Wow, what an (another) eye opener. Your explanation answered many of my questions too, thank you @A DiabetesTeam Member 😊

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A Diabete...

Type 2 is progressive BUT "some" can practically halt it, so will NOT progress "far enough" for it to become a issue

Keeping your A1C below 6.5% you will avoid the major diabetic complications

When might it advance, if it does and how quickly?

Who knows - and that is the answer. Type 2 is a metabolic disease/disorder and there are dozens of other factors that can mess with the diabetes - thyroid, pituitary or adrenal disorders - Liver and Pancreas issues as well

Depending on "what" advances - eg if you lost total ability to produce insulin and didn't know until the next A1C test, it could double or triple from your current level

And yes, the various complications are all "vascular" at their core

Retinopathy, Chronic Kidney Disease (diabetes induced) and Diabetes (vascular) Dementia are "micro-vascular" complications and they start setting in at blood sugar levels above 8.7 mmols/156

Peripheral Neuropathy and the Arterial diseases of the Heart leading to Congestive Heart Failure, Stroke or Heart Attack are "macro-vascular" complications and cumulative damage is done anytime our blood sugar remains above 7.8 mmols/140 for more than a total of 3 or 4 hours a day

This is why Peripheral Neuropathy is the most common complication effecting 1 in 2 Diabetics over the course of the disease - it "sets in" even if your Blood Sugar is "just a Little too high"

Timelines vary but permanent damage to insulin production in the pancreas can occur after 6 years which is also typical onset for Neuropathy or Frozen Shoulder

Assuming otherwise decent health, Congestive Heart Failure almost always follows advanced neuropathy which possibly included an amputation - maybe 20 years to finish the job but mobility would be terrible for the decade before

The Kidney Disease is trickier - but just "statistically" life expectancy drops to 5 years the day you start dialysis

The complications don't follow a strict timeline but rather a combination of "years dealing with the disease" and "blood sugar levels"

The longer you have had diabetes the less resilient your system is (and the more cumulative damage has occurred even if you are well controlled) so you could be cruising along for decades and then a year or two of poor control could lead to a stroke

Someone else's "timeline" will be of zero value to any of us - we don't progress the same

When I was diagnosed I made a plan:

I was 52 years old and I wanted to get to 60 with an A1C always below 6.0 - I have done that

So next target is now below 6.5 at least until 65 and 70 if I can manage it

And that's the trick - try to "delay" the onset of major complications until "after" we have passed - kick the can so far down the road that you just won't catch up to it - ever