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Complications of diabetes are common, particularly those at high risk and include:
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Risk factors for the development of diabetic complications
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Onset of diabetes at a young age
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Advancing age
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Long duration of diabetes
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Suboptimal glycaemic control
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Pre-existing complications or comorbidities e.g. established cardiovascular disease, microalbuminura and/or reduced eGFR
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Māori or Pacific people ethnicity
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Non-European ethnicity
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Lower socioeconomic status
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Hypertension
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Dyslipidaemia
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Smoking
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Obesity
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Reduced adherence or attendance
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Microvascular complications
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Diabetic retinopathy
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Diabetic nephropathy
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Peripheral neuropathy
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Autonomic neuropathy including erectile dysfunction
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Macrovascular complications
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Cardiovascular disease
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Cerebrovascular disease
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Peripheral vascular disease
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Common associated conditions with diabetes:
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Recurrent skin and genitourinary infections
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Dental and periodontal disease
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Other features of metabolic syndrome e.g. gout, polycystic ovarian syndrome
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Mental health e.g. depression, dementia and disordered eating
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Cardiac e.g. congestive heart failure and atrial fibrillation
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Musculoskeletal e.g. frozen shoulder and myopathy
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Dermatological e.g. diabetic dermopathy and acanthosis nigricans
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Gastrointestinal e.g. fatty liver disease and diarrhea
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Solid cancers e.g. breast, bowel, lung, pancreas, ovarian cancers etc.
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These complications should be screened for at least annually in all patients with diabetes
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Annual screening should consist of:
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Most patients with diabetes die from macrovascular disease
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To aid decision making on antiplatelet and blood pressure and lipid lowering therapy
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Currently recommended cardiovascular risk calculators are:
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NB: Cardiovascular risk calculators typically underestimate risk in younger patients and/or those with a strong family history of cardiovascular disease
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Consideration of antiplatelet therapy if high cardiovascular risk
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Ensuring adequate contraception and that pregnancies are planned in women with diabetes of reproductive age
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Screening for commonly associated comorbidities with diabetes including depression and erectile dysfunction, and that recommended cancer screening is up to date
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Common associated comorbidities with diabetes
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Recurrent skin and genitourinary infections
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Dental and periodontal disease
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Other features of metabolic syndrome e.g. gout, polycystic ovarian syndrome
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Mental health e.g. depression, dementia and disordered eating
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Cardiac e.g. congestive heart failure and atrial fibrillation
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Musculoskeletal e.g. frozen shoulder and myopathy
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Dermatological e.g. diabetic dermopathy and acanthosis nigricans
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Gastrointestinal e.g. fatty liver disease and diarrhea
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Solid cancers e.g. breast, bowel, lung, pancreas, ovarian cancers etc.