Causes and prevention of complications

Major advances in recent years have resulted in an actual decrease of some complications, notably nephropathy. Primary prevention of diabetic complications, together with retardation of their progression, is now possible, chiefly by tight control of the diabetes and of hypertension, together with reduction of other "risk factors" detailed in chapter 17. Even when the complications are established, their progression leading to serious damage can be delayed.

Although many attempts have been made to develop specific pharmacological agents to alter the course of diabetic complications, and although many trials are in progress at the present time, none have proved unequivocally successful and none are licensed. There is at present intense interest in and optimism for the use of protein kinase-C inhibitors.

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