Type 2 diabetesis a progressive condition in which blood sugar issues show up gradually. First signs begin with slightly elevatedblood sugar (glucose) levels—out of normal range but not high enough to be diagnosed with diabetes. This is called insulin resistance and is the first of four stages of type 2 diabetes.
From there, the stages of type 2 diabetes begin to progress from prediabetes to type 2 diabetes to type 2 diabetes with vascular complications.
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Stages of Type 2 Diabetes
Stage 1: Insulin Resistance
Insulin resistanceis the first sign of blood sugar issues, often occurring years before atype 2 diabetes diagnosis. The food you eat becomes sugar (orglucose) in your body as it enters your blood.
The pancreas releasesinsulinto remove the sugar from your blood and enter your cells for your body to use for energy. When your body is resistant to insulin or doesn’t properly respond to insulin, your blood sugar begins to rise.
As a result, your body signals the liver and muscles to store blood sugar. When the liver can’t hold anymore, it sends the extra sugar to fat cells, which get stored as body fat.
While this first stage can go unnoticed, many changes in the body can create serious health issues in the future.
Type A Insulin Resistance
Stage 2: Prediabetes
You haveprediabeteswhen your blood glucose is outside thenormal rangebut not high enough to be considered diabetes. While reversible through lifestyle changes, such as diet and exercise, prediabetes increases your chances of developing type 2 diabetes, heart disease, and stroke.
Similar to insulin resistance, you may not see any signs of prediabetes until a blood test reveals glucose levels that are higher than they should be. Prediabetes risk increases if you have:
Prevalence of prediabetes increases for African Americans, Native Hawaiians, Alaska Natives, American Natives, Asian Americans, Hispanics/Latinos, Pacific Islanders, and those 45 or older.
Can you prevent prediabetes from turning into diabetes?Yes, prediabetes is reversible. Think of it as a warning signal. Eating healthy, losing extra weight through regular physical activity, and taking prescribed medications can get your blood sugar levels back in a normal range.
Can you prevent prediabetes from turning into diabetes?
Yes, prediabetes is reversible. Think of it as a warning signal. Eating healthy, losing extra weight through regular physical activity, and taking prescribed medications can get your blood sugar levels back in a normal range.
Stage 3: Type 2 Diabetes
With type 2 diabetes, your blood glucose is in a dangerous range. Normal fasting blood sugar is 99 milligrams of sugar per deciliters of blood (mg/dL) or lower. With prediabetes, blood glucose is between 100 to 125 milligrams of sugar per deciliters of blood. Numbers that are 126 milligrams of sugar per deciliters of blood or higher mean you have type 2 diabetes.
Some with type 2 diabetes may not show symptoms; for others, symptoms may be mild. However, symptoms will get progressively worse.
Type 2 diabetes symptoms include:
Signs Blood Sugar Is Not Under ControlEven when you are following your diabetes treatment plan, blood sugar may get out of control due to the condition’s progressive nature.If you notice signs of your blood sugar slipping out of the normal range, contact your healthcare provider immediately to discuss your treatment plan.
Signs Blood Sugar Is Not Under Control
Even when you are following your diabetes treatment plan, blood sugar may get out of control due to the condition’s progressive nature.If you notice signs of your blood sugar slipping out of the normal range, contact your healthcare provider immediately to discuss your treatment plan.
Stage 4: Type 2 Diabetes With Vascular Complications
Diabetic retinopathy: The blood vessels in the back of your eye become swollen, leaking fluid into your eye. This can cause vision loss, retinal detachment, glaucoma (optic nerve damage), and cataracts (cloudy eye lens).
Atherosclerosis: A build-up of fat and cholesterol, calledplaque, collects in the arteries. It eventually hardens, and blood is unable to move freely. The plaque can get so thick that the pathway through the arteries is completely blocked, causing a heart attack or stroke.
Diabetic nephropathy: High blood sugar can also damage your kidneys. When this happens, the kidneys can’t remove waste and fluid from your body effectively, eventually leading to kidney failure. Treatment requires regulardialysis, a procedure that manually removes waste from the blood until you can receive a kidney transplant.
What is end-stage diabetes?End-stage diabetes is a series of complications that can occur in people who have had diabetes for a long time. These complications can include heart disease, kidney problems, and nerve damage. Older adults are more likely to experience end-stage diabetes because increased frailty and age-related cognitive changes can make it more difficult to manage diabetes.
What is end-stage diabetes?
End-stage diabetes is a series of complications that can occur in people who have had diabetes for a long time. These complications can include heart disease, kidney problems, and nerve damage. Older adults are more likely to experience end-stage diabetes because increased frailty and age-related cognitive changes can make it more difficult to manage diabetes.
Slowing Progression
The only way to prevent or slow the progression of type 2 diabetes is to control your blood sugar. If you’re diagnosed with insulin resistance or prediabetes, you can still avoid type 2 diabetes. If you are diagnosed with type 2 diabetes, prevention and management are the same:
Type 2 diabetes is a progressive disease, making it harder to control your blood sugar over time. Work with your healthcare provider to adjust your treatment plan and medications as needed to helpprevent serious complications.
How long can you live with diabetes?The average life expectancy of someone with type 2 diabetes is around 63 years. But this is highly dependent on how well you control your diabetes. Eating healthy, doing regular physical activity, and following your healthcare provider’s treatment plan will help keep your blood sugar under control.
How long can you live with diabetes?
The average life expectancy of someone with type 2 diabetes is around 63 years. But this is highly dependent on how well you control your diabetes. Eating healthy, doing regular physical activity, and following your healthcare provider’s treatment plan will help keep your blood sugar under control.
Summary
While a type 2 diabetes diagnosis may seem like it comes out of nowhere, the changes in your body begin years before a diagnosis. Diabetes occurs in four stages: Insulin resistance, prediabetes, type 2 diabetes, and type 2 diabetes with vascular complications.
If insulin resistance or prediabetes is caught early, lifestyle changes, such as eating a healthy diet, adding exercise to your daily activities, and possibly taking diabetes medication, can prevent you from developing type 2 diabetes.
Blood sugar management is key to preventing the most severe complications, such as eye disease, kidney damage, and cardiovascular disease. Some may be able to reverse type 2 diabetes, but for many, it is a lifelong medical condition.
15 SourcesVerywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.National Institutes of Health.Insulin resistance and prediabetes.Centers for Disease Control and Prevention.About insulin resistance and type 2 diabetes.MedlinePlus.Type a insulin resistance syndrome.MedlinePlus:Prediabetes.Centers for Disease Control and Prevention.Prediabetes - Your chance to prevent type 2 diabetes.Centers for Disease Control and Prevention.Testing for diabetes.MedlinePlus.Type 2 diabetes.Centers for Disease Control and Prevention.Symptoms of diabetes.American Diabetes Association.How type 2 progresses.Rask-Madsen C, King GL.Vascular complications of diabetes: mechanisms of injury and protective factors.Cell Metab. 2013;17(1):20-33. doi:10.1016/j.cmet.2012.11.012MedlinePlus.Diabetic eye problems.MedlinePlus.Atherosclerosis.MedlinePlus.Diabetic kidney problems.Dunning TL.Palliative and end-of-life care: vital aspects of holistic diabetes care of older people with diabetes.Diabetes Spectr.2020;33(3):246-254. doi:10.2337/ds20-0014Rosenquist KJ, Fox CS.Mortality trends in type 2 diabetes.In: Cowie CC, Casagrande SS, Menke A, et al., eds.Diabetes in America. 3rd ed. National Institute of Diabetes and Digestive and Kidney Diseases (US); 2018. PMID: 33651566
15 Sources
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.National Institutes of Health.Insulin resistance and prediabetes.Centers for Disease Control and Prevention.About insulin resistance and type 2 diabetes.MedlinePlus.Type a insulin resistance syndrome.MedlinePlus:Prediabetes.Centers for Disease Control and Prevention.Prediabetes - Your chance to prevent type 2 diabetes.Centers for Disease Control and Prevention.Testing for diabetes.MedlinePlus.Type 2 diabetes.Centers for Disease Control and Prevention.Symptoms of diabetes.American Diabetes Association.How type 2 progresses.Rask-Madsen C, King GL.Vascular complications of diabetes: mechanisms of injury and protective factors.Cell Metab. 2013;17(1):20-33. doi:10.1016/j.cmet.2012.11.012MedlinePlus.Diabetic eye problems.MedlinePlus.Atherosclerosis.MedlinePlus.Diabetic kidney problems.Dunning TL.Palliative and end-of-life care: vital aspects of holistic diabetes care of older people with diabetes.Diabetes Spectr.2020;33(3):246-254. doi:10.2337/ds20-0014Rosenquist KJ, Fox CS.Mortality trends in type 2 diabetes.In: Cowie CC, Casagrande SS, Menke A, et al., eds.Diabetes in America. 3rd ed. National Institute of Diabetes and Digestive and Kidney Diseases (US); 2018. PMID: 33651566
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.
National Institutes of Health.Insulin resistance and prediabetes.Centers for Disease Control and Prevention.About insulin resistance and type 2 diabetes.MedlinePlus.Type a insulin resistance syndrome.MedlinePlus:Prediabetes.Centers for Disease Control and Prevention.Prediabetes - Your chance to prevent type 2 diabetes.Centers for Disease Control and Prevention.Testing for diabetes.MedlinePlus.Type 2 diabetes.Centers for Disease Control and Prevention.Symptoms of diabetes.American Diabetes Association.How type 2 progresses.Rask-Madsen C, King GL.Vascular complications of diabetes: mechanisms of injury and protective factors.Cell Metab. 2013;17(1):20-33. doi:10.1016/j.cmet.2012.11.012MedlinePlus.Diabetic eye problems.MedlinePlus.Atherosclerosis.MedlinePlus.Diabetic kidney problems.Dunning TL.Palliative and end-of-life care: vital aspects of holistic diabetes care of older people with diabetes.Diabetes Spectr.2020;33(3):246-254. doi:10.2337/ds20-0014Rosenquist KJ, Fox CS.Mortality trends in type 2 diabetes.In: Cowie CC, Casagrande SS, Menke A, et al., eds.Diabetes in America. 3rd ed. National Institute of Diabetes and Digestive and Kidney Diseases (US); 2018. PMID: 33651566
National Institutes of Health.Insulin resistance and prediabetes.
Centers for Disease Control and Prevention.About insulin resistance and type 2 diabetes.
MedlinePlus.Type a insulin resistance syndrome.
MedlinePlus:Prediabetes.
Centers for Disease Control and Prevention.Prediabetes - Your chance to prevent type 2 diabetes.
Centers for Disease Control and Prevention.Testing for diabetes.
MedlinePlus.Type 2 diabetes.
Centers for Disease Control and Prevention.Symptoms of diabetes.
American Diabetes Association.How type 2 progresses.
Rask-Madsen C, King GL.Vascular complications of diabetes: mechanisms of injury and protective factors.Cell Metab. 2013;17(1):20-33. doi:10.1016/j.cmet.2012.11.012
MedlinePlus.Diabetic eye problems.
MedlinePlus.Atherosclerosis.
MedlinePlus.Diabetic kidney problems.
Dunning TL.Palliative and end-of-life care: vital aspects of holistic diabetes care of older people with diabetes.Diabetes Spectr.2020;33(3):246-254. doi:10.2337/ds20-0014
Rosenquist KJ, Fox CS.Mortality trends in type 2 diabetes.In: Cowie CC, Casagrande SS, Menke A, et al., eds.Diabetes in America. 3rd ed. National Institute of Diabetes and Digestive and Kidney Diseases (US); 2018. PMID: 33651566
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