Type 2 Diabetes Complications and How to Prevent Them

Hypoglycemia

Hypoglycemia is one of the most common short-term effects of type 2 diabetes. Blood sugar levels change throughout the day. If your blood sugar drops too low, it can be dangerous.

Symptoms of low blood sugar include:

• feeling anxious, hungry, or weak
• nausea
• sweating or feeling clammy
• dizziness or lightheadedness
• headaches
• tingling or numbness in hands or feet

Extremely low blood sugar can even cause fainting or seizures.

Monitor your blood sugar to prevent hypoglycemia. If you have symptoms or if your sugar is below 70 mg/dl, attempt to raise it by following the American Diabetes Association’s “15-15 Rule.”

Eat 15 grams of carbohydrates, wait 15 minutes, and check again. If it’s still too low, try again. Once things are back to normal, have a normal meal or a nutrient-dense snack. This will help to prevent hypoglycemia from recurring.

Hyperglycemia

Hyperglycemia is high blood sugar. Eating more carbohydrates or sugar than your body can handle can sometimes causes hyperglycemia.

Symptoms of hyperglycemia include:

• thirst
• increased urination
• too much sugar in your urine

You can check your urine for ketones with an at-home urine test kit if your doctor has confirmed you’re experiencing hyperglycemia through testing. If a urine test shows ketones, you should not exercise — it can be harmful. Read more on this below.

Talk with your doctor about the safest ways for you to lower your sugar levels.

Diabetic ketoacidosis

Ketoacidosis is sometimes called diabetic ketoacidosis or DKA. Ketoacidosis is a dangerous, life-threatening condition.

Ketoacidosis happens when your body doesn’t have enough insulin. When this happens, your body starts to break down fats to convert into energy. While this might sound helpful, it’s not — it creates ketones.

Ketones are a waste product, so your body tries to get rid of them with increased urine production. Unfortunately, your body can’t produce or get rid of enough urine to get ketones to a manageable level. The ketones then move to the blood, where they build up, leading to ketoacidosis.

Ketoacidosis must be treated immediately. Symptoms to watch for include:

• shortness of breath or heavy breathing
• extremely dry mouth
• nausea and vomiting
• fruity-smelling breath

If you have any of these symptoms, seek medical help immediately.

Hyperosmolar hyperglycemic state

This rare, but serious, condition is more common in people who are older or people who are sick with a coexisting illness or infection.

Hyperosmolar hyperglycemic nonketotic state/syndrome (HHNS) is when blood sugar is too high but no ketones are present. This is an emergency condition that must be treated immediately.

Symptoms of HHNS are severe and specific:

• vision loss
• hallucinations
• weakness down one side of the body
• confusion
• extreme thirst
• fever or warm skin without sweat

It’s always important to monitor your blood sugar levels, but it’s absolutely vital if you’re otherwise ill. If your sugar is too high, contact your doctor. If your sugar is too high and you’re experiencing any of the symptoms of HHNS, seek emergency help.

High blood pressure

People with type 2 diabetes should always monitor their blood pressure. High blood pressure, also called hypertension, is both a short- and long-term problem that can lead to very serious issues. These include:

• heart attack
• stroke
• vision problems
• kidney disease

People with type 2 diabetes should aim for blood pressure below 140/80 (below 130/80 if you already have kidney or vision complications or any kind of cerebrovascular disease).

Take steps to keep blood pressure in check. A low-sodium diet, regular exercise, and stress reduction can help. If you smoke, consider cutting back or quitting.

Your doctor can also prescribe medications to help treat hypertension.

Cardiovascular disease

Over time, unmanaged blood sugar can damage your arteries. Diabetes also tends to raise triglycerides and LDL cholesterol, which is the “bad” cholesterol that can clog your arteries and increase your risk of heart attack.

People with diabetes are more likely to develop cardiovascular or heart disease. To prevent this, talk with your doctor about addressing the main risk factors:

• manage your blood pressure and cholesterol levels
• maintain a moderate weight
• eat balanced and nutrient-dense foods
• exercise regularly if you can

If you smoke, consider cutting back or quitting. Smoking increases the risk of heart disease in people with diabetes.

Stroke

Most strokes occur when a blood clot blocks a blood vessel in the brain. People with diabetes are 1.5 times more likely to have a stroke, according to the American Diabetes Association.

Other factors that may increase your risk of a stroke include:

• high blood pressure
• smoking
• heart disease
• high cholesterol
• being overweight or having obesity

If you have any of these risk factors, talk with your doctor about treatment to lower your risk.

Vision problems

Diabetes can cause damage to the tiny blood vessels in your eyes. This increases your chances of developing serious eye conditions like:

• glaucoma, when fluid pressure builds up in your eye
• cataracts, or the clouding of the lens of your eye
• diabetic retinopathy, when blood vessels in the back of your eye (retina) become damaged

These conditions can result in vision loss and even blindness over time.

Make sure to schedule regular eye exams with an ophthalmologist. Any change in your vision should be taken seriously.

Early detection of vision problems can prevent serious problems. For example, early detection of diabetic retinopathy, for example, can prevent or postpone blindness in 90 percent of people with diabetes.

Foot ulcers

Damage to nerves and circulation problems caused by diabetes can lead to foot problems, like foot ulcers.

If an ulcer forms and isn’t addressed, it can become infected and lead to gangrene or even amputation.

You can prevent these issues with proper foot care. Here are some steps you can take:

• Keep your feet clean, dry, and protected from injury.
• Wear comfortable, well-fitting shoes with comfortable socks.
• Check your feet and toes frequently for any red patches, sores, or blisters.
• Contact your doctor right away if you notice any foot problems.

Nerve damage

Your risk for nerve damage and pain, known as diabetic neuropathy, increases the longer you’ve had type 2 diabetes. Neuropathy is one of the most common diabetes complications.

There are different kinds of diabetic neuropathy. If it affects your hands and feet, it’s called peripheral neuropathy. If it affects the nerves that control organs in your body, it’s called autonomic neuropathy.

Depending on what parts of the body are affected, symptoms may include:

• numbness, tingling, or burning in your hands or feet
• stabbing or shooting pains
• vision problems
• sensitivity to touch
• chronic pain
• diarrhea
• loss of balance
• weakness
• loss of control of bladder or bowels (incontinence)
• erectile dysfunction in people who have a penis
• vaginal dryness in people who have a vagina

Gastroparesis

If blood sugar levels remain high over a long period of time, damage to the vagus nerve can occur. The vagus nerve is the nerve that controls the movement of food through the digestive tract. This is another kind of autonomic neuropathy.

Gastroparesis happens when the vagus nerve is damaged or stops working. When this happens, the stomach takes longer than it usually does to empty its contents. This is called delayed gastric emptying.

Symptoms of gastroparesis include:

• nausea and vomiting
• heartburn
• feeling of fullness
• bloating
• loss of appetite
• weight loss
• stomach spasms

Gastroparesis can make it more difficult to manage blood glucose levels since food absorption is less predictable. The best way to prevent gastroparesis is to manage your blood sugar levels over time.

If you do develop gastroparesis, you’ll need to work with your doctor to adjust your insulin regimen.

Try to avoid eating high fiber, high fat foods, as they take longer to digest. Eating small meals throughout the day instead of fewer large meals can also help prevent gastroparesis.

Kidney damage

Not monitoring and managing blood sugar levels or blood pressure can lead to kidney disease. Over time, high levels of blood sugar can impair your kidney’s ability to filter waste. It’s essential to keep your blood glucose and blood pressure levels managed to prevent this.

There are different risk factors associated with kidney disease. Genetics plays a part, so if you have a family history of kidney disease, talk with your doctor.

Some of the symptoms of kidney disease are so common they can be overlooked, like weakness or sleep problems. For people with type 2 diabetes, the most common sign is protein in the urine. Talk with your doctor to schedule regular visits to check for protein.

Mental health

Scientists don’t yet fully understand the link between diabetes and mental health. But they do know that people with diabetes are at a higher risk of experiencing certain conditions, including anxiety, stress, and depression.

Diabetes can be stressful and emotionally draining. If you’re starting to feel isolated or sad because of your diabetes, or if you feel like your stress is increasing, it can be helpful to talk with a mental health professional.

Ask your doctor for a referral to a mental health professional experienced in working with people with diabetes. You should also consider taking an antidepressant or anti-anxiety medication if your doctor recommends it.

Dementia

Researchers are still trying to understand the connection between dementia-related conditions and type 2 diabetes. There’s some evidence that high blood sugar or high insulin can cause harm to the brain.

Research has shown some associations with an increased risk for the following cognitive conditions:

• mild cognitive impairment
• Alzheimer’s disease
• vascular dementia

A 2021 study found that having diabetes at a younger age may increase the likelihood of developing dementia. More research needs to be done to determine all of the reasons for this association.

A 2020 study seemed to indicate that people living with type 2 diabetes were 36 percent more likely to develop vascular dementia than those without diabetes. But they didn’t find that there was an increased risk of Alzheimer’s disease.

Tooth decay

In poorly managed diabetes, small blood vessels often become damaged. This includes the small blood vessels that help nourish your teeth and gums, which puts you at increased risk of tooth decay, gum infections, and periodontal disease.

According to the American Dental Association, periodontal disease occurs in 22 percent of people with diabetes.

To reduce your risk of dental issues, see a dentist every 6 months for a checkup. Brush your teeth with a fluoride-containing toothpaste, and floss at least once a day.

You can prevent long-term effects of type 2 diabetes with lifestyle changes, medications, and being proactive about your diabetes care.

• Keep blood sugar levels within the recommended range. Talk with your doctor or diabetes educator if you aren’t sure about your blood glucose target.
• Consider making changes to your diet and exercise routine, if you can. Avoid sugar and high-carbohydrate, highly processed foods. This includes candy, sugary drinks, white bread, rice, and pasta. All of this can help you maintain a healthy weight.
• Take care of your mental health. Find ways to reduce stress. You can also be on the lookout for signs of depression.
• Consider cutting back on or quitting smoking.

Assemble a healthcare team and schedule regular checkups. Your primary care physician can help you understand which specialists you should be visiting on a regular basis.

Be sure to regularly visit your doctor for a checkup, even if you don’t have any new symptoms. Early treatment can help prevent diabetes-related complications.

You can still live a long life free of complications with type 2 diabetes. Greater awareness of the risk factors is the key to reducing the impact of diabetes on your body.