What are the main complications of type 2 diabetes?

Complications are commonly grouped as microvascular — affecting small blood vessels in the eyes (retinopathy), kidneys (nephropathy), and nerves (neuropathy) — and macrovascular, affecting large blood vessels, which includes coronary heart disease, stroke, and peripheral artery disease. People with type 2 diabetes also have a higher risk of foot problems and some infections.

Can complications of type 2 diabetes be prevented?

Risk can be lowered. According to the ADA and CDC, managing glucose, blood pressure, and lipids, along with not smoking, reduces the risk of complications. Regular screening — such as eye, kidney, and foot checks — helps catch problems early when they are most treatable. Individual outcomes vary and are best managed with a clinician.

Type 2 diabetes · complications

Complications of Type 2 Diabetes

Q: How does high blood glucose cause damage?

Over time, sustained high blood glucose — often together with high blood pressure and abnormal blood lipids — can damage the walls of blood vessels and the nerves they supply. This underlies both the microvascular and macrovascular complications associated with type 2 diabetes.

6 min read · Updated July 2026

Type 2 diabetes raises the risk of damage to blood vessels and nerves over time, especially when blood glucose stays high for years. Understanding how that damage happens — and what lowers the risk — is one of the most useful things a person with type 2 diabetes can learn. The encouraging part is that much of this risk is modifiable and that early screening catches problems when they are most treatable.

How complications develop

Sustained high blood glucose — often alongside high blood pressure and abnormal blood lipids (cholesterol and triglycerides) — can gradually damage the walls of blood vessels and the nerves they supply. Complications are usually grouped by the size of the vessels involved: microvascular (small vessels) and macrovascular (large vessels). This page is part of the type 2 diabetes hub, which sets out the condition as a whole.

Microvascular complications

These affect the smallest blood vessels and tend to involve three organs:

Eyes (retinopathy): damage to the tiny vessels of the retina, a leading cause of vision loss in working-age adults. See diabetic retinopathy, explained.
Kidneys (nephropathy): damage to the kidneys' filtering units, which can progress over time. See diabetic kidney disease.
Nerves (neuropathy): nerve damage that often begins in the feet and legs. See diabetic neuropathy, explained.

Because these often develop silently, routine screening — dilated eye exams, urine and blood tests for the kidneys, and foot checks — is central to catching them early.

Macrovascular complications

These affect the large blood vessels and are driven by atherosclerosis — the narrowing and hardening of arteries:

Coronary heart disease: narrowing of the arteries that supply the heart, which can lead to angina or heart attack.
Stroke: interruption of blood flow to the brain.
Peripheral artery disease: reduced blood flow, most often to the legs, which can cause pain when walking and contributes to foot problems.

Cardiovascular disease is a major reason blood pressure and lipids are managed so closely in type 2 diabetes, not glucose alone.

Feet and infections

The combination of reduced sensation from neuropathy and reduced blood flow means foot problems deserve particular attention: small injuries can go unnoticed and be slow to heal, sometimes progressing to ulcers. People with diabetes may also have a higher risk of certain infections. Daily foot care and regular professional foot checks are standard advice for exactly these reasons.

What lowers the risk

The reassuring theme across all of these is that risk is not fixed. Bodies such as the American Diabetes Association (ADA) and the U.S. Centers for Disease Control and Prevention (CDC) emphasise that managing glucose, blood pressure, and lipids, together with not smoking, lowers the risk of complications. Regular screening then adds a second layer of protection by finding problems early. Endobits is clinical decision-support software used under clinician oversight; it can help organise and interpret glucose data that informs a care plan, but it does not diagnose or treat, and individual outcomes are always best managed with a qualified clinician.

Want your glucose data in context?

See how continuous glucose data can support the conversation with your care team about managing risk.

Explore for individuals

Sources

American Diabetes Association — Diabetes Complications. Centers for Disease Control and Prevention — Preventing Diabetes Complications. National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK) — Preventing Diabetes Problems.

This article is educational and not medical advice. Talk to a qualified healthcare provider about your health and your individual risk. Endobits is clinical decision-support software used under clinician oversight, not a diagnostic device.