First and foremost, diabetes is a vascular disease. (Repeat this 20 times)

• That is, diabetes is a small vessel vascular disease with an endocrinologic and metabolic component.
• The endocrine part is related to either faulty insulin manufacture and release (Type 1) or end-organ resistance (Type 2). This leads to metabolic problems of :
• Glucose
• Lipids and even
• Proteins

But it's the small vessel narrowing and resulting tissue damage that leads to so many of the long term problems.

• Mrs. Six-Killer's kidney failure
• This indirectly leads to her anemia and
• Problems of fluid retention
• Esophagitis, pericarditis and pleuritis.
• Her lack of appetite and sense of bloating.
• In time it will doubtless lead to an amputation of foot, and increases a risk of her having a stroke or heart attack.
• All of these problems are due to the highly reactive nature of the glucose molecule.

Let's briefly consider what's happened to her kidneys.