Diabetes complications and related health problems

Type 2 diabetes is what is known as a chronic health condition or disease. This means that it will affect you for the rest of your life. However, you can control type 2 diabetes and live a healthy life. When it comes to diabetes, you are the most important player on your care team. The lifestyle changes you make and knowledge that you acquire about preventing and/or delaying complications can make a big difference when it comes to living a full and healthy life.

Important things keep in mind…

Although you may be overwhelmed and shocked to learn that you have diabetes, keep in mind that most people with type 2 diabetes can:

  • Continue to lead a full and active life
  • Enjoy the foods and activities you’ve always enjoyed
  • Take part in almost any form of physical activity

Health complications associated with diabetes

What makes diabetes so dangerous is that it is associated with a long list of health complications: short- and long-term problems that can affect your health and quality of life.1

Short-term/Acute health problems

There are several serious short-term or acute complications that can affect people with diabetes. By short-term or acute, we mean health problems that happen in the present and can be resolved with the proper treatment. You are especially at risk for these complications if your diabetes is not under control. Short-term complications contrast with long-term complications that may take years and even decades to develop, if they every do. The important thing to keep in mind when it comes to both short- and long-term complications is that you can lower your risk for range of health problems by taking steps to control your blood sugar, blood pressure, and lipids.

Hypoglycemia.

Hypoglycemia is a short-term complication that affects many people with type 2 diabetes. It is the medical term for low blood sugar, defined by the American Diabetes Association (ADA) as a blood sugar level of 70 mg/dL or lower. Even though 70 mg/dL is the threshold for hypoglycemia, you may feel the effect of low blood sugar, including headache or dizziness, even before your blood sugar gets this low.2.3

Being aware of hypoglycemia and how to correct it is an essential part of your diabetes care plan. Low blood sugar can results from physical activity, especially in people with type 2 diabetes who are being treated with insulin or oral diabetes medications that cause insulin secretion (called secretagogues), including sulfonylureas and glinides (repaglinide and nateglinide), unless carbohydrate intake is not adjusted to compensate for the increased energy demands of physical activity.2.3

If you have type 2 diabetes (or other types of diabetes), it is important to recognize the signs and symptoms of hypoglycemia and to take steps to correct your low blood sugar. Signs and symptoms will vary from person to person, but may include sweating, trembling, feeling anxious, feeling weak, having difficulty with vision, and becoming confused. It is especially important to take steps to correct hypoglycemia when it occurs, because severe episodes can be life-threatening. When it comes to hypoglycemia, the best approach is to be prepared. This means that you should always have a quick-acting carbohydrate food or drink with you to help your correct your blood sugar rapidly when you need it.2.3

Learn more about hypoglycemia

Ketoacidosis.

Diabetic ketoacidosis is a dangerous short-term complication of diabetes that results from uncontrolled high blood glucose. When elevated blood glucose persists and is uncorrected, chemicals called ketones accumulate in the blood. Because a person with diabetes is unable to use glucose for energy, if they are not being treated properly, their body may burn fat instead to get energy. Burning fat causes the production of ketones, which can be toxic if they build up in the blood. While ketoacidosis is a complication that mostly affects people with type 1 diabetes, it can sometimes occur in people with type 2 diabetes.4

Ketoacidosis can affect someone with type 2 or type 1 diabetes who is not taking insulin as directed (in some cases, their insulin pump may not be working properly), or someone who is not getting a sufficient amount of insulin, or someone who is taking certain medications or illegal drugs that affect how insulin works. Additionally, a person with type 1 diabetes who has a major health problem, such as a heart attack or infection, is at risk for ketoacidosis. Ketoacidosis may also occur in a person with undiagnosed type 2 diabetes. Symptoms of ketoacidosis include extreme thirst, frequent urination (including during the night), fatigue, difficulty thinking clearly, and weight loss. In some cases, ketoacidosis can cause a person to go into a coma. Ketoacidosis should be treated as a medical emergency.4

Learn more about ketoacidosis

Hyperosmolar Syndrome

Hyperosmolar syndrome is a potentially dangerous short-term complication of diabetes that mostly affects elderly patients with either type 1 or type 2 diabetes. It occurs when a person with diabetes develops blood sugar that is extremely high. Unlike ketoacidosis, there little or no production of ketones occurs with hyperosmolar syndrome. The term hyperosmolar refers to increased levels of sugar and salts in the blood. Hyperosmolar syndrome can result in hyperosmolar nonketotic coma, which can be life-threatening and usually occurs in older adults with type 2 diabetes who stop taking diabetes medications as directed, develop an infection or other illness, become dehydrated, or take another medication that affects blood sugar levels.4

Learn more about hyperosmolar syndrome

Long-term health complications and associations

Diabetes is associated with a number of long-term complications, or health problems that may develop over years and decades. People who are at the highest risk for one or more long-term complications of diabetes are those who don’t adequately control their blood glucose, blood pressure, and lipids over the course of years.

Many of the most common and serious long-term complications associated with diabetes fall into two broad categories:

  • Macrovascular complications. These are complications affecting the large vessels of the body, including those involved in cardiovascular disease (heart attack and stroke)
  • – Microvascular complications. These are complications affecting the small vessels of the body and include kidney disease, diseases of the eye, and neuropathy (disease of the nerves).

Cardiovascular disease

People with type 2 diabetes face increased risk for a range of cardiovascular complications. This risk increases significantly if blood sugar, blood pressure, and lipids are uncontrolled. Most of these complications involve underlying atherosclerosis. Additionally, high blood pressure (hypertension) is also a common problem in people with type 2 diabetes and can increase the risk for cardiovascular complications.6

Cardiovascular complications associated with diabetes include heart disease, cerebrovascular disease, and peripheral vascular disease (diseases of the arteries outside of the chest and abdomen, such as those in the legs).

Learn more about cardiovascular complications related to diabetes.

Kidney disease

Uncontrolled diabetes can place a great deal of stress on kidney function and over time can cause kidney disease (also called diabetic nephropathy). This is because the kidney is the organ responsible for filtering and removing waste products from the blood (waste products are excreted in urine) and maintaining a critical balance of different substances (salt and water) in blood. In diabetes, excess blood glucose can make the kidney work overtime and can cause damage to the organ. Diabetes is the leading cause of kidney failure, accounting for up to half of all cases of kidney failure.6

Steps you can take to lower your risk for diabetes-associated kidney disease. If you have diabetes, studies have shown that you can prevent injury to your kidney by controlling your blood glucose and keeping your blood pressure under control. You can achieve these goals by eating a following a healthy eating plan and getting regular exercise, and quitting smoking, which has been shown to contribute to diabetic kidney disease. Also, your doctor may want you to take a blood pressure medication.6

If you have diabetes, you should have regular urine testing to determine whether kidney function is normal. If you have type 2 diabetes, your doctor will test your urine to measure excretion of a protein called albumin at least once a year. Measuring the amount of albumin in the urine can help determine whether your kidneys are functioning normally. An albumin level of greater than 30 mg per gram of creatinine is a sign of impaired kidney function.

Certain medications used to lower blood pressure called angiotensin receptor blockers (ARBs) and angiotensin converting enzyme inhibitors (ACE inhibitors) also decrease the amount of protein in the urine and can prevent or decrease the risk of developing diabetes-related kidney disease.1

Learn more about kidney complications related to diabetes

Disease of the eye

Diabetes (both type 1 and type 2) is the leading cause of new cases of blindness in the US population. Because we rely on our vision to engage in many of the ordinary activities of life, diabetes-related vision problems (called diabetic retinopathy) can among the scariest complications associated with the disease. Diabetic retinopathy results from the effects of high blood sugar on the small blood vessels in the eye. As with other complications associated with diabetes, keeping blood sugar under control is an important key to preventing or delaying vision problems.

If you have type 2 diabetes, it is important to have a dilated and comprehensive eye exam by an ophthalmologist or optometrist who is experienced in caring for patients with diabetes shortly after you are diagnosed. If there is no evidence of retinopathy, you should have follow-up check-ups on a schedule of every 2 years. If this exam finds of evidence of retinopathy, you will be referred to an ophthalmologist who is experience in management of diabetic retinopathy. There are various treatment options that can reduce the risk of vision loss.6

Neuropathy

Neuropathy (diseases of the nerves) are common long-term complications of diabetes, with as many as three-quarters of people with diabetes experiencing some sort of peripheral neuropathy (damage affecting the legs, feet, or arms). Nerve damage can range from mild to severe in nature and typically appears within 10 years of diagnosis or onset of diabetes. Controlling blood sugar is a key to improvement of neuropathy. Studies including the UK Prospective Diabetes Study (UKPDS) and the ADVANCE study have shown that keeping blood glucose close to normal has beneficial effects in terms of decreasing risk for neuropathy in people with type 2 diabetes.6

Learn more about nerve complications related to diabetes

Other diabetes complications and associated health problems

Beside cardiovascular, kidney, eye, and nerve disease, other long-term complications and health problems associated with diabetes include foot problem(with increased risk for amputation), resulting from a combination of peripheral neuropathy and peripheral vascular disease, problems affecting the skin, oral and dental complications, increased risk for certain infections, problems affecting sexual functioning, and psychosocial complications (such as depression).

Other long-term diabetes complications and associated health problems

Tell me more about…

Examples

Skin complications
  • Infections (bacterial, fungal)
  • Necrobiosis lipoidica diabeticorum
  • Diabetic dermopathy
  • Blisters, tags
  • Xanthomas
  • Intertrigo
  • Generalized granuloma annular
  • Acanthosis Nigricans
  • Scleredema
Foot complications
  • Neuropathy
  • Skin changes
  • Calluses
  • Circulatory problems
  • Deformities
Oral and dental complications
  • Gum disease
  • Gingivitis
  • Periodontitis
  • Dry mouth
Sleep disorders
  • Sleep apnea
  • Restless leg syndrome
  • Insomnia
Infections
  • Urinary tract (bladder, kidney)
  • Foot
  • Fungal (fingernails, toenails, or between toes)
  • Influenza
  • Pneumonia
  • Cellulitis
  • Rare infections exclusively associated with diabetes
Sexual health
  • Erectile dysfunction
  • Sexual dysfunction
Psychosocial complications
  • Depression
  • Anxiety
Written by: Jonathan Simmons | Last reviewed: May 2014.
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