Diabetes mellitus is a common multisystemic disorder with serious effects on the gastrointestinal tract, genitourinary system and soft tissues. The long-term effects of diabetes are mainly related to macro- and microvascular disease, neuropathy, both autonomic and somatic, and to an increased susceptibility to infections, which generally develop 15-20 years after the appearance of overt hyperglycemia. Herein, we discuss the unusual long-term complications related to the disease that can display a characteristic CT pattern. CT, together with clinical findings, proved useful in the identification and characterization of such unusual pictures. Knowledge of the specific pathology and imaging features of unusual late effects related to the disease is of paramount importance for the correct management of diabetic patients.