Can you die from diabetes?

According to the American Diabetes Association, 11% of the population has diabetes (also called diabetes mellitus), and another 96 million have prediabetes—making it one of the most common chronic diseases in the U.S. Sadly, it’s also one of the most preventable diseases. Of the two main types of diabetes, Type 2, which develops over years and is usually linked to obesity or a lack of physical activity, accounts for roughly 95% of American cases. 

With treatment, most people with either Type 1 diabetes, which is a genetic immune system disease, or Type 2 diabetes can manage their conditions effectively and avoid most of the major complications of diabetes. If it’s left untreated, however, diabetes can lead to more serious health problems, including some that can be life-threatening. 

Can diabetes kill you?

The short answer is, yes, untreated diabetes can kill you. But in a strictly medical sense, diabetes won’t be what kills you. A complication that arose from your diabetes will most likely be the real culprit.

“The actual cause of death is a combination of factors and complications,” says Daniel Boyer, MD, a doctor and medical researcher with the Farr Institute. “The most common causes of death among people with Type 2 diabetes include heart disease, stroke, and kidney disease.”

With diabetes, the body can’t produce enough insulin or effectively use insulin, a hormone produced by the pancreas that helps regulate blood sugar levels (or blood glucose levels). This can cause blood sugar levels to be higher than they should be, a condition called hyperglycemia. Over time, hyperglycemia can cause a number of health problems, such as vision loss, heart disease, kidney disease, and nerve damage.

Although some of its complications can be fatal over time, diabetes itself doesn’t cause sudden death. Severe hypoglycemia and diabetic ketoacidosis can cause sudden death—but it is rare and can be treated if caught in time. And in rare cases, diabetes causes nerve damage, or neuropathy, which can be a secondary cause of sudden death due to an infection.

“Neuropathy causes patients to lose sensation or sensitivity in their legs, which makes it more difficult for them to notice they’ve been injured,” says Nancy Mitchell, RN, a geriatric nurse and healthcare writer with Assisted Living Center. “If a wound goes untreated, it could progress into a gangrenous infection. If that infection is neglected or not treated adequately, it could develop into sepsis and cause sudden death.”

RELATED: What is insulin resistance?

How many people die from diabetes each year?

Diabetes was listed as the underlying cause in 87,647 deaths in 2019 and was mentioned as a cause of death on 282,801 death certificates in all. In 2020, the Centers for Disease Control and Prevention (CDC) had diabetes ranked as the eighth most common cause of death in the U.S.

Which body system is affected by diabetes?

Gangrenous infections aside, most deaths due to diabetes can be traced to other complications of having high blood sugar levels in the blood over an extended period of time. Too much glucose in the blood can damage the organs, blood vessels, and nerves—eventually leading to life-threatening health problems.

• Cardiovascular problems: Diabetes can affect the heart and blood vessels in many ways, often causing high blood pressure, increased cholesterol levels, thickening of the arteries (atherosclerosis) or coronary artery disease. Damage to the blood vessels and the nerves that control the heart can greatly increase a person’s risk of heart attack or stroke.
• Kidney damage: High blood sugar levels can damage the blood vessels and nephrons (tiny organs that help filter the blood) in the kidneys. Over time, the kidneys will start to fail. If kidney failure isn’t treated with dialysis or a kidney transplant, it can be fatal. 
• Diabetic ketoacidosis: Insulin helps glucose enter cells to be used as fuel for muscles and other tissues in the body. When insulin levels get too low and cells can’t burn glucose for fuel, the body starts to burn fat instead. This causes acidic compounds called ketones to build up in the blood. In time, this, along with increasing blood glucose levels, leads to a condition called ketoacidosis, in which the blood is too acidic. If it goes untreated, ketoacidosis can lead to unconsciousness and, eventually, death. Ketoacidosis is more common in people with Type 1 diabetes.
• Nerve damage: Elevated blood sugar levels can damage tiny blood vessels that feed the body’s nerves, often resulting in numbness, tingling or pain, especially in the hands and feet. Damage can also occur to the nerves controlling the digestive system, leading to nausea, vomiting, constipation or diarrhea. With decreased nerve function, injuries may go unnoticed or fail to heal, increasing the risk of infection. If infections go untreated, they can spread and become life-threatening and may require amputation of the infected body part.
• Low blood sugar: Hypoglycemia, when blood sugar levels get too low, can lead to neurological and physical symptoms that come on quickly. People with hypoglycemia may be confused, disoriented, fatigued, hungry or nauseous, and they may suffer headaches or blurred vision. If it goes untreated, low blood sugar can starve the brain of the glucose it needs to function correctly. This can lead to seizures, coma, and death.
• Alzheimer’s disease: Studies have shown that older adults with Type 1 diabetes are 93% more likely than people without diabetes to develop dementia. And some people in the medical community have proposed calling Alzheimer’s disease Type 3 diabetes since there is such a strong link between high blood sugar levels and an increased risk of developing dementia. Alzheimer’s disease is the most common cause of dementia and was the seventh-leading cause of death (just ahead of diabetes) in the U.S. in 2020.
• Mental health issues: According to the CDC, people with diabetes are two to three times more likely to suffer from depression and 20% more likely to experience anxiety than people without diabetes. These sorts of mental health issues can contribute to other diabetes symptoms getting worse, which may, in turn, make the feelings of depression and anxiety worse. This can increase the risk of thoughts of self-harm or suicide. (If you feel suicidal, call the Suicide and Crisis Lifeline at 988 for help.)
• Vision loss: Over time, diabetes can damage the eyes and cause cataracts, glaucoma, or a condition called diabetic retinopathy. Although these conditions won’t kill you, if they go untreated, all three conditions can cause vision loss and, eventually, blindness. This can increase a person’s risk of depression or accidental death.

What happens if diabetes goes untreated?

One of the problems with Type 2 diabetes is that the early symptoms can be very hard to detect, and the disease can go on for years before someone even notices it. By then, unfortunately, damage will have already been done, but lifestyle and diet changes, along with other treatments, can help halt the progression of the disease and repair some of the damage to organs and other tissues. Early signs of untreated diabetes include the following:

• Excessive thirst
• Frequent urination
• Blurry vision
• Headaches
• Feeling tired or weak
• Irritability or mood changes
• Cuts or sores that are slow to heal
• Getting more infections than usual
• Unexplained weight loss
• Numbness or tingling in the hands or feet
• Very dry skin
• Excess ketones in the blood (this can be detected by a urine test)
• High blood sugar (this can be detected by a hemoglobin a1c test) 

As diabetes progresses and more damage is done to organs, blood vessels, and nerves, symptoms will generally become more serious in nature. At this point, a person with diabetes will typically know that something is wrong. This is when most people consult a doctor or other healthcare professional, who might refer diabetic patients to an endocrinologist to determine if there is something wrong with their pancreas.

Without treatment, the effects of diabetes will continue to cause slow but steady damage, leading to serious complications. Vision loss, foot problems, gastrointestinal issues, infections, bladder problems, erectile dysfunction, and cognitive decline are all signs that diabetes is getting worse. Eventually, over the course of years, one of the life-threatening complications, whether it be a heart attack, stroke, kidney failure or ketoacidosis, will be fatal. 

The bottom line

The bad news is that untreated diabetes can kill you. The good news is that diabetes is very treatable, and Type 2 diabetes is mostly preventable. Good diabetes management starts with scheduling regular checkups and formulating a treatment plan with a healthcare provider or diabetes educator. This is especially true if you have a family history of diabetes or meet certain risk factors for the disease, including being overweight, being 45 or older, having had gestational diabetes (diabetes during pregnancy), or being physically inactive.

For most people, diabetes care begins with taking steps to lead a healthy life. This means getting plenty of exercise, losing weight and eating a healthy diet or specialized diabetic diet that is high in whole grains, lean proteins, fruits and vegetables and low in carbohydrates, which can contribute to high blood glucose levels. Healthy lifestyle changes like these can help you manage diabetes effectively, but without careful monitoring of blood sugar levels or necessary treatment, you’ll still be putting yourself at higher risk of serious complications.

“While it may not be possible to predict precisely how long a person with diabetes can live without treatment,” Dr. Boyer says, “the more well-controlled the disease is, the better the outlook for long-term health and quality of life.”

The bottom line: If you think you might have diabetes, see a healthcare provider, and don’t let the disease go untreated because it could eventually kill you.