We’re all trained to recognize the signs of high and low blood sugar. But do you know the signs of a serious complication?

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Photography by Aya Brackett

On the surface, managing type 2 diabetes seems like a numbers game. Checking blood glucose numbers, going to the lab for bloodwork, and dealing with the daily highs and lows of this condition are all part of the job description.

As patients, we put a lot of pressure on ourselves to “perform” in terms of our numbers, so we tend to focus on our glucose management in the immediate moment and not put much attention on the long-term effects of diabetes until we have something to worry about.

This means the symptoms of high and low blood sugar are more commonly known and recognized as warning signs.

Signs of high blood sugar:

  • sleepiness
  • excessive thirst
  • blurry vision
  • frequent urination

Signs of low blood sugar:

  • shakiness
  • hunger
  • sweating
  • feeling nervous or anxious
  • irritability

But what about complications beyond the highs and lows? How do we know when something more serious is brewing?

Here are five symptoms you shouldn’t ignore if you’re living with type 2 diabetes.

Typically, when we think of neuropathy associated with type 2 diabetes, we think of tingling in our feet, described as pins and needles. Neuropathy is nerve damage caused by long-term high blood glucose.

Though it commonly begins in the feet, neuropathy can also affect the arms, hands, and legs. Neuropathy also causes numbness, which means you may not notice a cut or sore on your foot until it is already infected.

It’s important to get into a consistent foot care routine that involves daily self-checks at home, as well as having a foot examination at every doctor’s appointment.

Diabetes can have a serious impact on your vision, even causing blindness. Diabetic retinopathy, a condition where the retina’s blood vessels are damaged by high blood glucose levels, is one of the most common causes of blindness in adults.

In the early stage of diabetic retinopathy, there may be no obvious symptoms. As the condition advances, the retina begins to grow new blood vessels that aren’t as strong, and these vessels may bleed, causing the dark spots in your vision.

Since there may not be any noticeable symptoms in the early stage of diabetic retinopathy, it’s imperative to keep up with annual visits to the eye doctor to detect any possible problems.

People with diabetes are 1.5 times more likely to have a stroke than people without diabetes. A stroke happens when the blood supply to the brain is temporarily blocked.

Other signs of stroke include:

  • double vision
  • mobility issues
  • trouble speaking
  • headaches
  • dizziness
  • confusion

Every small step you take toward increasing your physical activity and incorporating heathy eating is a step in the right direction toward risk reduction. These improvements, along with keeping your blood pressure, cholesterol, and blood sugar in range, can help prevent a stroke.

What’s the link between diabetes and hearing? Blood sugar that is consistently high or consistently low can cause damage to blood vessels in various areas of the body, including the ears. This damage can cause hearing loss.

Hearing loss is twice as common in people with diabetes as it is in their peers without diabetes. It’s important to note that even people diagnosed with prediabetes are at a 30 percent higher rate of hearing loss than those with blood sugar levels that are in range.

Signs of hearing loss can include:

  • trouble following conversations
  • asking people to repeat themselves
  • trouble hearing in a loud environment
  • turning up the TV volume
  • difficulty hearing small children or other soft-spoken individuals

If you notice a difference in your hearing, be sure to mention it to your doctor.

Loss of interest in your favorite activities

It may surprise you that there is a strong link between diabetes and depression. Depression is a medical condition that causes sadness and a loss of interest in daily life activities, even your favorites. It can influence how you function in the community, at work, and how you take care of yourself and your diabetes.

People with diabetes are 2 to 3 times more likely to be diagnosed with depression as those without diabetes.

Other signs of depression include:

  • overeating or not wanting to eat
  • insomnia or sleeping too much
  • feeling hopeless
  • feeling very tired
  • having trouble concentrating
  • having thoughts of suicide or death

If you feel you might have depression, please reach out to your doctor as soon as possible to get help with treatment options.

As you can see, type 2 diabetes management is about so much more than the numbers. Paying attention to your body’s signals, scheduling and keeping doctors’ appointments, and staying consistent with healthy habits is equally important.

By making yourself a priority now, you can greatly reduce your risk of diabetes complications later.

Mary Van Doorn lives in Georgia with her husband, their two kids, three dogs, and three cats. She’s a type 2 diabetes advocate and the founder of Sugar Mama Strong and Sugar Mama Strong Diabetes Support. When she’s not taking care of the kids, the house, or the zoo, you can find her binge-watching her favorite shows: “Grey’s Anatomy,” “This is Us,” and “A Million Little Things.”