Diabetes is a disease that occurs when your body doesn't make enough of a hormone called insulin, or if your body doesn't use insulin the right way. If left untreated, it may result in blindness, heart attacks, strokes, kidney failure and amputations. Only half of the people who have diabetes are diagnosed because in the early stages of diabetes, there are few symptoms, or the symptoms may be the same as in other health conditions.
How to know if you might have Diabetes
"Most people are unaware that they have diabetes in its early or even middle phases." says Aaron Cypess, MD, assistant professor of medicine at Harvard Medical School and staff physician at Joslin Diabetes Center.
"It's not like you wake up one day and all of a sudden you're thirsty, hungry, and [going to the bathroom] all the time" says Melissa Joy Dobbins, RD, a certified diabetes educator in Illinois and a spokesperson for the American Association of Diabetes Educators.
Diabetes is a metabolic disorder that affects your body's ability to either use or produce insulin, which how your body can use blood sugar for energy. When your cells become resistant to insulin or your body doesn’t make enough of it, your blood sugar levels rise, causing many of the short-term and long-term symptoms of diabetes.
There are four different types of “sugar” diabetes: pre-diabetes, type 1, type 2, and gestational, although the majority of cases diagnosed each year are type 2 diabetes. In each of these types, there are both similar symptoms and symptoms that distinguish each type from the others.
Some common symptoms of diabetes: The following symptoms of diabetes are typical. However, some people with type 2 diabetes have symptoms so mild that they go unnoticed.
1. You're taking more bathroom breaks
When you have diabetes, your body becomes less efficient at breaking food down into sugar, so you have more sugar sitting in your bloodstream, says Dobbins. "Your body gets rid of it by flushing it out in the urine. That’s why you’re going to the bathroom a lot." Most patients aren't necessarily aware of how often they use the bathroom, says Dr. Cypess. "When we ask about it, we often hear, 'Oh yeah, I guess I’m going more often than I used to,'" he says. But one red flag is whether the need to urinate keeps you up at night. Once or twice might be normal, but if it's affecting your ability to sleep, that could be a symptom to pay attention to.
2. You're thirstier than usual
Urinating a lot will also make you feel parched. A common symptom Dobbins sees with patients is that they use drinks like juices, soda, or chocolate milk to quench their thirst. These sugary beverages then pack the bloodstream with excess sugar, which can lead to the problem all over again.
3. You've lost a little weight
Considering that being overweight is a risk factor for diabetes, it sounds counterintuitive that shedding pounds could be a sign of the disease. "Weight loss comes from two things," says Dr. Cypess. "One, from the water that you lose [from urinating]. Two, you lose some calories in the urine and you don’t absorb all the calories from the sugar in your blood."
Once people learn they have diabetes and start controlling their blood sugar, they may even experience some weight gain—but "that's a good thing,” says Dr. Cypess, because it means your blood sugar levels are more balanced.
4. You feel shaky and hungry
It's not uncommon for patients to suddenly feel unsteady and immediately need to reach for carbs, says Marjorie Cypress, a nurse practitioner at an endocrinology clinic in Albuquerque, New Mexico, and 2014 president of health care and education for the American Diabetes Association.
“When you have high blood sugar, your body has a problem regulating its glucose,” she explains. “If you’ve eaten something high in carbohydrates, your body shoots out a little too much insulin, and your glucose drops quickly. This makes you feel shaky, and you tend to crave carbs or sugar. This can lead to a vicious cycle.”
5. You're tired all the time
Of course you're exhausted every now and then. But ongoing fatigue is an important symptom to pay attention to; it might mean the food you’re eating for energy isn’t being broken down and used by cells as it’s supposed to. “You’re not getting the fuel your body needs,” says Dobbins. “You’re going to be tired and feel sluggish.” But in many cases of type 2 diabetes, your sugar levels can be elevated for awhile, so these symptoms could come on slowly.
6. Foot Pain and Numbness
Over time, a prolonged exposure to high blood sugar can damage the nerves throughout the body — a condition called diabetic neuropathy. Some people may not have any symptoms of the damage, while others may notice numbness, tingling, or pain in the extremities. “At the beginning, [diabetic neuropathy] usually starts in the feet and then it progresses upward,” says Dr. Ovalle.
Although most common in people who have had type 2 diabetes for 25 years or more, it can occur in people who have prediabetes as well. In some studies, almost 50 percent of unexplained peripheral neuropathy [in the extremities], whether painful or otherwise, turns out to be caused by prediabetes or diabetes, says Dr. Einhorn.
7. You're moody and grumpy
When your blood sugar is out of whack, you just don't feel well, says Cypress, and might become more short-tempered. In fact, high blood sugar can mimic depression-like symptoms. "You feel very tired, you don’t feel like doing anything, you don’t want to go out, you just want to sleep," Cypress says. She'll see patients who think they need to be treated for depression, but then experience mood improvement after their blood sugar normalizes.
8. Skin problems
Itchy skin, perhaps the result of dry skin or poor circulation, can often be a warning sign of diabetes, as are other skin conditions, such as acanthosis nigricans. "This is a darkening of the skin around the neck or armpit area," Dr. Collazo-Clavell says. "People who have this already have an insulin resistance process occurring even though their blood sugar might not be high. When I see this, I want to check their blood sugar."
9. Yeast infections
"Diabetes is considered an immunosuppressed state," Dr. Collazo-Clavell explains. That means heightened susceptibility to a variety of infections, although the most common are yeast (candida) and other fungal infections, she says. Fungi and bacteria both thrive in sugar-rich environments. Women, in particular, need to watch out for vaginal candida infections.
10. Your vision seems blurry
Don’t be alarmed—this is not diabetic retinopathy, where the blood vessels in the back of the eye are getting destroyed, says Dr. Cypess. In the early stages of diabetes, the eye lens is not focusing well because glucose builds up in the eye, which temporarily changes its shape. "You're not going blind from diabetes,” Dr. Cypess says he assures patients. "In about six to eight weeks after your blood sugars are stabilized, you’re not going to feel it anymore; the eye will adjust."
11. Your cuts and scrapes heal more slowly
The immune system and the processes that help the body heal don't work so well when your sugar levels are high, explains Dr. Cypess.
12. Slow healing
Infections, cuts, and bruises that don't heal quickly are another classic sign of diabetes. This usually happens because the blood vessels are being damaged by the excessive amounts of glucose traveling the veins and arteries. This makes it hard for blood—needed to facilitate healing—to reach different areas of the body.
13. You're more prone to urinary tract and yeast infections
Higher levels of sugar in urine and the vagina can become a breeding ground for the bacteria and yeast that cause these infections. Recurrent infections are particularly worrisome. "Usually when you keep getting infections, doctors will check for diabetes if you don't already have it," says Cypress. "Even women who go to the emergency room for urinary tract infections are often checked."
14. Frequent Infections
Since both yeast and bacteria multiply more quickly when blood sugar levels are elevated, women with type 2 diabetes may be more susceptible to vaginal infections, says Einhorn. Foot infections are also common because diabetes can damage the architecture of the foot, including the skin, blood vessels, and nerves. However, Einhorn says, foot problems are usually seen more frequently in those with advanced diabetes.
15. Fatigue and irritability
"When people have high blood sugar levels, depending on how long it's been, they can get used to chronically not feeling well," says Dr. Collazo-Clavell. "Sometimes that's what brings them into the office." Getting up to go to the bathroom several times during the night will make anyone tired, as will the extra effort your body is expending to compensate for its glucose deficiency. And being tired will make you irritable.
"We see people whose blood sugar has been really high, and when we bring the blood sugar down, it's not uncommon that I hear, ‘I didn't realize how bad I felt,'" she says.
16.Blood tests
Several tests are used to check for diabetes, but a single test result is never enough on its own to diagnose diabetes (the test has to be repeated). One is the fasting plasma glucose test, which checks your blood sugar after a night (or eight hours) of not eating. Blood glucose above 126 milligrams per deciliter (mg/dL) on two occasions means you have diabetes. The normal cutoff is 99 mg/dL while a blood sugar level of 100 to 125 mg/dL is considered prediabetes, a serious condition on its own.
Tips & Warnings
1. Early diagnosis of this disease is vital to protect your organs from damage.
2. Exercise and healthful diets are known to have beneficial effects for diabetics.
3. Any of the symptoms mentioned above warrant further testing to rule out diabetes.
