Type 2 Diabetes

What Are the Possible Complications of Type 2 Diabetes, and How Can You Avoid Them?

Valencia Higuera
Moira Lawler
By
and
Kacy Church, MD
by
eye problems and heart disease and stroke
Cardiovascular diseases are common diabetes complications.Canva; Everyday Health

If you have type 2 diabetes, you already know that smart medication, diet, and lifestyle choices can help you maintain healthy blood sugar levels and enjoy an excellent quality of life.

But in some cases, despite your best efforts to manage the disease, issues can arise.

Warding off the serious and sometimes fatal health complications linked with type 2 diabetes starts with being aware of their potential to affect you. Then, it’s important to take steps to decrease the risk of developing them.

5 Ways To Lower Your Risk Of Diabetic Kidney Disease

Diabetic nephropathy, also called diabetic kidney disease, is a common and serious complication of diabetes. In order to prevent or delay the onset, there are essential lifestyle factors to take into consideration.
5 Ways To Lower Your Risk Of Diabetic Kidney Disease

Next up video playing in 10 seconds

What Causes Health Complications of Diabetes?

Type 2 diabetes occurs when your blood sugar level remains consistently high because of a condition called insulin resistance.

During digestion, your body converts carbohydrates into sugar, and then your pancreas releases a hormone called insulin to help your cells absorb this sugar. But with insulin resistance, your body doesn’t use insulin properly, which forces your pancreas to work harder to produce enough insulin to meet your body’s needs.

Hyperglycemia occurs when your pancreas can’t keep up and your blood sugar rises to an unhealthy level. Persistent hyperglycemia can lead to diabetes complications because too much sugar in the bloodstream can cause tissue, organ, and nerve damage, and weaken the immune system.

Hyperglycemia can develop gradually over days or weeks, and symptoms include frequent urination, increased thirst, fatigue, headache, and blurry vision.

Risk Factors for Type 2 Diabetes Complications

To avoid complications of type 2 diabetes, it’s imperative that you take care of yourself and keep your blood sugar under control.

That means taking your diabetes medication correctly — the proper dosage at the right time, every time.

It’s also important to maintain a healthy weight and good cholesterol levels.

Any factor that interferes with your body’s ability to use insulin properly can increase your chances of developing health complications. This includes a sedentary lifestyle, because activity and regular exercise can help your body improve insulin resistance and lower your blood sugar levels.

 Plus, regular exercise can help you maintain a healthy weight, and losing just 5 to 7 percent of your body weight has been shown to improve blood sugar.

 Meanwhile, managing your weight could even help reverse type 2 diabetes, according to a study published in 2017.

Stress, illnesses, alcohol, exercise, and certain medicines can also affect your blood sugar levels.

How Common Are Diabetes Complications?

While the prevalence of all diabetes complications is unknown, the longer you live with diabetes, the greater your chances are of developing further health issues.

Side effects or complications of diabetes can be short-term (acute) or long-term (chronic). Short-term means the problem can develop quickly at any time, and long-term means the problem generally develops later or more slowly over a period of time.

Possible Short-Term Complications of Diabetes

Sexual Issues

Because high blood sugar can damage nerves in the genital area, some people with type 2 diabetes have sexual side effects. This complication affects up to 75 percent of men and 42 percent of women with diabetes at some point.

 Nerve damage can cause weak ejaculation, and some women experience painful sexual intercourse and can’t achieve orgasm. If a person is unable to manage their glucose levels, these side effects can worsen over time.

Diabetic Coma

Even though diabetic comas are rare, there’s the risk of unconsciousness with hyperglycemia and hypoglycemia (abnormally low blood sugar).

Hypoglycemia can arise from excessive insulin, typically from drugs such as sulfonylureas or insulin. Unconsciousness happens when your brain doesn’t receive a sufficient amount of glucose to function properly. Early warning signs of hypoglycemia include hunger, sweating, and shaking.

A diabetic coma can also occur with hyperglycemic hyperosmolar syndrome. This condition is more common in the elderly and people with other chronic illnesses, but it can occur in anyone with poor control of diabetes.

 When your blood sugar level rises, your body compensates for the higher level by eliminating extra glucose through urination. This process can lead to severe dehydration, causing a variety of complications, including muscle breakdown and even loss of consciousness. This is a potentially fatal complication that requires immediate medical attention.

Diabetic Ketoacidosis

This condition mainly affects people with type 1 diabetes but can also occur as a rare complication of type 2 diabetes.

 Like the process that leads to hyperosmolar hyperglycemic nonketotic coma, this process can lead to severe dehydration. But a deficiency of insulin also leads to ketone production.
With insulin deficiency, sugar can’t be absorbed into cells, and the body can’t use glucose for energy, so it starts burning fat for energy. This process causes the body to produce toxic acids called ketones. A buildup of ketones in the bloodstream can poison the body and also lead to a diabetic coma.

The risk of ketoacidosis increases when you’re sick, when you miss a meal, or if you skip an insulin dose or don’t inject enough insulin.

 Your body produces more cortisol and adrenaline when sick, which can counteract the effects of insulin and raise your blood sugar

 Check your blood sugar every four hours while sick, and go to the emergency room if your blood sugar is lower than 60 milligrams per deciliter (mg/dL).

Diarrhea From Medication Use

Diarrhea can be a sign of medication intolerance. For example, some people with diabetes take the oral medication metformin (Metformin Eqv-Fortamet) to treat high blood sugar.

 This is usually the first line of treatment for type 2 diabetes, but it can also cause side effects such as nausea, constipation, and diarrhea. Side effects vary from mild to severe and typically go away once your body adjusts to the medication. GLP1 agonists may also result in diarrhea.

Possible Long-Term Complications of Diabetes

Diabetic Neuropathy and Amputation

High blood sugar can damage nerves in the body, including those in the lower extremities, such as the legs and feet. This complication can cause diabetic nerve pain, bone and joint pain, numbness, poor blood circulation, and ulcers.

 If left untreated, an ulcer can become infected, and reduced blood flow can result in amputation of a toe, foot, or leg.
Diabetic neuropathy — the term used to describe nerve damage from diabetes — affects about 50 percent of people with diabetes.

 Risk factors include uncontrolled blood sugar, being overweight, smoking, kidney disease, and a long history of diabetes.

Eye Problems

Chronic high blood sugar can also damage the blood vessels in the back of the eye. This condition is known as diabetic retinopathy, and it affects more than 40 percent of people who have diabetes.

 The risk of this complication increases the longer you have diabetes. Because diabetic retinopathy can lead to blindness, it’s important to contact your doctor immediately if you notice any vision changes.
Having diabetes also nearly doubles your risk of glaucoma, which is an eye disease that develops as a result of damage to your optic nerve.

Additionally, persistent high blood sugar can cause a cataract or swelling in the lens of the eye.

 This can affect vision and clarity.

Heart Disease and Stroke

Heart disease and stroke are other complications of diabetes. High blood sugar causes hardening of the blood vessels, which can contribute to high blood pressure.

 Elevated blood sugar can also thicken blood, causing the heart to work harder to deliver blood throughout your body.
High blood pressure increases the risk of heart disease and stroke. In fact, people with diabetes are two to four times more likely to develop cardiovascular disease. Cardiovascular disease is the most common cause of death for people with diabetes.

Kidney Disease

About 25 percent of people living with diabetes will develop kidney disease. Persistent high blood sugar can damage blood vessels in the kidney.

 This decreases kidney function and can result in kidney failure if diabetes remains uncontrolled. Being a smoker and having high cholesterol or high blood pressure increases the risk. There’s also a greater risk if you have a family history of diabetes and kidney disease.

Sleep Apnea

Sleep apnea is when breathing pauses while you’re asleep. Symptoms of sleep apnea include daytime fatigue, loud snoring, and waking up coughing or choking.

This condition sometimes goes undiagnosed, but it’s estimated that up to 86 percent of people with type 2 diabetes also have obstructive sleep apnea. The more severe the case of sleep apnea, the harder it is to control glucose level.

 If left untreated, sleep apnea can cause high blood pressure, heart disease, and sudden death.

Diabetic Dermopathy

When the blood vessels that supply the skin with blood become damaged as a result of diabetes, oval or circular light brown, scaly spots can develop on the skin. Diabetic dermopathy usually occurs on the fronts of the legs.

This condition is harmless, and the skin patches don’t usually hurt or itch. Treatment isn’t necessary, and spots may disappear on their own.

Gum Disease

Nearly 22 percent of people with diabetes have periodontal disease, which develops as a result of bacteria camping out in your gums.

 High blood sugar can encourage bacteria to grow.

Better blood sugar management can prevent gum disease or keep it from spreading. But if the disease progresses, your gum line may start to recede and the bones supporting your teeth can weaken, resulting in tooth loss.

Poor blood sugar control is a risk factor for gum disease, along with poor dental hygiene and tobacco use. People who have diabetes are more likely to develop gum disease than people without diabetes.

Cancer

Type 2 diabetes may increase your risk of cancer, including breast, pancreatic, uterus, colon, liver, and bladder cancer, likely because high glucose levels in the blood may cause DNA damage.

 The risk of cancer is higher if you’re overweight, don’t exercise, and smoke.

How to Prevent Complications of Diabetes

Diabetes is unpredictable, but you can take steps to prevent complications. More than anything else, make sure your diabetes is well controlled. This includes taking diabetes medication as prescribed and never skipping a dose.

It also means making sure your A1C is in your target range. While your goal will vary depending on your doctor’s recommendation, having an A1C of less than 7 percent can prevent complications of diabetes.

Also, learn how to recognize signs that your diabetes therapy isn’t working, and then speak with your doctor before complications arise. These signs include increased hunger, increased urination, fatigue, blurry vision, and headaches.

Tips to prevent complications include:

  • Lose weight.
  • Eat a balanced, healthy diet with plenty of fruits, vegetables, and lean meats.
  • Monitor your intake of carbohydrates and sugary foods.
  • Manage your cholesterol and blood pressure.
  • Exercise for at least 30 minutes most days of the week.
  • Check your blood sugar level frequently when sick.
  • Get seven to nine hours of sleep.
  • Don’t smoke.
  • Get annual physicals, vaccines, and eye examinations.
  • Drink alcohol in moderation.
  • Manage stress (stress hormones can increase insulin resistance).

How Doctors Diagnose Diabetes Complications

If you have type 2 diabetes symptoms, your doctor may perform several tests to diagnose a complication. These include:

Blood Sugar Testing This test evaluates the amount of sugar in your bloodstream and can help your doctor determine whether your current diabetes treatment is working.

Retina Exam Eyedrops are used to dilate or widen your pupils, and then your doctor uses a machine to take a picture of your retina. This test assesses the health of your eyes and can help diagnose diabetic retinopathy.

Foot Examination Your doctor examines your feet for signs of infection, nerve damage, and poor circulation.

Cholesterol and Blood Screening Your doctor will draw a blood sample to check your cholesterol and also test to see if your blood pressure is within a healthy range. High blood pressure and cholesterol increase the risk of heart disease, kidney disease, stroke, and vision problems.

Kidney Screening You’ll provide a urine sample to see if there’s protein in your urine. Protein can be a sign of kidney damage.

Treatment for Diabetes Complications

Treatment for diabetes complications involves controlling your blood sugar. When your blood sugar is very high, taking an insulin dose through injection or intravenously can help stabilize your blood sugar and help you begin to feel better.

 For more serious complications, treatment varies and depends on the specific problem.
For example, treatment for diabetic retinopathy usually involves laser surgery to reduce the size of blood vessels in the eye and stop the leaking.

If you have early-stage kidney disease, lowering your blood pressure and cholesterol and taking medication can reduce protein in your urine and improve your condition. On the other hand, late-stage kidney disease may require dialysis or a kidney transplant.

Doctors will come up with a treatment plan after determining the severity of the condition.

Summary

Type 2 diabetes isn’t a disease to be taken lightly. So it’s important to take your medication as prescribed and to be open and honest with your doctor. Don’t ignore unusual symptoms of diabetes. These could indicate that your current therapy is no longer working, which puts you at risk for potentially serious complications.

Editorial Sources and Fact-Checking

Everyday Health follows strict sourcing guidelines to ensure the accuracy of its content, outlined in our editorial policy. We use only trustworthy sources, including peer-reviewed studies, board-certified medical experts, patients with lived experience, and information from top institutions.

Sources

  1. Insulin Resistance and Prediabetes. National Institute of Diabetes and Digestive and Kidney Diseases.
  2. Hyperglycemia in Diabetes: Symptoms and Causes. Mayo Clinic.
  3. Diabetes Care: 10 Ways to Avoid Complications. Mayo Clinic.
  4. It’s a Great Time to Get Moving. American Diabetes Association.
  5. Prediabetes — Your Chance to Prevent Type 2 Diabetes. Centers for Disease Control and Prevention.
  6. GP Based Weight Loss Programme Can Reverse Type 2 Diabetes. BMJ.
  7. What Affects Blood Sugar Levels. Diabetes.co.uk.
  8. Diabetes: Symptoms and Causes. Mayo Clinic.
  9. Diabetes, Sexual, and Bladder Problems. National Institute of Diabetes and Digestive and Kidney Diseases.
  10. Diabetic Hyperglycemic Hyperosmolar Syndrome. MedlinePlus.
  11. Diabetic Coma: Symptoms and Causes. Mayo Clinic.
  12. Diabetes and DKA (Ketoacidosis). American Diabetes Association.
  13. Diabetic Ketoacidosis: Symptoms and Causes. Mayo Clinic.
  14. Managing Sick Days. Centers for Disease Control and Prevention.
  15. Metformin (Oral Route). Mayo Clinic.
  16. Adverse Effects of GLP-1 Receptor Agonists. The Review of Diabetic Studies.
  17. Diabetic Neuropathy. National Institute of Diabetes and Digestive and Kidney Diseases.
  18. Diabetic Neuropathy: Symptoms and Causes. Mayo Clinic.
  19. Diabetic Retinopathy. National Eye Institute.
  20. Diabetes, Heart Disease, and Stroke. National Institute of Diabetes and Digestive and Kidney Diseases.
  21. Diabetes and Heart Disease. Johns Hopkins Medicine.
  22. Diabetic Nephropathy (Kidney Disease): Symptoms and Causes. Mayo Clinic.
  23. Sleep Apnea: Symptoms and Causes. Mayo Clinic.
  24. Can Long-term Treatment of Obstructive Sleep Apnea With CPAP Improve Glycemia and Prevent Type 2 Diabetes? Diabetes Care.
  25. Diabetes and Skin Complications. American Diabetes Association.
  26. Diabetes and Dental Health. MouthHealthy.
  27. Gum Disease. Diabetes.co.uk.
  28. Gum Disease and Other Diseases. American Academy of Periodontology.
  29. Diabetes and Cancer: What’s the Link? National Foundation for Cancer Research.
  30. A1C Test: About. Mayo Clinic.
  31. Diabetes. Cleveland Clinic.
  32. Screening for Diabetes Complications. Diabetes.co.uk.
  33. Insulin Routines. American Diabetes Association.
  34. Chronic Kidney Disease: Diagnosis and Treatment. Mayo Clinic.

Resources

Show Less