Long term effects of type-2 diabetes (what you need to know)

When diagnosed and treated on time, type 2 diabetes can be managed well with no problems. With the right actions, many people with type 2 diabetes can prevent or delay the onset of complications. If not diagnosed on time, or if not controlled well, type 2 diabetes often times present with complications. The complications are due to constantly high levels of blood sugar damaging parts of the body.

Complications can be divided into acute (can happen anytime) or chronic (build up overtime) complications. Chronic complications are the long term effects of diabetes.

Short term (acute) effects of type 2 diabetes include hypoglycemia (extremely low blood sugar levels) and hyperosmolar hyperglycemic non-ketotic syndrome (extremely high blood sugar levels).

Long term effects (complications) are divided into two large groups i.e. micro-vascular and macro-vascular complications.

Micro-vascular complications

Micro-vascular complications happen when high blood sugar levels affect the small blood vessels. They include injury to the kidneys (diabetic nephropathy), eyes (diabetic neuropathy), and nerves (diabetic neuropathy).

Diabetic nephropathy

Persistently elevated blood sugar levels may damage small blood vessels of the kidneys causing your kidneys not to function properly. The process is slow and painless and you may not experience any symptoms until the kidneys are so severely damaged. This is why screening your kidneys at least once a year is an important practice because if noticed early, it can be slowed down or prevented.

When kidneys are damaged, they cannot effectively remove waste material from your body. High blood pressure, high cholesterol levels and being a smoker increases your risks of getting diabetic kidney disease. The risk is even more increased if you have a family history of kidney disease.

Learn more about diabetes and the kidneys here.

Diabetic retinopathy

Uncontrolled blood sugar levels may affect small blood vessels in your eyes resulting in eyesight problems. This is called diabetic neuropathy.

High blood sugar levels can also increase your chances of developing serious eye conditions such as cataract, glaucoma and macular edema. All these may lead to poor vision or blindness.

If detected early, diabetic retinopathy can be prevented. Regular eye checks allow for early treatment and prevention of further damage to the eye. Report any changes to you eye doctor even if they may sound insignificant to you.

Diabetic neuropathy

Elevated blood sugar levels overtime may damage your nerves causing diabetic neuropathy. Diabetic neuropathy is one of the most common complications related to type-2 diabetes. It can affect your hands and feet (peripheral neuropathy) or the nerves that control your body organs ( autonomic neuropathy).

Alcohol abuse, smoking and vitamin b12 deficiency may increase your risks of getting neuropathy

Read more about diabetes and neuropathy by following this link.

Macro-vascular complications

These complications happen when constantly high blood sugar levels affect large blood vessels of the body. They include injury to the heart, the brain and the legs.

Cardiovascular diseases

Cardiovascular diseases are diseases that affect the heart and blood vessels. They include heart attack and stroke. Uncontrolled blood sugar levels may cause damage to your arteries increasing your risk of having cardiovascular diseases. This risk is worsened by other factors such as smoking, obesity, lack of exercise and unhealthy diet. Eliminating these risk factors may prevent development of these diseases.

It is an important practice to do these routine checks if you have diabetes.

  • Routine HbA1c checks. HbA1c shows you how well controlled your blood sugar levels have been for the past 3 months.
  • 6 monthly BP checks. Diabetes and high blood pressure commonly co-exist. It is therefore important to routinely screen for one if you have the other.
  • Yearly cholesterol checks. Cholesterol clogs on your blood vessels and if they are already damaged by the uncontrolled blood sugar levels, then your chances of getting diseases like stroke and heart attack are greatly increased. Routine testing is important to keep these levels at a desirable level if need be.

The feet

The feet often have to endure both micro-vascular and macro-vascular complications of diabetes.

Nerve damage (peripheral neuropathy) leaves your feet vulnerable to injury because of reduced feeling when you are injured or are wearing uncomfortable shoes. Once injured your feet cannot get enough blood supply (because of damage to the large blood vessels), and wound healing become poor.

When the ulcer forms, it can become infected. This puts you at a risk of serious complications as this may lead to amputations. That is why it is very important to maintain proper foot care to avoid any injuries.

Inspect your feet every day to look for any cuts, blisters or fungus between the toes. Keep them clean and dry. Wear comfortable shoes that fit well. Have your doctor inspect feet at least once a year to assess for any changes. Contact your doctor immediately if you notice any problems in your feet.

Other complications

Diabetes can as well affect other parts of the body like the skin, the gums and teeth, the sexual organs and the digestive system. We will discuss some of these complications below.

The skin

Diabetes does affect the skin in so many ways. Some skin conditions happen uniquely to people with diabetes. Others however, may be found in everyone else. Even though some skin conditions may affect everyone else, people living with diabetes are more prone to being affected by these skin conditions. These include fungal infections, bacterial infections and itching.

To learn more about diabetes and the skin click here.

Teeth and gums

When the sugar level in your blood is persistently high, it is bound to also be constantly high in your saliva. High sugar level in your saliva is the breeding area for bacteria. The bacteria then produce an acid that attacks the enamel and damages your gums.

The small blood vessels that supply the teeth and gums may also be damaged by high blood sugar. This will accelerate the tooth decay and gum infections associated with diabetes.

Teeth and gum diseases may be made worse by poor oral care and smoking. It is therefore important to reduce your risk and gum and teeth problems by doing the following:

  • Brush your teeth at least twice a day with a soft toothbrush
  • Floss once in a day
  • 6 monthly visits to your dentist
  • Controlling your blood sugar levels can reverse gum diseases

Mental health

The effects of diabetes on your mental health should not be undermined as they are very significant. People with diabetes are at a higher risk of depression and other mental issues. This is because living with diabetes can at times be taxing. If you experience anxiety, stress, loneliness or depression, talk to your doctor who will help you accordingly. The doctor will refer you to a counselor, a psychologist or a psychiatrist.

The immune system

Poor controlled blood sugar levels do affect you immunity negatively. When your immunity is affected, it cannot fight infections adequately.

For more information on this topic, you can click here

Sexual problems

Sexual dysfunction in diabetes is often due to nerve damage and reduced blood supply to the sex organs. Men often experience erectile dysfunction (inability to achieve or maintain an erection) and this is often more common in men with diabetes.

The digestive system

As diabetes does affect the nerves, it can also affect the vagus nerve. The vagus nerve controls the heart, the lungs and the digestive system. In the digestive system, this nerve controls movement of food. When it is damaged by sugar, the stomach gets delayed in emptying its contents and hence gives you symptoms such as heartburn, feeling of fullness, loss of appetite etc.


Having diabetes does not automatically mean you will have complications. Diabetes related complications can be reduced or prevented by making good lifestyle choices.

Do regular screening of the following as advised above

  • BP- at least 6 monthly or any time you visit your doctor
  • HbA1c- yearly
  • Cholesterol- at least once a year
  • Kidneys- yearly
  • Eyes -yearly
  • Feet- at least once a year
  • Teeth and gums -6 monthly

Make good lifestyle changes

  • Stop smoking
  • Maintain a healthy weight
  • Watch your diet
  • Limit alcohol intake
  • Exercise

Once you have one complication, it is highly likely that you may get another one as they are all linked to one thing i.e. blood sugar control. That is why you need to put you levels in check always as this can prevent worsening of the condition or development of the new ones.

Take good care of your body and it will not disappoint you. If you have any questions or comments, be sure to leave them in the section below and I will get back to you soonest

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