Type 2 diabetes can lead to long-term health complications that reduce both your lifespan and quality of life. Smoking, high blood pressure and high cholesterol can further negatively impact your longevity.
Fortunately, carefully managing your diabetes, reaching certain health targets, and making healthy lifestyle adjustments can all reduce the impact of type 2 diabetes on your lifespan, potentially adding years to your life.
1. Keep Your Blood Sugar in Your Target Range
Chronically high blood sugar levels, which are common with diabetes, increase oxidative stress and inflammation, accelerating the body’s cellular aging process.
“High blood sugar ages your body. Period,” says Aimée José, RN, CDCES, a diabetes educator in private practice in the San Diego area. “If you need motivation to improve your daily blood sugar levels, this is a big one.”
José recommends working with your healthcare team to fine-tune your insulin and other diabetes medication doses to improve your daily time in range, which is the percentage of the day in which your blood glucose levels are between 70 and 180 milligrams per deciliter (mg/dL). She also suggests using a continuous glucose monitor to better support your blood sugar management efforts.
“I’ve met many people with diabetes who are so reluctant to try a new medication or take an injection, but preventing the long-term consequences of high blood sugar is worth it,” says José.
2. Protect Your Cognitive Health
Type 2 diabetes may also increase your risk of cognitive impairment. It’s associated with accelerated brain atrophy and aging, as well as double the risk for dementia.
Since the brain relies on a steady stream of glucose to function properly, careful blood sugar management is key to both keeping diabetes under control and protecting your long-term cognitive health. Daily physical activity can also play a helpful role in reducing the impact of diabetes on your brain health, further supporting longevity. Following a healthy diet and staying engaged socially help protect cognitive function as well. Fun ways to support your cognitive health include social sports like pickleball, volunteering with a local organization you feel passionate about, and joining a club to pursue a hobby you enjoy.
3. Manage Your Weight
Striving to reach a healthy body weight may lengthen your life, too. Obesity, a major health factor associated with type 2 diabetes, can reduce a person’s life expectancy by 5 to 20 years.
Meanwhile, a loss of just 5 to 10 percent of your body weight can improve your overall health and well-being, including easier blood sugar management, better sleep, and increased energy.
“A little weight loss goes a long way,” says José. “Don’t get overwhelmed by the idea that you have to lose it all to make a difference.”
4. Lower Your Blood Pressure
People with diabetes are twice as likely as those without diabetes to experience high blood pressure (hypertension), which increases the risk for heart disease, the leading cause of death in the United States, and stroke.
To protect your heart health, an essential component of longevity, experts recommend keeping your blood pressure below 130/80 mmHg if you have hypertension.
“The same habits that support weight loss and diabetes inevitably help your blood pressure, too,” says José. Eat more whole foods and fewer processed foods, get more physical activity, reduce your salt intake, reach a healthy body weight, and manage stress for a healthier blood pressure.
5. Lower Your LDL Cholesterol
Cholesterol levels also play a significant role in cardiovascular disease risk, and type 2 diabetes tends to lower “good” HDL cholesterol and raise triglycerides and “bad” LDL cholesterol. Current guidelines for people with diabetes ages 40 to 75 with higher cardiovascular risk factors include use of statin medications to decrease LDL cholesterol by at least 50 percent, with the goal of reducing it below 70 mg/dL.
To keep LDL cholesterol in a healthy range, Jennifer C. Smith, CDCES, RD, a Wisconsin-based certified diabetes educator for Integrated Diabetes Services, advises people with type 2 diabetes to:
Limit saturated fats and eliminate trans fats in their diet.
Eat more plants, which also helps increase fiber intake.
Smoking is particularly harmful for people with type 2 diabetes, doubling all-cause mortality risk and reducing life expectancy by a collective 15 years.
Both high levels of nicotine in tobacco and the inflammation that smoking causes throughout the body contribute to insulin resistance. In fact, people who smoke cigarettes are 30 to 40 percent more likely than nonsmokers to develop type 2 diabetes.
By quitting smoking, you remove a major contributing factor to insulin resistance, improving your insulin sensitivity and, ultimately, your blood sugar levels, both of which are key to managing diabetes successfully, says José.
Quitting smoking isn’t easy, but the following expert tips may help:
Identify your key smoking triggers and avoid them.
Make a list of smoking alternatives to keep you busy during a craving.
Consider nicotine replacement therapy, like patches or gum.
Tell your community you’re quitting and let loved ones support you.
Motivate and reward yourself for every day of progress.
7. Reduce Your Alcohol Consumption
The relationship between alcohol and longevity is a complex one, and it can be even more complicated for people with type 2 diabetes. Alcohol can interact with diabetes medications such as insulin and sulfonylureas, which can lead to hypoglycemia (when blood sugar levels dip too low). Such complications can have adverse effects on life expectancy.
If you don’t already drink alcohol, it’s best to keep it that way. According to the World Health Organization, no level of alcohol consumption is confirmed safe for overall health. But if you do choose to drink alcohol with diabetes, know that moderation is critical for blood sugar control, and the less you drink, the better.
“Alcohol is a very difficult thing to cut back on,” says Smith. “It’s everywhere. It’s a huge part of social activities. It’s fun.” But the more you drink, the worse it is for your health. “If you can create some firm guidelines for yourself, like only drinking on Fridays, Saturdays, and Tuesdays, for example, and then limit yourself to two drinks on those nights, you can curb a lot of the negative side effects.”
The other less obvious impact on your health is how it may interfere with daily physical activity if you’re feeling tired from drinking the night before.
“Alcohol definitely doesn’t inspire exercise,” says Smith. “If it’s getting in the way of your physical activity goals because you’re feeling hungover, [it’s] time to set some boundaries around your alcohol habits.”
The Takeaway
With careful management, you can reduce the negative effects of type 2 diabetes on your lifespan and improve your odds of living a longer, healthier life.
You can strive to meet certain health targets, such as healthy body weight, blood pressure, and cholesterol levels, to promote longevity as well.
Lifestyle adjustments, including quitting smoking, reducing your alcohol consumption, and getting more physical activity also improve life expectancy for people with diabetes.
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Wang B et al. Assessing the Impact of Type 2 Diabetes on Mortality and Life Expectancy According to the Number of Risk Factor Targets Achieved: An Observational Study. BMC Medicine. March 2024.
Zhang Z et al. Type 2 Diabetes Mellitus: A Metabolic Model of Accelerated Aging — Multi-Organ Mechanisms and Intervention Approaches. Aging and Disease. May 23, 2025.
Time in Range (TIR) for Diabetes. Cleveland Clinic. July 9, 2024.
Dove A et al. Diabetes, Prediabetes, and Brain Aging: The Role of Healthy Lifestyle. Diabetes Care. October 1, 2024.
Castelo-Branco M et al. Regular Physical Activity Moderates the Adverse Impact of Type 2 Diabetes on Brain Atrophy Independently From HbA1c. Frontiers in Endocrinology. February 16, 2023.
Elise M Brett, MD, is a board-certified adult endocrinologist. She received a bachelor's degree from the University of Michigan and her MD degree from the Icahn School of Medicine at Mount Sinai. She completed her residency training in internal medicine and fellowship in endocrinology and metabolism at The Mount Sinai Hospital. She has been in private practice in Manhattan since 1999.
Dr. Brett practices general endocrinology and diabetes and has additional certification in neck ultrasound and fine-needle aspiration biopsy, which she performs regularly in the office. She is voluntary faculty and associate clinical professor at the Icahn School of Medicine at Mount Sinai. She is a former member of the board of directors of the American Association of Clinical Endocrinology. She has lectured nationally and published book chapters and peer reviewed articles on various topics, including thyroid cancer, neck ultrasound, parathyroid disease, obesity, diabetes, and nutrition support.
Ginger is a freelance writer and editor with a bachelor's degree in professional writing, and a background in cognitive coaching, video blogging, record-setting competitive powerlifting, personal training, Ashtanga yoga, and motivational speaking.
She lives in Vermont with a handsome husband, two daughters, and a loyal dog named Pedro.
