What is diabetes, and what is it like to live with the disease?

Type 2 diabetes is a lifelong disease that develops when the pancreas cannot produce enough insulin or the body's tissues become resistant to insulin. Insulin helps sugar (glucose) enter cells, where it is used for energy. Living with type 2 diabetes requires daily attention to what and how much you eat, getting regular exercise, monitoring blood sugar levels, and possibly taking medication. If you work with your health professional to keep your blood sugar at or near a normal range, you will feel better and may prevent -- or at least delay -- complications from diabetes. The American Diabetes Association (ADA) recommends that people with diabetes keep their blood sugar between 90 milligrams per deciliter (mg/dL) and 130 mg/dL before meals and less than 180 mg/dL 1 to 2 hours after eating.

What symptoms do I need to watch for?

You need to be aware of symptoms of high blood sugar (hyperglycemia), which usually develops over a few days or weeks. Early symptoms are increased thirst, frequent urination, increased hunger, and blurred vision. If you take insulin or a sulfonylurea oral medication for diabetes, you need to watch for early symptoms of low blood sugar, including sweating, weakness, shakiness, and hunger. Your symptoms may vary over time. These symptoms also may occur if you have a sudden large drop in blood sugar, even though the level does not drop below the normal or near normal range.

What are the complications of diabetes and their symptoms?

Complications are caused by persistently elevated blood sugar levels. High levels over months or years damage your blood vessels and nerves, increasing your risk of developing eye, kidney, heart, blood vessel, and nerve problems. High blood sugar levels also affect your immune system, placing you at risk for infections. If you are pregnant and your diabetes is poorly controlled, your baby may be larger (more than 4000 g(8.8 lb)) than average and you could be at risk for complications such as preeclampsia, a serious condition involving pregnancy-induced high blood pressure, swelling of the feet and hands, and protein in your urine. Your baby may also be at risk for birth defects if your blood sugar was poorly controlled when you became pregnant. You may already have a complication from diabetes, especially if you had the disease several years before being diagnosed. Even if you don't have a complication now, the longer you have diabetes, the greater your risk for developing one or more complications. Symptoms of diabetes complications include:

Chest pain; shortness of breath with exercise or other exertion; heart attack; stroke; or tight or squeezing pain in the calf, foot, thigh, or buttock that occurs during exercise, causing changes in skin color, poor wound healing, and leg cramps (all symptoms of large blood vessel complications, or macrovascular disease).

Tingling and numbness in your feet, indicating nerve damage (diabetic peripheral neuropathy).

Seeing floaters and flashes of light, indicating eye damage (diabetic retinopathy).

Feeling dizzy or weak when you sit or stand up suddenly; frequent bloating, belching, and abdominal pain (gastroparesis); sweating profusely after meals, difficulty sensing when your bladder is full or difficulty emptying the bladder completely; or erection problems or vaginal dryness (indicating diabetic autonomic neuropathy).

Kidney damage (diabetic nephropathy) does not have noticeable early symptoms. Have regular screening tests for protein in your urine to detect diabetic nephropathy before severe damage has developed.

How can complications be prevented?

You can prevent, or at least delay, complications from diabetes by consistently keeping your blood sugar levels within a normal or near normal range. If you have high blood pressure or high cholesterol, or both, treatment can help prevent diabetes complications. If you smoke, quit: Smoking increases your risk for complications.

If you are age 30 or older, talk to your health professional about taking a low-dose, or baby, aspirin daily to help prevent heart attack, stroke, or other large blood vessel disease. People with diabetes are 2 to 4 times more likely than people who don't have diabetes to die from heart and blood vessel diseases.

See your health professional every 3 to 6 months throughout your life. He or she will review your treatment and do tests and exams to monitor how well your blood sugar levels are staying within a normal or near normal range and whether you have developed any complications. Some exams and tests need to be done during every visit; some are done yearly, such as eye exams and tests for cholesterol and protein in your urine. Others may be done only if a complication develops.

Will my treatment change over time?

The goal of treatment will always be to keep your blood sugar levels within a normal or near normal range. At first, you may be able to accomplish this goal with diet and exercise alone. At some point, you may need to take one or more oral medications for diabetes and may need insulin. You always need to:

Follow a diet that spreads the amount of carbohydrate you eat throughout the day.

Get regular exercise.

Monitor your blood sugar.