Priority Medicines for Europe and the World 2013 Update. Background Paper 6 - Priority Diseases and Reasons for Inclusion. BP 6.04 - Diabetes
(2013; 59 pages)


Diabetic hyperglycaemia (i.e. excessive blood sugar) is associated with potentially devastating long-term damage, dysfunction, and failure of various organs. The eyes, kidneys, nerves, heart, and blood vessels are especially prone to such complications. Long-term complications include retinopathy with potential loss of vision, nephropathy leading to renal failure, peripheral neuropathy with pain and risk of foot ulcers, and amputation. People with diabetes are also at increased risk of cardiovascular (CVD), peripheral vascular, and cerebrovascular diseases, thus public health systems cannot approach diabetes without addressing with its associated co-morbidities.

Diabetes profoundly affects quality of life and represents a life-long burden on a patient’s social support system. The impact of diabetes and its sequelae is enormous. In many countries:

  • Diabetes is the leading cause of new blindness in people aged 20–74 years
  • Diabetes is the leading cause of kidney disease requiring dialysis
  • As a result of the effects of diabetes on nerve and peripheral vascular tissue, diabetes is the most common cause of amputation
  • People with diabetes suffer heart disease two to four times more frequently than people without diabetes
  • Persons with diabetes suffer strokes two to four times more frequently than those without diabetes
  • The rate of congenital malformation in offspring of diabetic mothers may be as high as 10 per cent, and fetal mortality occurs in 3 to 5 per cent of pregnancies.
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