Can You Die From Untreated Diabetes?

Diabetes can increase the risk of other health problems, but people can also live with it for many years.

Diabetes is a chronic condition that affects millions of people in the United States. This condition occurs when your body cannot regulate blood sugar levels, which can cause dangerous health effects. However, people can live for many years with proper diabetes treatments.

Two types of diabetes exist: type 1 and type 2. Type 1 diabetes prevents you from making insulin, a hormone that controls blood sugar. Type 2 diabetes prevents you from creating enough insulin or responding to insulin signals. Both conditions can lead to high blood sugar.

Treatments for diabetes are effective at controlling blood sugar levels. However, untreated diabetes can lead to several health complications:

  • Untreated type 1 diabetes can lead to diabetic ketoacidosis, which occurs when your body does not make enough insulin, causing a harmfully high amount of ketones (the chemical that breaks down fat to create energy) in your blood. That can lead to weight loss and dehydration.
  • Untreated type 2 diabetes can lead to kidney and eye damage, heart disease, and stroke due to unregulated high blood sugar.

Health complications from diabetes are a major concern and can result in death. Before insulin was discovered, people with diabetes were living shorter lives. Now, treatments are allowing people with diabetes to live longer lives with good quality of life. Still, diabetes was the seventh leading cause of death in the U.S. in 2021, according to the Centers for Disease Control and Prevention (CDC). But what, exactly, causes complications, and what can be done to prevent them?

To find out more, Health spoke with Donald Mcclain, MD, professor of endocrinology and metabolism at Wake Forest School of Medicine in North Carolina. Here are some common but dangerous complications of diabetes and how people with diabetes can protect themselves.

Chemicals in Your Blood

When diabetes is well managed, patients can live long and healthy lives. However, untreated diabetes can lead to high blood sugar and diabetic ketoacidosis, a serious condition that can be deadly.

Diabetic ketoacidosis occurs when people with diabetes cannot use their blood sugar for energy. Your body's cells use normally sugar for energy, but they require insulin signals to get that sugar from the blood. Without insulin, people with diabetes have to use fat for energy, creating harmful amounts of chemicals called ketones. This complication is more common in people with type 1 diabetes but can also occur in people with type 2 diabetes.

Diabetes treatments prevent high blood sugar and diabetic ketoacidosis by ensuring the cells can take sugar from the blood. Most people with type 1 diabetes can use an insulin pump or manually inject themselves with insulin several times a day. Meanwhile, people with type 2 diabetes can make lifestyle changes, take medications, or use insulin, depending on their case. If you have diabetes, ask a healthcare professional which approach is the best for you.

Despite treatments for diabetes, ketoacidosis can still happen—and without immediate insulin injections, it can be fatal. This can happen when people skip doses of insulin but can also be caused by illnesses or certain medications. Keep tabs on your blood sugar regularly so you can make sure it stays in the target range. This is especially important if you're sick when you may not be drinking enough fluids or eating enough.

Some symptoms of diabetic ketoacidosis include feeling thirsty, urinating frequently, vomiting, difficulty breathing, weakness, confusion, and fruity-smelling breath. If you suspect you have diabetic ketoacidosis, contact a healthcare professional and get immediate medical help.

Organ Damage Over Time

Another way diabetes can lead to death is by damage done to organs and tissues in the body over time. "For example, the blood vessels in the kidneys can be damaged by high blood sugar," said Dr. Mcclain—a complication that can lead to kidney failure.

This same type of organ and blood-vessel damage can also lead to blindness and amputation of feet or legs. People with diabetes should get in a habit of checking their feet every day. Things to look for are cuts, sores, swelling, skin and nail changes, and changes in temperature. If you spot a cut or sore that is infected or isn't healing properly, it's time to get medical attention.

High blood sugar levels don't just damage organs and blood vessels over time. They can also cause nerve damage, a condition called diabetic neuropathy. Damaged nerves can cause a range of problems from mild numbness to pain that interferes with normal activities, according to the CDC. If you have nerve damage in your foot, for example, you may not even feel a cut or sore.

These changes in organs and tissues can reduce your quality of life and raise the risk of infection, injuries, or additional illnesses. "We know that keeping blood sugar under control, for both type 1 and type 2 diabetes, is one of the best ways to reduce the risk of these complications," Dr. Mcclain said.

In addition to diet and lifestyle changes, people with type 2 diabetes sometimes need insulin injections to control their blood sugar. This can be helpful for people with more severe diabetes who do not respond strongly enough to the levels of insulin their body makes. However, not all people with diabetes need insulin injections. Talk to a healthcare professional about the best way to control your blood sugar.

Heart and Blood Vessel Problems

About two-thirds of deaths among people with diabetes are caused by cardiovascular conditions like heart attacks or strokes, Dr. Mcclain said. People with diabetes have a high risk for these diseases because high blood sugar can damage your heart and blood vessels.

Furthermore, according to the CDC, people with diabetes more often have clinical obesity, high cholesterol, or high blood pressure. These conditions can also damage or harden your blood vessels and heart, increasing your risk for heart disease. And the nerves that control your heart can also become damaged. In fact, compared to people without diabetes, people with diabetes have twice the chance of having heart disease or stroke, says the CDC.

Maintaining a healthy weight, eating a balanced diet, and getting regular physical activity are all ways people with diabetes can help protect their hearts and brains as they age. Also, make sure to work with your healthcare professional to monitor your blood sugar, pressure, and cholesterol.

Low Blood Sugar

Overtreatment of diabetes can also harm your health. "If you take too much insulin and your blood sugar goes way down, that can cause seizure, coma, and death," Dr. Mcclain said. Low blood sugar can starve the brain of oxygen, Dr. Mcclain added, and it can also trigger irregular heartbeats. According to the American Heart Association, these irregular heartbeats increase your risk for strokes or heart attacks.

Improvements in medical technology have made overtreatment much less likely than it once was, but it's still a risk—especially as patients get older. "The warning system that lets your brain know that your blood sugar is getting too low becomes blunted as you age," Dr. Mcclain said. You may not feel the symptoms of low blood sugar when you get older. Medically, this is called hypoglycemia unawareness.

Some mild symptoms of low blood sugar can include shakiness, sweating, and feeling irritated. If you have low blood sugar, the American Diabetes Association recommends taking 15 grams of carbohydrates every 15 minutes until your blood sugar levels are at least 70 mg/dL. In severe cases, people with low blood sugar may need to be treated with a hormone called glucagon that raises blood sugar.

Mental Health

People with diabetes can be affected by several mental health problems. They are two to three times as likely to develop depression and are 20% more likely to have anxiety at some point, according to the CDC.

Mental health problems can affect how well you take care of yourself and, therefore, how well you are managing your diabetes. For example, if you're stressed, stress hormones can make blood sugar levels increase. And if you're depressed, you may not be managing your diabetes as well as you should.

There is also something called diabetes distress, per the CDC. This is stress that comes from managing diabetes on a daily basis. Part of that stress comes from having to monitor blood sugar multiple times a day. And another part can come from high medical bills. According to the CDC, people with diabetes have more than double the healthcare costs compared to people without diabetes.

If you notice any signs of depression or anxiety, don't ignore them. Talk to your healthcare professional and/or join a support group. Help is available.

Diabetes Treatments Protect Your Health

Medical practitioners are getting better at treating diabetes and preventing complications so patients can live longer, healthier lives. "I had several diabetes patients in their 80s who are doing quite well," Dr. Mcclain said. "It's not easy, and it's a lot of work on the part of the patient, but we have good tools that are getting better all the time, and we can do this."

A Quick Review

Both high and low blood sugar can lead to serious health complications, including death, in people with untreated diabetes, whether type 1 or type 2. It takes work to manage blood sugar levels, but new technologies are making it easier. By controlling blood sugar levels and managing risk factors to reduce the chances of developing heart disease, stroke, and other diseases, people with diabetes can live a long time with good quality of life.

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