Although your experience with type 2 diabetes may be different from that of others with the disease, everyone with diabetes has to pay attention to eating a healthy, balanced diet and exercising regularly. Eating too much carbohydrate can cause your blood sugar levels to rise quickly. A plate format is a simple way to plan a balanced diet. For information, see:

Using a plate format.

It is important to have a healthy eating lifestyle-including eating whole grains, lean meats, fish, and vegetables-and to reduce calorie intake if you need to lose weight. You may be able to keep your blood sugar levels within your target range with only these measures for a while, but you will likely need to take oral diabetes medicines as time goes on.

As diabetes progresses, your pancreas may produce less and less insulin. If your blood sugar level is persistently high, it also may cause your pancreas to produce less insulin. This is called glucose toxicity. When your pancreas produces too little or no insulin, you will have to give yourself shots of insulin.

Because it is difficult to achieve the perfect balance of insulin and blood sugar level that your body would have if you didn't have diabetes, you will experience high blood sugar levels from time to time. If you take insulin or certain oral diabetes medicines, you also may experience low blood sugar. Early treatment of high or low blood sugar can prevent a medical emergency.

What could happen if your blood sugar level is very high?

Symptoms of high blood sugar (hyperglycemia) usually develop gradually over a period of hours or days. Early symptoms are increased thirst, frequent urination, increased hunger, and blurred vision. But you may not have any early symptoms. If your blood sugar level continues to rise and you do not drink enough liquids, you can become dehydrated.

If you do not take your diabetes medicine (pills or insulin), or if you have a severe infection or other illness or become severely dehydrated, your blood sugar may rise to a dangerous level called a hyperosmolar state. Left untreated, the condition can lead to coma and death. Hyperosmolar state usually is treated in a hospital and often in the intensive care unit. There you are closely observed and receive frequent blood tests for glucose and electrolytes. You will receive insulin and other fluids through a vein (intravenous, or IV) to bring your blood sugar down and correct the dehydration.

Complications

Long-term diabetic complications are caused by persistently high blood sugar levels continuing over months or years. You may already have one or more complications, because you may have had the disease for several years before being diagnosed. There are four types of complications:

• Microvascular disease, which affects your eyes or kidneys. Diabetic retinopathy (eye disease) and diabetic nephropathy (kidney disease) develop without early noticeable signs. You are also at risk for other eye diseases, such as cataracts and glaucoma.
• Macrovascular disease, which affects your heart and the large blood vessels throughout your body. Diabetes damages the lining of large blood vessels and contributes to developing atherosclerosis. Atherosclerosis and a greater tendency toward blood clot formation can lead to peripheral arterial disease, heart attack, or stroke.
• Diabetic neuropathy, which affects the nerves in your body. Diabetic neuropathy can decrease or completely block the movement of nerve impulses or messages to organs, legs, arms, and other parts of your body. Nerve damage can affect both the functioning of internal organs, such as the stomach (gastroparesis), and your ability to feel pain when injured. When blood vessels and nerves are affected, broken bones (fractures) and joint deformities can develop within weeks without noticeable pain, especially in your feet (Charcot foot).
• Weakened immune system, which puts you at risk for difficult-to-treat and persistent infections and delayed healing of wounds, especially in your feet. Severe infections in your feet may lead to amputation.

Other health problems