Type 2 Diabetes Complications You Can Avoid

• By Jennifer Anderson
• Reviewed by Farrokh Sohrabi, MD

• Cut Your Risks With Better Diabetes Management

  Without a solid management plan, type 2 diabetes can be like a house of cards, causing your overall health to come crashing down.
  Heart attack, kidney failure, vision issues, and nerve damage are among the problems that can result from poorly managed diabetes, says William Sullivan, MD, a senior physician at the Joslin Diabetes Center and an assistant professor of medicine at Harvard Medical School in Boston. But by working on diet and exercise and following your treatment plan, you can reduce your risk of diabetes complications, and live a healthy life.
  Here are potential type 2 diabetes health risks and serious complications you can help prevent:
  
  

  High Blood Pressure

  
  High blood sugar levels in the bloodstream can cause the blood to thicken, forcing the heart to work harder to pump blood, says Lori Zanini, RD, CDE, of Manhattan Beach, California, spokesperson for the Academy of Nutrition and Dietetics.
  In fact, high blood pressure is very common with diabetes, impacting about 70 percent of affected adults, according to the American Diabetes Association (ADA). It doesn't always have noticeable symptoms and you may not know you have it unless your doctor checks. Still, it can lead to serious complications including heart attack, stroke, eye problems, and kidney disease.
  “Achieving better glycemic control will be helpful in reducing the blood pressure of individuals with diabetes,” Zanini says. Other strategies for lowering blood pressure include eating a healthy diet, limiting sodium intake, utilizing successful stress management techniques, and participating in regular physical activity, if cleared by a physician.
  
  

  Heart Disease

   Someone with type 2 diabetes has the same level of heart attack risk as someone who's already had a heart attack, according to the National Heart, Lung, and Blood Institute. There are numerous reasons for the link between diabetes and heart disease, Dr. Sullivan says, including a "group attack" from diabetes and other heart disease risk factors like high blood pressure and high cholesterol, which already affect many people with type 2 diabetes.
  Taking control of your diabetes management, lowering your blood pressure and cholesterol levels, and not smoking can lower your risk of heart disease
  

  Stroke

   Most strokes happen when a blood clot blocks a blood vessel within or leading to the brain. Type 2 diabetes increases your risk of stroke by two to four times, according to the American Heart Association. Fortunately, the same steps that will help you prevent heart disease — controlling your blood sugar and blood pressure levels, maintaining a healthy weight, exercising regularly, and not smoking — are also the best ways to reduce your risk of stroke.
  
  
  

  Kidney Failure

  Diabetes is the primary cause in more than 40 percent of cases of kidney failure — the kidney's inability to filter waste and fluid from the blood, according to the ADA. As blood flows through tiny vessels in the kidneys, waste products are filtered out and leave the body through urine. Too much sugar in the blood can stress these filters, making it hard for the kidneys to work effectively. After a while, the filters can break down and leak protein into the urine. If kidney damage continues, you may need dialysis or a kidney transplant.
  The ADA recommends regular checks for protein in the urine, an early sign of loss of kidney function. Good diabetes control, including a low-sugar diet, weight control, exercise, and medications, can help prevent the loss of kidney function from type 2 diabetes.
  
  

  Eye Problems

  Several vision complications can result from type 2 diabetes, the most common of which is diabetic retinopathy. Over time high blood sugar levels can damage the blood vessels in the eyes, Sullivan says. If left untreated, diabetic retinopathy can cause severe vision loss and even blindness. Nearly half of everyone diagnosed with diabetes has some degree of diabetic retinopathy, according to the National Eye Institute. Diabetes also increases the risk of glaucoma and cataracts.
  Since diabetic retinopathy can go undetected until it reaches advanced stages, Sullivan recommends annual eye exams.
  
  

  Nerve Damage

  Chronically elevated blood sugar levels can lead to nerve damage (neuropathy). About half the people with diabetes have nerve damage, which feels like a tingling or burning sensation, usually in the feet, or even a loss of sensation, the ADA states.
  Keeping your blood sugar levels in check may help you prevent nerve damage or lessen the symptoms of it. Once you have nerve damage, regular visits with your doctor should supplement your own daily foot examinations and care routine so that any problems can be spotted early.
  
  

  Infection

  Once nerve damage sets in, your risk of infection increases because you may not be able to feel an injury, like a cut on your foot, to help it heal early on. In addition to examining your feet every day, check in with your doctor at the first sign of infection, such as redness or swelling. Protect your feet by keeping your skin moisturized with a coat of petroleum jelly or rich cream, but make sure to keep the areas between your toes dry because extra moisture there can increase the risk of infection, the ADA suggests.
  
  

  Digestion Problems

  Also called neuropathy of the stomach, gastroparesis is a type of nerve damage that results in food taking a long time to be emptied from the stomach and digested. This condition can be caused by high blood sugar levels over time. Symptoms include abdominal bloating and decreased appetite, which can make diabetes harder to control, Sullivan says.
  Eating small, frequent meals can reduce further complications. Medications such as metoclopramide can be helpful, Sullivan says. In severe cases, intravenous feeding may be needed.
  
  

  Weight Gain

  Many people who develop type 2 diabetes are overweight or obese, and weight loss is a big factor in controlling diabetes. Occasionally, medications essential to managing diabetes can exacerbate weight gain. These include insulin, sulfonylureas to encourage the pancreas to secrete more insulin, and glitazones to decrease insulin resistance.
  If you are obese, your doctor may suggest medications to suppress the appetite and promote weight loss, Sullivan says. Gastric bypass surgery may be another option if you have significant weight to lose. "Exercise works better in some people than others," he says, "and it's always encouraged as the first line of therapy."
  
  
  
  
  
  
• 

  High Blood Pressure

  High blood sugar levels in the bloodstream can cause the blood to thicken, forcing the heart to work harder to pump blood, says Lori Zanini, RD, CDE, of Manhattan Beach, California, spokesperson for the Academy of Nutrition and Dietetics.
  In fact, high blood pressure is very common with diabetes, impacting about 70 percent of affected adults, according to the American Diabetes Association (ADA). It doesn't always have noticeable symptoms and you may not know you have it unless your doctor checks. Still, it can lead to serious complications including heart attack, stroke, eye problems, and kidney disease.
  “Achieving better glycemic control will be helpful in reducing the blood pressure of individuals with diabetes,” Zanini says. Other strategies for lowering blood pressure include eating a healthy diet, limiting sodium intake, utilizing successful stress management techniques, and participating in regular physical activity, if cleared by a physician.
  
• 

  Heart Disease

  Someone with type 2 diabetes has the same level of heart attack risk as someone who's already had a heart attack, according to the National Heart, Lung, and Blood Institute. There are numerous reasons for the link between diabetes and heart disease, Dr. Sullivan says, including a "group attack" from diabetes and other heart disease risk factors like high blood pressure and high cholesterol, which already affect many people with type 2 diabetes.
  Taking control of your diabetes management, lowering your blood pressure and cholesterol levels, and not smoking can lower your risk of heart disease.
  
• 

  Stroke

  Most strokes happen when a blood clot blocks a blood vessel within or leading to the brain. Type 2 diabetes increases your risk of stroke by two to four times, according to the American Heart Association. Fortunately, the same steps that will help you prevent heart disease — controlling your blood sugar and blood pressure levels, maintaining a healthy weight, exercising regularly, and not smoking — are also the best ways to reduce your risk of stroke.
  
• 

  Kidney Failure

  Diabetes is the primary cause in more than 40 percent of cases of kidney failure — the kidney's inability to filter waste and fluid from the blood, according to the ADA. As blood flows through tiny vessels in the kidneys, waste products are filtered out and leave the body through urine. Too much sugar in the blood can stress these filters, making it hard for the kidneys to work effectively. After a while, the filters can break down and leak protein into the urine. If kidney damage continues, you may need dialysis or a kidney transplant.
  The ADA recommends regular checks for protein in the urine, an early sign of loss of kidney function. Good diabetes control, including a low-sugar diet, weight control, exercise, and medications, can help prevent the loss of kidney function from type 2 diabetes.
  
• 

  Eye Problems

  Several vision complications can result from type 2 diabetes, the most common of which is diabetic retinopathy. Over time high blood sugar levels can damage the blood vessels in the eyes, Sullivan says. If left untreated, diabetic retinopathy can cause severe vision loss and even blindness. Nearly half of everyone diagnosed with diabetes has some degree of diabetic retinopathy, according to the National Eye Institute. Diabetes also increases the risk of glaucoma and cataracts.
  Since diabetic retinopathy can go undetected until it reaches advanced stages, Sullivan recommends annual eye exams.
  
• 

  Nerve Damage

  Chronically elevated blood sugar levels can lead to nerve damage (neuropathy). About half the people with diabetes have nerve damage, which feels like a tingling or burning sensation, usually in the feet, or even a loss of sensation, the ADA states.
  Keeping your blood sugar levels in check may help you prevent nerve damage or lessen the symptoms of it. Once you have nerve damage, regular visits with your doctor should supplement your own daily foot examinations and care routine so that any problems can be spotted early.
  
• 

  Infection

  Once nerve damage sets in, your risk of infection increases because you may not be able to feel an injury, like a cut on your foot, to help it heal early on. In addition to examining your feet every day, check in with your doctor at the first sign of infection, such as redness or swelling. Protect your feet by keeping your skin moisturized with a coat of petroleum jelly or rich cream, but make sure to keep the areas between your toes dry because extra moisture there can increase the risk of infection, the ADA suggests.
  
• 

  Digestion Problems

  Also called neuropathy of the stomach, gastroparesis is a type of nerve damage that results in food taking a long time to be emptied from the stomach and digested. This condition can be caused by high blood sugar levels over time. Symptoms include abdominal bloating and decreased appetite, which can make diabetes harder to control, Sullivan says.
  Eating small, frequent meals can reduce further complications. Medications such as metoclopramide can be helpful, Sullivan says. In severe cases, intravenous feeding may be needed.
  
• 

  Weight Gain

  Many people who develop type 2 diabetes are overweight or obese, and weight loss is a big factor in controlling diabetes. Occasionally, medications essential to managing diabetes can exacerbate weight gain. These include insulin, sulfonylureas to encourage the pancreas to secrete more insulin, and glitazones to decrease insulin resistance.
  If you are obese, your doctor may suggest medications to suppress the appetite and promote weight loss, Sullivan says. Gastric bypass surgery may be another option if you have significant weight to lose. "Exercise works better in some people than others," he says, "and it's always encouraged as the first line of therapy."