Prevention of Microvascular Complications of Diabetes

Global prevalence estimates from 2019 suggest that the number of people diagnosed with diabetes was 463 million and is projected to increase to 700 million by the year 2045.1 The growing prevalence and increase in life-years spent with diabetes has a significant impact on the development of macrovascular and microvascular complications and places a huge societal and financial burden on almost every health care system in the world.2 Although, declining trends in cardiovascular complications, cardiovascular-related mortality and lower extremity amputation rates have been reported over the last 2 decades, particularly from high-income countries including Europe and North America, the global burden of cardiovascular disease, blindness due to retinopathy, and end-stage kidney disease (ESKD) in people with diabetes compared with those without has increased alarmingly.3 The “DISCOVER” observational study program from 2014 to 2019 reported that the global crude prevalence of microvascular complications in people with type 2 diabetes was 18.8%, being highest in Europe (23.5%) and lowest in Africa (14.5%).4 Among individuals with a median duration of type 2 diabetes of 4.1 years, the prevalence of peripheral neuropathy was 7.7%, chronic kidney disease 5.0%, and albuminuria 4.3%.