If not managed effectively, Type 2 diabetes can cause both short- and long-term complications, including stroke and high blood sugar.

Inadequately managed blood sugar can lead to a range of health issues over time.

The longer you’ve had diabetes, the higher your risk for complications.

In this article, we discuss some of the complications of type 2 diabetes, how to prevent them, and when you should talk with your doctor.

Type 2 diabetes can cause short-term complications that include:

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 help prevent hypoglycemia. If you have symptoms or if your sugar is below 70 mg/dl, attempt to raise it by following the “15-15 Rule.”

Eat 15 grams of carbohydrates (such as a tablespoon of honey or 4 ounces of juice), wait 15 minutes, and check again. If it’s still too low, repeat. Once your levels have recovered, have a regular meal or nutrient-dense snack. This will help prevent hypoglycemia from recurring.

Hyperglycemia

Hyperglycemia is high blood sugar. Eating more carbohydrates or sugar than your body can handle can sometimes cause 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, as it can be harmful. Read more on this below.

Talk with your doctor about the safest ways 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 does not have enough insulin. When this happens, your body starts to break down fats to convert them into energy. While this might sound helpful, it actually creates ketones.

Ketones are a waste product, so your body tries to get rid of them with increased urine production. Your body cannot 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, get 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 or general weakness
  • confusion
  • extreme thirst
  • fever or warm skin without sweat

It’s always important to monitor your blood sugar levels, but it’s especially 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 medical 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 serious complications. These include:

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, such as:

Your doctor can also prescribe medications to help treat hypertension.

Type 2 diabetes can also cause chronic, long-term complications, such as:

Cardiovascular disease

Over time, blood sugar that is not well managed 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 at a higher risk of developing cardiovascular or heart disease. To help prevent this, talk with your doctor about addressing primary risk factors through the following methods:

  • managing your blood pressure and cholesterol levels
  • maintaining a moderate weight
  • following a balanced and nutritious eating plan
  • staying as physically active as possible, such as exercising

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

Stroke

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

Other factors that may increase your risk of 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, which occurs when fluid pressure builds up in your eye
  • cataracts, which is the clouding of the lens of your eye
  • diabetic retinopathy, which occurs when blood vessels in the back of your eye (retina) become damaged

These conditions can lead to 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 and treatment of vision problems can prevent serious problems. For example, early detection of diabetic retinopathy can prevent or postpone blindness in 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 it is not addressed, it can become infected and lead to gangrene or even amputation.

Proper foot care can help you prevent these issues. Some steps you can take include:

  • keeping your feet clean, dry, and protected from injury
  • wearing comfortable, well-fitting shoes with comfortable socks
  • checking your feet and toes frequently for any red patches, sores, or blisters
  • contacting 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 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 usual 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.

If you have gastroparesis, 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.

Kidney damage

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

Different risk factors are associated with kidney disease. Genetics plays a part, so if you have a family history of kidney disease, consider talking with your doctor.

Some of the symptoms of kidney disease, such as weakness or sleep problems, are so common they can be overlooked. 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. However, 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.

A doctor can provide 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 the reasons for this association.

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

Tooth decay

When diabetes is not managed well, small blood vessels often become damaged, including the small blood vessels that help nourish teeth and gums. When damage occurs, the risk of tooth decay, gum infections, and periodontal disease increases.

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

To help reduce your risk of dental issues, experts recommend seeing a dentist every 6 months for a checkup, brushing your teeth with fluoride-containing toothpaste, and flossing at least once daily.

You can prevent the long-term effects of type 2 diabetes through lifestyle changes, medications, and being proactive about your diabetes care. Recommendations include:

  • Keeping blood sugar levels within the recommended range: If you are unsure about your blood glucose target, talk with your doctor or diabetes educator.
  • Following a health-promoting dietary plan and staying as physically active as possible: For example, limit or avoid sugar and high carbohydrate, highly processed foods. These include candy, sugary drinks, white bread, rice, and pasta. Following these recommendations can help you maintain a healthy weight.
  • Taking care of your mental health: Engaging in stress-relieving activities is helpful. Also, keep an eye out for symptoms of depression and consider talking with a healthcare or mental health professional to get support if needed.
  • Cutting back on or quitting smoking if you smoke: Smoking increases the risk of many type 2 diabetes complications.

What is the most common complication of type 2 diabetes?

Neuropathy, or nerve damage, is one of the most common complications of type 2 diabetes.

What is the life expectancy for a person with type 2 diabetes?

Many people with well-managed type 2 diabetes have a life expectancy similar to people without diabetes, according to 2024 research. Certain complications, such as cardiovascular disease, may affect the outlook.

How does type 2 diabetes affect your life?

If you have type 2 diabetes, you may need to make changes to your eating pattern and physical activity routine and take medications to manage your blood sugar levels. Blood sugar that is not well managed can cause complications, including cardiovascular disease and nerve damage, that may affect your quality of life.

If you have type 2 diabetes, doctors recommend assembling a healthcare team and scheduling regular checkups. A primary care physician can help you understand which specialists you may need to visit on a regular basis.

It’s important to schedule and keep routine checkups with your medical team, even if you don’t have any new symptoms. Early treatment can help prevent diabetes-related complications.

You can live a long life free of complications with type 2 diabetes. Knowing the risk factors and monitoring your health are important in reducing the effect of diabetes on your body.