While many who view diabetes as a simple sugar problem know the short-term effects of the disease, those who have diabetes or know someone who suffers from it are familiar with the long-term problems that can result from this ailment. Chronic complications are problems that need to be managed and dealt with over a longer period of time. Here are the long-term problems associated with diabetes.

Long-term elevation of blood glucose level leads to angiopathy, the damage of blood vessels. The endothelial cells lining the blood vessels don't depend on insulin, so they can take in more glucose than the normal amount. They then form more surface glycoproteins than normal. This causes the weakening of the basement membrane, which grows thicker as well. In diabetes, the resulting problems are generally referred to as "microvascular disease" (referring to the damage to the small blood vessels) and "macrovascular disease" (referring to the damage to the arteries).

The damage suffered by the small blood vessels results in microangiopathy, which can cause many different health problems, such as:

* Diabetic retinopathy, growth of poor-quality new blood vessels in the retina that can break easily. It also refers to macular edema, or the swelling of the macula, which can cause severe loss of vision or even total blindness. The retinal damage caused by microangiopathy makes it the most common cause of blindness among non-elderly adults in the United States.

* Diabetic neuropathy, nerve damage and the loss of sensation, generally starts with with the feet, but it can affect other nerves in the body, and often afflicts fingers and hands. When combined with damaged blood vessels, diabetic foot can develop. Other forms of diabetic neuropathy may be mononeuritis or autonomic neuropathy. Diabetic amyotrophy, another result, is muscle weakness that develops from the neuropathy.

* Diabetic nephropathy is damage to the kidney which can lead to renal failure, eventually requiring dialysis treatment. Diabetes is the most common cause of adult kidney failure worldwide.

* Diabetic cardiomyopathy, or heart damage, can lead to diastolic dysfunction and eventually heart failure.

Macrovascular disease leads to cardiovascular disease. This can also lead to artheroscoliosis:

* Coronary artery disease, including angina or myocardial infarction – commonly referred to as a "heart attack".

* Stroke

* Peripheral vascular disease, which contributes to severe leg and foot pain as well as diabetic foot, which leads to amputation.

* Diabetic myonecrosis

Diabetic foot results from a combination of numbness or insensitivity and vascular damage. This leads to an increases risk of skin ulcers and infection and, in serious cases, necrosis and gangrene. This is the reason why many diabetics are prone to leg and foot infections and why healing times from leg and foot wounds are so much longer. As mentioned above, it is the most common cause of adult amputation, usually of toes and or feet, that is not caused by an accident of some sort.

There are other health risks, but it is important to remember the most common long-term problems associated with diabetes. While some of these problems can be traced to a specific type of diabetes (Type 1 or Type 2), it is crucial to understand where they come from and how you can avoid them.