Macrovascular Complications

Macrovascular complications are related to the large blood vessels or arteries in your body. When your blood sugar levels are high, your blood becomes thick and syrupy. This requires your heart to pump harder to push the blood around your body. This extra work puts strain on your heart and can damage your blood vessels.

Cardiovascular Disease

People with diabetes are at an increased risk of having a heart attack or stroke. A heart attack is caused by a hardening of the large blood vessels that supply the heart, where as a stroke is caused by a hardening of the large blood vessels supplying the brain. This hardening of the large blood vessels can also cause the development of blood clots that break off and travel around your body. High blood sugar levels and high levels of fat in your blood contribute to this hardening and clot formation. It is important to have both your blood glucose and blood cholesterol levels in target range to reduce this risk.

Peripheral Vascular Disease

Peripheral vascular disease (PVD) is also a common complication of diabetes. PVD is a condition where a hardening of your large blood vessels and the formation of blood clots reduce blood flow to your limbs. The lack of blood flow to the limbs can result in symptoms such as leg pain.


Hypertension, or high blood pressure, occurs frequently in people with diabetes. High levels of sugar in your blood along with narrowing of your arteries caused by uncontrolled diabetes can increase your blood pressure. Blood pressure can also be influenced by your intake of alcohol and salt. Your doctor may prescribe you medications to help lower your blood pressure.

Microvascular Complications

Microvascular complications are related to the small blood vessels in your body. When your blood sugar levels are high blood your blood vessels can harden and clots can form. These clots can break off and block or break the small blood vessels in different parts of your body.


Diabetes is the number one cause of blindness in Canada. Diabetic retinopathy, also known as eye disease is when damage occurs to the back of the eye (retina). The retina is the part of the eye that sends the images you see to your brain. There are two ways that diabetes can damage your retina. Uncontrolled or high blood sugar can cause swelling in the retina, or can cause the small blood vessels at the back of your eye to break causing blood to leak into your eye. Both of these can eventually lead to blindness.

Retinopathy like many other aspects of diabetes is progressive. In the beginning stages, you may have no symptoms of retinopathy, or you may experience blurriness or other changes in your vision. As retinopathy worsens blood clots may float in your eye causing spots in your vision. Eventually parts of your retina will die causing blindness.

Many people experience blurred vision in the early stages of diabetes. This blurred vision is caused by fluid leaking into the lens of the eye, changing its shape and causing vision changes. Once diabetes and blood sugar levels are under control this swelling will disappear and your normal vision will return. Blurred vision can also occur when starting insulin therapy or when blood sugar levels are fluctuating. Be patient as this is temporary, and as your blood sugar levels get closer to normal your vision should improve.

It is important to see an optometrist or ophthalmologist once per year to monitor for retinopathy.


Nephropathy is also known as kidney disease, and is a complication often linked with long standing diabetes. Almost 50% of people with diabetes will develop kidney damage at some point in their life. The kidneys job is to filter waste out of your blood and remove it from your body in your urine. Your kidneys are also important in helping to manage your blood pressure. If you imagine inside your kidney to be like a coffee filter, the high levels of sugar in uncontrolled diabetes punch small holes in the filter allowing things beyond waste (such as protein) to leak into your urine. Protein in your urine is called proteinuria, and is a sign of kidney disease. Without treatment, your kidneys will eventually stop working, and will likely require dialysis or a kidney transplant.

For more information on diabetic nephropathy visit


Diabetic neuropathy is a complication of long standing diabetes that causes damage to the peripheral nerves (nerves that run to the hands and feet). While the nerve damage can happen in many parts of the body, the most common symptoms of neuropathy are burning, tingling, or numbness in the hands and feet. Neuropathy puts people with diabetes at an increased risk of developing pressure ulcers on their feet. These ulcers can go unnoticed and become infected. If the infection is left untreated, gangrene can develop and amputation may be needed.

It is important to inspect your feet everyday if you have diabetes. Your doctor or podiatrist can test the development of neuropathy in your feet with a simple painless test by pressing a monofilament to different areas of your foot. If you have type 1 diabetes you should have monofilament tests every year starting 5 years after your diagnosis. If you have type 2 diabetes, you should have monofilament tests every year starting at diagnosis. If you have not had a monofilament test, request to have one done by your doctor.

Foot Care

For support in dealing with neuropathy visit the Calgary Neuropathy Association website.

Erectile Dysfunction

Erectile dysfunction (ED) is defined as the persistent inability to get or maintain an erection that is satisfactory for sexual activity, and most men at some point in their life will experience it. However, ED is much more common in men with diabetes, almost 50% will experience ED within 6 years of diagnosis. High blood sugar levels damage the walls of the blood vessels and can impair blood flow to the penis, causing ED. Nerve damage from diabetes can also impair the ability to get and maintain an erection. Some medications given to men with diabetes can also contribute to ED.

Talk to your doctor if you are experiencing ED as there are many ways they can help.