The term complication as employed in reference to a chronic disease is commonly used to refer to an associated disease as well as to a condition more directly the result, per se, of the primary condition.
In diabetes, a vascular complication, or associated vascular disease, is considered, as to degree at least, to be the direct result of the disturbed metabolic state, or greatly aggravated by it in both tempo and time.
Many pathologic conditions observed in the diabetic person are most favorably influenced through our ability to control the diabetes. Thus, for example, the person with controlled diabetes is less susceptible to infection and acidosis than the one with uncontrolled diabetes. Surgical procedures, acute and elective, trauma, neoplastic disease and even pregnancy—this latter if especially approached—do not present to the surgeon and internist a more formidable problem in the diabetic person than in the nondiabetic.
Premature vascular disease, with
PALMER LJ. MEDICAL AND SURGICAL VASCULAR COMPLICATIONS OF DIABETES. JAMA. 1948;138(5):351-353. doi:10.1001/jama.1948.02900050019006