Ask an Expert: What Happens If Diabetes Is Not Managed Properly?

Type 2 diabetes impacts 37.3 million people in the United States, according to the Centers for Disease Control and Prevention (CDC), and this number is on the rise. The CDC predicts that if current trends continue, by 2025, 1 in 5 people in the United States may be living with the disease–doubling the current rate. 

The good news is type 2 diabetes is manageable with the correct regimen. However, people can develop further health complications or life-threatening conditions when it’s not.

Among others, diabetes is the leading cause of chronic kidney disease (CKD), with approximately 1 in 3 adults with type 1 or type 2 diabetes also having CKD, according to the CDC. Diabetes can also increase a person’s risk for nerve damage, heart disease, mouth problems, foot problems, vision loss, and mental health conditions.

Do-Eun Lee, MD, an endocrinologist specializing in diabetes treatment, discusses how type 2 diabetes can impact a person’s health when left unchecked and what interventions people and healthcare providers can take to fight it.

Verywell Health: What are some of the complications that can result from type 2 diabetes?

Dr. Lee: Many complications can result from type 2 diabetes. That’s because every aspect of health can be affected by high glucose and high insulin—nothing is spared. When you have high glucose and high insulin, that speeds up your body’s environment for inflammation, which can be a breeding ground for cancer development, among other complications.

Some risks include:

• Losing eyesight
• Experiencing neuropathy complications, including amputations
• Experiencing cardiovascular complications
• Increased stroke and heart attack risk
• Increased cancer risks

There is also an emotional burden of having type 2 diabetes—the psychiatric burden of being labeled as “diabetic,” in addition to the mental toll of taking multiple medications, is very burdensome.

Verywell Health: What medical interventions are needed to reduce these risks?

Dr. Lee: Based on The UK Prospective Diabetes Study (UKPDS), healthcare providers like myself want to intensify diabetes treatment regimens by intensifying our counseling, reviewing their diet, and encouraging them to do the right thing for their health. We also want to get their A1C levels as low as possible. The target A1C level that we’d shoot for would vary per person.

For a person who doesn’t otherwise have a lot of comorbidities and whose baseline health is pretty good, I would aim to reduce their A1C levels to below 6%. If the person already has cardiovascular disease or a lot of comorbidities, lowering A1C as low as 6% might be dangerous. In that case, we would set their A1C goals higher because their life expectancy may not be as long as the people I described before.

Ongoing surveillance for detecting complications, including eye exams, foot exams, and cardiovascular exams, can also help mitigate risks.

Verywell Health: Can type 2 diabetes go into remission with the proper regimen?

Dr. Lee: It’s possible! But it involves a lot of initiative by the person living with diabetes. They have to revamp their diet and revamp their life.

I’ve been practicing for about 15 years and have had this occur in only one person—1 in 1,000s. To get there, he cut down his carbohydrate intake significantly and exercised in a very controlled way. He was one of my earliest patients and has kept himself healthy for the past 15 years. He’s impressed me.

In other cases, people may not completely rid themselves of the disease but can reach a manageable A1C level of under 6%. These people typically take Glucophage (metformin), which is a medication for glucose control. This is almost equivalent to remission of diabetes, but you can’t use the word “remission” because they are using an intervention.

Verywell Health: What advice do you give people trying to manage their diabetes or fully recover?

Dr. Lee: I highly recommend downloading phone apps, counting carbs and looking at food labels—scanning what you eat is essential for improving health. So I’m a massive advocate of My Fitness Pal for people with type 2 diabetes because it has so much data. It’s enlightening and can help people start consuming food more consciously.