Background: Diabetes mellitus (DM) has become the epidemic of the 21st century. In Kenya, diabetic patients face multiple risk factors that increase vulnerability to long-term complications. This study explored the factors associated with increased risks to long-term complications among patients with Type 2 DM (T2DM) at the Kenyatta National Hospital (KNH). Methods: A descriptive cross-sectional study was conducted to estimate the distribution characteristics of the long-term complications, and collect data of participants’ medical history, physical examination findings and responses of the focused group discussion. We recruited 147 adults with T2DM and 10 nurses involved in diabetes care. Continuous data were analyzed using parametric methods while categorical data were analyzed by Chi- Square tests. Results: Participants faced multiple obstacles as they sought diabetes care at the KNH. Most obstacles resulted from long distance to the facility (43%), inadequate essential services (75.2%) and high costs (66%). Inadequate income (83.7%), psychological stress (91.8%) and obesity (47.6%) were found to be associated with increased vulnerability to complications. Conclusions: At the KNH, diabetes control is inadequate due to limited access to essential health services and the individual participants’ report of facing challenges in self-management. Decentralized comprehensive DM clinics and increased insurance cover would improve access to health services. It is important to implement structured diabetic health education early in the course of the disease taking into account patients’ cultural and socioeconomic variations. These measures would adequately address the modifiable risk factors and decrease the risks of long-term diabetic complications in Kenya.