Complications of Type 2 Diabetes and Reducing Your Risk of Developing Complications
- In the short-term:
- In the long-term:
- Taking too much insulin or oral diabetes medication
- Skipping or delaying a meal, or eating a smaller meal than usual
- Exercising harder or longer than your usual pattern
- Lightheadedness or fainting
- Pale skin color
- Sudden moodiness or behavior change
- Clumsy or jerky movements
- Confusion or difficulty paying attention
- Tingling sensations around the mouth
- Loss of consciousness
- 4 ounces (118 milliliters) fruit juice or regular soda
- 2 tablespoons raisins
- 4 or 5 saltine crackers
- 4 teaspoons sugar
- 1 tablespoon honey or corn syrup
- Taking too little insulin or oral medication
- Eating a larger meal than usual
- Experiencing stress from an illness or from factors in daily life
- Frequent urination
- Increased thirst
- Blurred vision
- Unexplained weight loss
Hyperosmolar Nonketotic Coma
- Very high blood glucose
- Dry mouth
- Warm, dry skin
- Absence of sweating
- Leg cramps
- Vision loss
- Weakness or strange movements on one side of the body with or without seizures
- Frequent urination
- Blurry or double vision
- Halos, flashing lights, or black spots
- Dark or floating spots
- Pain or pressure in one or both of your eyes
- Trouble seeing things
Heart Disease and Stroke
- Chest pain ( angina )—This pain or pressure typically starts in your chest and radiates to your arms (especially the left). This type of pain may appear when you exercise or after eating a large meal, and it may get better when you rest.
- Cardiomyopathy —This is a general weakening of the heart muscle caused by narrowed, small blood vessels that decrease the blood flow through the heart. This can progress and cause heart failure .
- Heart attack—This is caused by the blockage of a blood vessel in or near your heart. As a result, part of your heart muscle does not receive oxygen and the essential nutrients it needs to function, so it stops working and dies. Symptoms of a heart attack include: chest pain, pressure feeling, nausea, indigestion, extreme weakness, and sweating.
- Sudden weakness or numbness of your face, arm, or leg on one side of your body
- Sudden confusion, trouble talking, or trouble understanding
- Sudden lightheadedness, loss of balance, or trouble walking
- Sudden trouble seeing in one or both eyes or sudden double vision
- Sudden severe headache
- Drop in blood pressure when you stand
- Diarrhea at night
- Difficulty in emptying your bladder
- Erectile dysfunction
Lower Your Risk of Complications
- Have regular checkups even if you feel fine. Your doctor can often spot early signs of complications.
- Strive to keep your blood glucose levels, hemoglobin A1c (HbA1c) levels, blood pressure, and cholesterol levels within a healthy range at all times. Work with your doctor to determine which levels are safe for you.
- Do not smoke. If you do smoke, talk with your doctor about how you can quit.
- Get vaccinated against the flu and pneumonia .
- Have a regular exercise routine.
- If you are overweight, talk to your doctor about a safe weight loss program.
- Tell your doctor if you have symptoms of any diabetes complications.
- Ask your doctor if there are any medications that you should take to prevent complications. For example, find out if daily aspirin therapy is right for you.
- Make lifestyle changes to lower your LDL cholesterol levels. Reduce the amount of saturated fat and cholesterol in your diet. If you are overweight, lose weight. Increase how much physical activity you do each day.
If you do not have cardiovascular heart disease:
- The goal is to have LDL cholesterol level less than 100 mg/dl.
- If you are over age 40 years old and have at least one other risk factor for heart disease, treatment goal is a 30%-40% reduction of LDL regardless of baseline LDL levels.
- If you are younger than 40 years old with other risk factors for heart disease and lifestyle changes fail to achieve the desired lipid-lowering goals, the ADA recommends medication.
If you have cardiovascular heart disease:
- The ADA recommends statins to reduce LDL 30%-40% from original values.
- Lowering LDL cholesterol to below 70 using a higher dose of a statin is an option.
- Lower triglycerides to less than 150 mg/dl and raising HDL cholesterol to over 40 mg/dl in men and over 50 mg/dl in women are other ADA treatment goals.
- All adults should eat fish at least twice weekly.
- If you have coronary heart disease, you should receive at least 1 gram of eicosapentaenoic acid (EPA) and docosahexaenoic acid (DHA) combined every day.
- EPA plus DHA supplement (eg, 2-4 grams) is useful in lowering triglyceride levels by 20%-40%.
American Diabetes Association. Executive summary: standards of medical care in diabetes—2010. Diabetes Care. 2010;33:S4-S10.
Diabetes mellitus type 2. EBSCO DynaMed website. Available at: http://www.ebscohost.com/dynamed.ebscohost.com/about/about-us . Updated July 29, 2013 Accessed August 29, 2013.
Heart disease. American Diabetes Association website. Available at: http://www.diabetes.org/living-with-diabetes/complications/heart-disease . Accessed August 29, 2013.
Hyperosmolar hyperglycemic crisis. EBSCO DynaMed website. Available at: http://www.ebscohost.com/dynamed.ebscohost.com/about/about-us . Updated January 12, 2013 Accessed August 29, 2013.
Hypoglycemia. EBSCO DynaMed website. Available at: http://www.ebscohost.com/dynamed.ebscohost.com/about/about-us . Updated August 23, 2013 Accessed August 29, 2013.
Skyler JS, Bergenstal R, Bonow RO, et al. Intensive glycemic control and the prevention of cardiovascular events: implications of the ACCORD, ADVANCE, and VA Diabetes Trials. Circulation. 2009;119:351-357.
Stroke. American Diabetes Association website. Available at: http://www.diabetes.org/living-with-diabetes/complications/heart-disease/stroke.html . Accessed August 29, 2013.
What is hyperosmolar hyperglycemic nonketotic syndrome (HHNS)? American Diabetes Association website. Available at: http://www.diabetes.org/living-with-diabetes/complications/hyperosmolar-hyperglycemic.html . Updated August 21, 2013. Accessed August 29, 2013.
Zeitler P, Haqq A, Rosenbloom A, Glaser N. Drugs and Therapeutics Committee of the Lawson Wilkins Pediatric Endocrine Society. Hyperglycemic hyperosmolar syndrome in children: pathophysiological considerations and suggested guidelines for treatment. J Pediatr. 2011;158(1):9-14.
2/7/2008 DynaMed Systematic Literature Surveillance https://dynamed.ebscohost.com/about/about-us : Armstrong DG, Holtz-Neiderer K, Wendel C, Mohler MJ, Kimbriel HR, Lavery LA. Skin temperature monitoring reduces the risk for diabetic foot ulceration in high-risk patients. Am J Med. 2007;120:1042-1046.
2/7/2008 DynaMed Systematic Literature Surveillance https://dynamed.ebscohost.com/about/about-us : Lavery LA, Higgins KR, Lanctot DR, et al. Home monitoring of foot skin temperatures to prevent ulceration. Diabetes Care. 2004;27:2642-2647.
2/13/2008 DynaMed Systematic Literature Surveillance https://dynamed.ebscohost.com/about/about-us : For safety, NHLBI changes intensive blood sugar treatment strategy in clinical trial of diabetes and cardiovascular disease. NIH News. National Institutes of Health website. Available at: http://www.nih.gov/news/health/feb2008/nhlbi-06.htm . Accessed August 29. 2013.
2/21/2008 DynaMed Systematic Literature Surveillance https://dynamed.ebscohost.com/about/about-us : Major international diabetes study does not confirm increased risk of death reported by US trial. Action in Diabetes and Vascular Disease: PreteraAx and DiamicroN MR Controlled Evaluation (ADVANCE) website. Available at: http://www.advance-trial.com/static/html/virtual/contents.asp?P=39 . Accessed August 29, 2013.
4/10/2008 DynaMed Systematic Literature Surveillance https://dynamed.ebscohost.com/about/about-us : The ONTARGET investigators. Telmisartan, ramipril, or both in patients at high risk for vascular events. N Engl J Med. 2008;358(15):1547-1559.
6/18/2008 DynaMed Systematic Literature Surveillance https://dynamed.ebscohost.com/about/about-us : ADVANCE Collaborative Group. Intensive blood glucose control and vascular outcomes in patients with type 2 diabetes. N Engl J Med. 2008;358:2560-2572.
- Reviewer: Kim Carmichael, MD
- Review Date: 09/2013
- Update Date: 09/30/2013