Persistently high blood sugar levels associated with type 2 diabetes can have devastating health consequences down the road, but carefully monitoring your blood sugar and keeping it under control with medication and lifestyle changes will reduce the risk of related health problems, including heart disease. 

Here, we look at the most common complications of type 2 diabetes, how they occur, and what you can do to prevent them. or significantly delay their onset.

Heart disease

If you have diabetes, you’re twice as likely to develop heart disease or have a stroke as someone without diabetes. That’s because high blood sugar, over time, can damage the blood vessels and nerves of the heart. Additionally, people with diabetes are more likely to have high blood pressure and high cholesterol.

Coronary artery disease is the most common type of heart disease associated with type 2 diabetes. This is caused by the buildup of cholesterol plaques on the blood vessels that supply the heart with blood and oxygen, called the coronary arteries. Coronary artery disease is an important risk factor for heart attack and stroke. Plaque can also build up in the arteries of the legs and feet as well, a condition known as peripheral arterial disease that’s often the first sign that someone with type 2 diabetes has heart disease.

Heart failure is another condition associated with type 2 diabetes, which occurs when your heart can’t pump blood efficiently, leading to fluid buildup in the lungs and swelling in the legs. Early diagnosis and treatment of heart failure can relieve symptoms and slow or stop its progression. 

In addition to keeping your blood sugar levels under control, lowering your blood pressure, managing cholesterol levels, quitting smoking, and managing your stress levels are important ways you can reduce your risk of heart disease and stroke.

Kidney disease

Around one in three adults with type 1 or type 2 diabetes has chronic kidney disease, or CKD, which typically develops slowly and without many symptoms. In many cases, people don’t realize they have CKD until it’s advanced and dialysis or a kidney transplant is needed to survive. High blood sugar can, over time, damage the blood vessels in the kidneys, preventing them from working like they should. High blood pressure, which is common in people with type 2 diabetes, also damages the kidneys. 

People with diabetes should have regular blood and urine tests to check for kidney disease. If it’s caught early enough, CKD can be effectively treated to prevent it from progressing and causing additional health problems.

Nerve damage

Diabetic neuropathy is a common complication of diabetes that affects the nerves in the body. Over time, high blood sugar damages the nerves, which can cause numbness and pain. Around half of all people with diabetes have nerve damage, which is generally irreversible. However, keeping your blood sugar as close to your target level as possible can prevent or delay further damage to the nerves. 

The four major types of nerve damage that result from diabetes are:

Peripheral nerve damage

Peripheral nerve damage affects the extremities—the hands, feet, legs, and arms—and is the most common type of nerve damage. It usually starts in the feet and causes tingling, pain, or sensitivity, especially at night. It may also cause numbness or weakness as well as serious foot problems like infections, ulcers, and joint or bone pain.

Autonomic nerve damage

Autonomic nerve damage affects the stomach, intestines, eyes, bladder, heart, and sex organs, causing a range of problems, including gastrointestinal and vision issues, sexual dysfunction, and incontinence.

Proximal nerve damage 

This type of nerve damage affects the legs, hips, thighs, or buttocks as well as the stomach and chest. It can cause severe pain in the stomach or in the lower extremities, usually on one side of the body. Proximal neuropathy may cause weakness in the legs that makes it difficult to rise to a standing position, and it can lead to weight loss, muscle wasting, and the loss of reflexes. 

Focal nerve damage

Focal nerve damage affects individual nerves, typically in the hands, legs, torso, or head. It can cause double vision, problems focusing the eyes, aching behind the eyes, and numbness, tingling, or weakness in the hands or fingers. 

Oral health problems

High blood sugar can weaken white blood cells, which are essential for fighting mouth infections, people with type 2 diabetes have a high risk for oral health problems. When you have high levels of glucose in your blood, you also have high levels in your saliva, which feeds the bacteria found in plaque and can lead to tooth decay and gum disease—and tooth loss, if it’s not treated. 

Brush your teeth twice a day, floss daily, and visit your dentist for regular checkups to help prevent oral problems. See your dentist right away if your gums are red or swollen, if they bleed easily, or if you have a very dry mouth or mouth pain.

Hearing loss

Nerve damage can affect numerous parts of the body, including the ears. High blood sugar over time can damage the nerves and small blood vessels in the inner ear, which can lead to hearing loss over time. Have your hearing checked every year as part of your diabetes management plan.

Vision loss

People with diabetes may be at a higher risk for diabetic retinopathy, the leading cause of blindness in adults with type 2 diabetes. Diabetic retinopathy usually affects both eyes and is caused by high blood sugar that damages the blood vessels in the retina, which may swell and leak, causing blurred vision. Abnormal growth of blood vessels can cause further problems with your vision. 

Early-stage diabetic retinopathy is characterized by weakened blood vessel walls in the retina, which form tiny pouches that may leak blood and other fluids and cause swelling that distorts your vision. Advanced-stage retinopathy can cause floating spots, flashes, blind spots, or distorted vision—or completely blocking your vision. In the advanced stages, you may also have trouble discerning colors. 

Annual eye exams are an important part of your diabetes care plan, since you may not have symptoms of retinopathy until it’s advanced enough to cause vision problems. Early detection and treatment can help prevent vision loss. Treatment typically involves laser therapy, medications, or surgery.

Mental health problems

People with diabetes are two to three times more likely to have depression and 20 percent more likely to have anxiety than those without diabetes. Unfortunately, only around 25 to 50 percent of people seek help for the mental distress they’re feeling. Taking care of your mental health is essential for successfully managing your diabetes and enjoying a high quality of life. 

Diabetes distress is a well-known condition that causes worry, frustration, and feeling a loss of control over your body and your life. Diabetes distress can lead to poor self-care, including unhealthy habits and getting off-track with your blood sugar management plan. In any given 18-month period, up to 50 percent of people with diabetes may experience diabetes distress.

Getting professional help for mental distress can be life-changing. Talk therapy is highly effective for treating anxiety, stress, and depression, and regular exercise can help keep these conditions under control. Meditation has also been proven to reduce stress, anxiety, and depression as well. You don’t have to live with mental distress on top of your diabetes—treatment helps improve your quality of life and keep you motivated to stick with a healthy lifestyle and stay on top of blood sugar monitoring.

How you can prevent diabetes complications

High blood sugar over time causes myriad health issues that are largely preventable if managed early on.. Monitoring your blood sugar, making the necessary lifestyle changes to lower it, and taking any medications as directed are the best ways to prevent complications. Eating a nutritious diet, getting plenty of exercises, and managing your stress will go a long way toward keeping your blood sugar under control—you may even be able to reverse type 2 diabetes through these lifestyle changes.

Attend all of your doctor’s appointments, and have your Hemoglobin A1C tested every three months or as recommended by your doctor. Get screened for hearing and vision problems regularly, and make sure your diabetes care team is testing your kidney and heart function, blood pressure, and cholesterol levels on a regular basis. Knowing your current numbers and what your targets are—and understanding how to achieve them—will help ensure your diabetes is under control, and it’ll help you prevent or delay the onset of complications.

Forward can help

Forward members enjoy a variety of resources and programs that are included in the membership. Our Heart Health Program and our Weight Management Program are ideal for people with type 2 diabetes and include blood tests, personalized management plans, ongoing monitoring, and a variety of helpful tips and tricks to keep you informed and motivated to take care of your health. Our app keeps you connected to your care team 24/7 and provides access to test and assessment results and personal health goals and progress. You can order prescriptions, make appointments, and find the information you need to manage your blood sugar, blood pressure, cholesterol. As your primary care provider, Forward is your healthcare partner, and we’ll be with you every step of the way.

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