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Type 2 diabetes doesn’t necessarily lead to a loss of independence on its own. But diabetes complications such as vision loss, muscle weakness, and cognitive decline can make it harder to maintain your quality of life on your own.
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1. Risk: Vision Loss
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When insulin isn’t working effectively, too much sugar stays in your bloodstream. Over time, this can damage blood vessels throughout the body, says Charles Barron Jr., MD, chief medical officer of Friend Health, a provider for medically underserved communities in Chicago.
“The eyes have very small blood vessels, and when we can’t get blood flow to them, cellular death starts to occur,” Dr. Barron says.
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It is the leading cause of vision loss among people with diabetes, says Jennifer Cheng, MD, chief of endocrinology at Hackensack Meridian Health in Neptune, New Jersey.Solution: Get Your Blood Sugar and Blood Pressure Under Control
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Eating healthy foods, exercising regularly, losing excess weight, and taking prescribed medication can help.[2]
Injections or lasers can also treat macular edema.[7]
2. Risk: Muscle Weakness (Sarcopenia)
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It can lead to depression, falls, and bone fractures, all of which can reduce your ability to get around on your own.[9]
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Dr. Cheng says that the following factors contribute to this increased risk of muscle breakdown:Insulin resistanceChronic inflammationIncreased accumulation of harmful substances in muscle fibers caused by high blood sugar
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High blood pressureLow calcium levelsNerve damageLow amount of physical activity
Solution: Strength-Building Exercise
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You don’t even need to go to the gym and use heavy equipment to get results. Barron recommends using a can of food as a dumbbell and performing flexing exercises (think curls or overhead presses) to maintain strength.3. Risk: Foot Problems
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About 15 percent of people with diabetes get diabetic foot ulcers, usually on the bottom of the foot. Although often preventable, they can lead to amputation in 14 to 24 percent of cases.[13]
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“The toes have very small blood vessels, and when circulation is compromised, these areas are particularly vulnerable,” says Barron, adding that doctors typically check your toes and feet for sensation changes and look for evidence of decreased blood flow.
Solution: Daily Foot Care
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4. Risk: Severe Hypoglycemia
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Symptoms include hunger, shakiness, and confusion. Though mild cases of hypoglycemia can be treated with a sugary snack or drink, severe cases of hypoglycemia cause a risk of losing consciousness, Barron says.
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Solution: More Blood Sugar Testing
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Barron says that doctors may monitor your blood sugar levels remotely to gauge blood sugar control more accurately. Continuous glucose monitors give you real-time updates and alarms so you can learn quickly if you have hypoglycemia.[18]
5. Risk: Chronic Fatigue
“Chronic fatigue is a prevalent and often overlooked symptom in type 2 diabetes, significantly eroding quality of life,” Cheng says.
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Solution: Good Sleep Hygiene
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Don’t use electronic devices before bed.Exercise during the day.Keep blood sugar and blood pressure levels consistent.Limit daytime naps of more than 30 minutes.Create a comfortable sleep environment, free of light and noise.
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6. Risk: Cognitive Decline
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“Insulin resistance can impair brain cell function and communication,” Cheng says. “If there is not enough sugar in the brain, then there could be damage, especially with severe hypoglycemia.”
Solution: Brain Stimulation
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7. Risk: Social Isolation
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“From a social perspective, people may decline to go out because they feel like they’re not going to be able to eat freely, they’re embarrassed because they may have to check blood sugar, or [they experience] different social aspects that can impact whether they want to spend time with others,” Barron says.
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Solution: Explore and Expand Your Community
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It’s also important to educate your family members and friends about type 2 diabetes so they can help you navigate certain situations, without putting pressure on you to do something you can’t because of the disease, Barron says.The Takeaway
Effective management of type 2 diabetes, including control of your blood sugar level and weight, can substantially reduce the risk of complications that threaten your independence.If you do not control your blood sugar well, you may risk changes to your vision, muscle mass, and cognitive abilities, as well as foot problems, hypoglycemia, and fatigue.In addition to good blood sugar control and metabolic health, solutions such as ensuring that your blood pressure is under control, exercising, and even staying socially active can help mitigate risks of complications.Talk to your healthcare team about the best ways to manage your type 2 diabetes and what change you can make to maintain and improve your quality of life.
