at national and international meetings. He is active researcher and also has had over 100 research papers published in peer-reviewed journals.

He is the subject editor for various peer-reviewed journals too, and is a member of several professional organisations. These include Diabetes UK, the European Association for the Study of Diabetes and the American Diabetes Association. He's also a member of the American Society of Nephrology, the European Diabetic Nephropathy Study Group and ERA-EDTA.

The awards for his research include The Diabetes Research Excellence Award from the American University of Beirut, the Ruth Osterby Price Lecture, the Prof M. Viswanathan Honour Award Oration, and the Candlelight Lecture.

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