When you are diagnosed with type 2 diabetes, you typically get standard information about the condition including taking medication, following a healthy diet, and staying active every day. However, there are several aspects of living with type 2 diabetes that people diagnosed with diabetes are often not told, but which can significantly impact their management of the condition and overall quality of life.

1. The psychological impact 

The emotional and psychological toll of managing a chronic condition like diabetes is often overlooked. Many people with type 2 diabetes experience feelings of anxiety, guilt, or depression. This can stem from the daily stress of managing diabetes, fear of complications, or the perception that you are somehow responsible for your condition. Mental health support is crucial but often not emphasised at diagnosis. Understanding that it’s normal to feel overwhelmed and speaking with your doctor about psychological support can be key in managing the condition long-term.

2. The risk of hypoglycaemia 

People are usually told about the dangers of high blood glucose levels but low blood glucose (hypoglycaemia) can also be a serious concern, especially if you are on insulin or certain oral medications. Symptoms of hypoglycaemia include shakiness, sweating, dizziness, headaches, confusion and, in severe cases, loss of consciousness. It’s important to know how to recognise the signs of low blood glucose and to always have a quick source of glucose, like jelly beans or glucose tablets, on hand.

3. Diabetes and heart disease 

Type 2 diabetes significantly increases your risk of developing cardiovascular diseases, including heart attack and stroke. While this is sometimes mentioned, the link between diabetes and heart disease isn’t always fully explained. People with diabetes are more likely to also have high blood pressure and high cholesterol, both of which can also increase your risk of developing cardiovascular problems. Keeping your blood pressure and cholesterol in the target range, and not smoking are just as important as managing your blood glucose levels in preventing cardiovascular complications. Find more information on diabetes and heart disease here.

4. Effect on sleep 

Diabetes can have a profound effect on sleep patterns. Sleep disturbances are common in people with type 2 diabetes and can include insomnia, sleep apnoea, and restless leg syndrome. High blood glucose levels also affect sleep, as you may need to go to the toilet more often. Poor sleep can make managing blood glucose levels harder and contribute to a vicious cycle of fatigue and stress. Aiming for sufficient, quality, sleep is another critical part of your diabetes management plan. Discuss any sleep issues with your doctor.

5. Effect on digestive system 

Gastroparesis, a condition that affects the stomach muscles and prevents proper stomach emptying, is more common in people with diabetes than in the general population. It is linked to autonomic neuropathy, a type of nerve damage which can be caused by high blood glucose levels over a long period of time. Symptoms can include bloating, nausea, vomiting, changes in bowel movements and feeling full after eating only a small amount of food. It can make managing blood glucose levels harder because it disrupts the timing of food absorption and lead to unpredictable hypoglycaemia. 

6. Skin problems 

Diabetes can cause various bacterial and fungal skin problems. A common skin condition is acanthosis nigricans. This condition is often caused by insulin resistance, obesity, or hormonal disorders. It appears as dark, thickened skin, usually in body folds. Keeping your glucose levels in your target range and your skin clean and moisturised, and monitoring for any changes are all essential to minimise the risk of developing skin problems due to diabetes. 

7. Increased risk of infections 

High blood glucose levels can weaken the immune system, making people with type 2 diabetes more susceptible to infections. Common infections may include urinary tract (bladder and kidneys), infections respiratory (lung) infections, and even infections in the mouth or gums. Wounds may not heal well if your glucose levels are high, this can also lead to infections. Keeping your blood glucose levels in your target, maintaining good personal hygiene, staying up to date with vaccinations, and seeking treatment at the first sign of infection are all critical in reducing your risk of infections. 

8. The importance of foot care 

You may be told to check your feet regularly, but the reasons may not be fully explained. Diabetes can lead to nerve damage (neuropathy) which reduces sensation in your feet, and poor blood circulation (peripheral vascular disease) which makes it harder for wounds to heal. The combination of these issues increases the risk of foot ulcers and, in severe cases, can lead to amputation. Regular foot checks, by a health professional once or twice a year, daily self-checks, and wearing appropriate footwear are crucial in preventing foot problems. Did you know that more than 85% of diabetes-related foot amputations are preventable? Find out more at Foot Forward.

9. Impact on vision 

Although you may be aware that diabetes can affect vision, the full extent of the potential complications may not be fully explained. Diabetic retinopathy, where high blood glucose levels damage the blood vessels in the retina, is a leading cause of blindness in adults. Regular eye exams are essential, as early detection and treatment can prevent significant vision loss. For more information visit KeepSight and download this factsheet. 

10. Diabetes can be a progressive condition 

While you may be able to manage type 2 diabetes effectively with lifestyle changes and medications in the early stages, it is important to also know that diabetes can be progressive. This means that over time, the pancreas may produce less insulin, and the body may become more resistant to the insulin. This means that even if you do everything “right”, your treatment plan may need to be adjusted. You may need to add or change medications or, in some cases, start insulin therapy as diabetes progresses.

11. The importance of continuous education 

Diabetes is a complex condition that requires ongoing learning. What works for you today may not work in the future, and new research and treatments are constantly emerging. Staying informed through reliable sources, attending diabetes education programs, and maintaining open communication with your healthcare team are vital components of effective diabetes management.

12. Social and financial effects 

The social and financial aspects of managing type 2 diabetes are often underestimated. The cost of medications, frequent doctor’s visits, healthy food, blood glucose monitoring and other supplies, and higher (health and travel) insurance premiums, can add up quickly. Managing diabetes can also affect your social life, making it harder to do things spontaneously like eating out, travelling, or participating in other social activities.  

In conclusion, understanding these lesser-known aspects of type 2 diabetes can help you better prepare for the challenges ahead and empower you to take proactive steps in managing your health. 

Being open about your condition with family and friends can help create a supportive environment that makes it easier for you to stick to your management plan. 

Call the NDSS Helpline, on 1800 637 700, if you have any general questions about the content of this article, or your diabetes management, and ask to speak with a diabetes educator. 

Vania Khoury, Credentialled Diabetes Educator, Registered Nurse