A nurse provides diabetic education at a public health fair. Which disorders should the nurse include as complications of diabetes mellitus? (Select all that apply.)

Choice A rationale: Stroke, also known as a cerebrovascular accident, is a significant macrovascular complication of diabetes mellitus. Chronic hyperglycemia damages the endothelial lining of blood vessels, leading to the formation of atherosclerotic plaques. These plaques can rupture, forming thrombi that obstruct blood flow to the brain, causing ischemic stroke. Hypertension, a common comorbidity, also increases stroke risk by damaging vessel walls. Choice B rationale: Kidney failure, specifically diabetic nephropathy, is a major microvascular complication. Persistent hyperglycemia causes glomerular hyperfiltration and damage to the small blood vessels and filtering units (glomeruli) in the kidneys. This leads to protein leakage (albuminuria), which progresses to a decrease in the glomerular filtration rate, ultimately resulting in end-stage renal disease and the need for dialysis or kidney transplantation. Choice C rationale: Blindness, specifically diabetic retinopathy, is a primary microvascular complication. Chronic high blood glucose levels damage the tiny capillaries supplying the retina, causing them to leak fluid or close off completely. This can lead to the growth of new, fragile blood vessels (proliferative retinopathy) that are prone to bleeding, scarring, and retinal detachment, causing irreversible vision loss or blindness. Choice D rationale: Respiratory failure is not a direct complication of diabetes mellitus. While conditions like diabetic ketoacidosis can lead to Kussmaul respirations (deep, rapid breathing) as a compensatory mechanism, this is not considered respiratory failure. Respiratory failure is more often associated with primary pulmonary diseases, severe infections, or neuromuscular disorders. Choice E rationale: Cirrhosis, a late-stage liver disease, is not a direct complication of diabetes mellitus. While non-alcoholic fatty liver disease (NAFLD) is prevalent in individuals with diabetes and metabolic syndrome, and can progress to cirrhosis, it is not an inevitable or direct consequence of the disease itself. Cirrhosis is more directly caused by chronic viral hepatitis, alcohol abuse, or other liver diseases.