Here’s a scary stat: More than 30 million people in the U.S. have diabetes, according to the Centers for Disease Control and Prevention (CDC)—and 25 percent don’t even know they have it.

But it gets worse: 84 million more Americans have pre-diabetes (a.k.a., almost diabetes, when your blood sugar levels are high, but not high enough for full-blown diabetes)—and 90 percent of those people don’t know they have it either, per the CDC.

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Back up—remind me what diabetes is again.

Diabetes isn’t just one disease. There are actually three types of diabetes: type 1, type 2, and gestational diabetes. Most people with diabetes have type 2—it happens when your body doesn’t use insulin well and is unable to keep your blood sugar stable, per the CDC.

Type 1 diabetes is much less common—only about 5 percent of those with diabetes have type 1—and it’s essentially an autoimmune disease where your body stops making insulin at all (and as such, can’t regulate blood sugar).

And gestational diabetes occurs in pregnant women—it usually goes away after you give birth, but it can increase your likelihood of developing type 2 diabetes later on, according to the National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK).

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All three types of diabetes can easily be detected though a blood test. The test, essentially, checks to see if your blood glucose (a.k.a. blood sugar) is too high. But be warned: You can’t diagnose yourself—not even with an OTC blood glucose meter, per the NIDDK.

Unfortunately, many people are walking around with undiagnosed diabetes or prediabetes because the symptoms are super-subtle, says Poorani Goundan, M.D., an endocrinologist at Boston Medical Center.

These sneaky diabetes symptoms might indicate that it’s time to head into your doctor’s office for a test.

1. You have to pee all the time.

When you have excess sugar coursing through your blood stream, your body instinctively tries to get rid of it, says Mary Vouyiouklis Kellis, M.D., an endocrinologist at Cleveland Clinic. “Water follows sugar, so you end up having high-volume urine loss,” she explains.

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If you notice you’re suddenly peeing a lot, and more often, for no real reason—especially if you’re waking up a few times during the night to go—it’s time to talk to your doctor, she says.

2. You never stop drinking water.

With all that peeing, dehydration is a very real possibility. And, to make matters worse, “some patients who don’t know they have diabetes quench their thirst with sugary drinks like soda or juice, which adds to their blood sugars,” Goundan says. Signs of dehydration include dark-colored urine, a drop in (water) weight, and extreme thirst.

Sound familiar? Talk to your doc about this potential symptom of diabetes, especially if it occurs in tandem with lots of bathroom breaks.

3. Your breath smells awful.

Diabetes-related dehydration contributes to dry mouth, and the bad breath that can accompany it. (After all, with dry mouth, there’s not enough spit to wash away bacteria and balance the pH in your mouth, Kellis says.)

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What’s more, undiagnosed or uncontrolled diabetes can trigger ketosis, a process in which the body uses fat, rather than glucose, for energy. Ketosis releases a chemical byproduct called ketones, which can make your breath smell unpleasantly sweet or fruity, she says—sometimes it might even smell like acetone, since that’s a type of ketone.

Unless you’re on a keto diet (which is designed to put you into ketosis), it’s worth talking to your doctor.

4. Your vision’s getting increasingly blurry.

Blurry vision is a common—and often ignored—diabetes symptom in women. What does diabetes have to do with your vision? Kellis explains that fluid can form in your eye’s lens as sugar levels increase (remember: fluid follows sugar).

Diabetes can cause significant, unexplained weight loss. Think: 10 or 20 pounds.

A buildup of fluid in the eye blurs vision, causes nearsightedness, and sends many people to the optometrist for a new glasses or contacts prescription.

Fortunately, getting your blood sugar levels under control can clear up blurred vision, she adds.

5. Your hands and feet fall asleep a lot.

Neuropathy—a condition characterized by numbness or weird sensations like pins and needles in your arms, legs, hands, and feet—occurs in more than half of people with type 2 diabetes, according to a 2017 Diabetes Care review.

Why so common? Diabetes reduces blood flow to your extremities and, over time, damages your blood vessels and nerves, Kellis says.

6. Your cuts and bruises take forever to heal.

Reduced sensation in your extremities makes you more prone to injuries. “You’re less likely to notice a cut because you can’t feel it, which means you’re less likely to take care of it and it’s more likely to get infected,” says Goundan.

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Then, once you do have an injury, uncontrolled diabetes can make it harder for your body to heal. “High blood sugars provide a good environment for bacteria to grow,” she says. That’s because diabetes is also often accompanied by high blood pressure and high cholesterol, and the resulting plaque buildup can narrow blood vessels, reducing blood supply and leading to slow healing.

Diabetes can also weaken the T-cells that make up your immune system—your body’s defense against infection. “When you have high blood sugar, it’s like delaying your body’s army to go to the wound to heal it,” says Kellis.

7. You’re losing weight…but aren’t trying to.

Unexplained weight loss can happen for lots of reasons, and diabetes is one of them. Goundan explains that insulin helps your body move sugar from your blood to your cells, so when you have an insulin resistance, you don’t get enough energy into your cells despite all that sugar flowing through your body. “Because you’re unable to get enough energy from sugar, your body burns your own fat and muscle for energy,” Kellis says. “Weight loss can be pretty significant, sometimes 10 to 20 pounds.”

Generally, doctors recommend visiting the doc if you unintentionally lose between 5 to 10 percent of your body weight over the course of six months.

8. You get enough sleep, but you’re still so tired.

Carbohydrates, which your body breaks down into glucose, are your body’s main source of energy. But your body can’t effectively use that source of energy when you have diabetes, explains Goundan. (And diabetes-related dehydration can also bring on fatigue.)

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Of course, there are tons of other reasons you could be feeling exhausted, including your diet, stress levels, and how much you’ve been sleeping.

Still, if you can’t think of any other good reason for your extreme fatigue, and your low energy levels are accompanied by some of these other diabetes symptoms, it’s worth getting checked out.

9. You get a surprising number of yeast infections.

High blood sugars create an environment in your vagina that’s ripe for yeast infections. “Glucose is fuel for yeast. The more that’s around, the more they can multiply,” says Kellis.

If you’re having two to three yeast infections every few months or if the standard treatments just aren’t working, it’s time to see a doctor. “Once blood sugar is controlled, the frequency goes down,” says Goundan.

10. You’ve got weird dark spots on your skin.

Darkening skin around the nape of your neck, under your armpits, or even in your groin area is a surprising and common early sign of insulin resistance, the precursor to diabetes—the medical name for the condition is acanthosis nigricans (AN).

“We see this often in women with polycystic ovary syndrome (PCOS),” says Kellis, who notes that women with PCOS are at an increased risk of insulin issues. If you notice new dark spots on your skin, they’re worth checking out with your doctor.

11. You feel really itchy all the time.

Those with diabtetes often experience itching due to yeast infections (which can occur on the skin, too), dry skin, or poor circulation, according to the American Diabetes Association. If poor circulation is to blame, your legs will be the itchiest area.

Per the ADA, you can try to treat the itching yourself by limiting how much you bathe (especially in less humid climates), using soap with a built-in moisturizer, and remembering to apply lotion immediately after washing up.

Colleen de Bellefonds Colleen de Bellefonds is an American freelance journalist living in Paris, France, with her husband and dog, Mochi.

Type 1 Diabetes – Symptoms

Diabetes Symptoms

The following symptoms of diabetes are typical. However, some people with diabetes have symptoms so mild that they go unnoticed.

Common symptoms of diabetes:

  • Urinating often
  • Feeling very thirsty
  • Feeling very hungry—even though you are eating
  • Extreme fatigue
  • Blurry vision
  • Cuts/bruises that are slow to heal
  • Weight loss—even though you are eating more (type 1)
  • Tingling, pain, or numbness in the hands/feet (type 2)

Early detection and treatment of diabetes can decrease the risk of developing the complications of diabetes.

Although there are many similarities between type 1 and type 2 diabetes, the cause of each is very different. And the treatment is usually quite different, too. Some people, especially adults who are newly diagnosed with type 1 diabetes, may have symptoms similar to type 2 diabetes and this overlap between types can be confusing. Take our Risk Test to find out if you are at increased risk for having type 2 diabetes.

Symptoms of type 1 diabetes onset in an infant or child

The young child who is urinating frequently, drinking large quantities, losing weight, and becoming more and more tired and ill is the classic picture of a child with new-onset type 1 diabetes. If a child who is potty-trained and dry at night starts having accidents and wetting the bed again, diabetes might be the culprit.

Although it is easy to make the diagnosis diabetes in a child by checking blood sugar at the doctor’s office or emergency room, the tricky part is recognizing the symptoms and knowing to take the child to get checked. Raising the awareness that young children, including infants, can get type 1 diabetes can help parents know when to check for type 1 diabetes.

Sometimes children can be in diabetic ketoacidosis (DKA) when they are diagnosed with diabetes. When there is a lack of insulin in the body, the body can build up high levels of an acid called ketones. DKA is a medical emergency that usually requires hospitalization and immediate care with insulin and IV fluids. After diagnosis and early in treatment, some children may go through a phase where they seem to be making enough insulin again. This is commonly called the “honeymoon phase”. It may seem like diabetes has been cured, but over time they will require appropriate doses of insulin to keep their blood sugar levels in the normal range.

Symptoms of type 1 diabetes onset in adults

When an adult is diagnosed with diabetes, they are often mistakenly told that they have type 2 diabetes. This is because there is still a lack of an understanding in the medical community that type 1 diabetes can start at any age. It can also be tricky because some adults with new-onset type 1 diabetes are often not sick at first. Their doctor finds an elevated blood sugar level at a routine visit and starts them on diet, exercise and an oral medication. On the other hand, there are people who look like they have type 2 diabetes—they may be Latino or African American and/or overweight, but they have type 1 diabetes after all. This can be difficult for even the brightest doctor to diagnose.

Maybe it’s a different type

If you or someone you know is diagnosed with type 2 diabetes but isn’t responding well to the typical treatments for type 2 diabetes, it may be worth a visit to an endocrinologist to determine what type of diabetes is happening. Generally, this requires antibody tests and possibly the measurement of a C-peptide level.

Gestational diabetes

Women with gestational diabetes often have no symptoms, which is why it’s important for at-risk women to be tested at the proper time during pregnancy.
Learn more

Symptoms of diabetes complications

Have you already been diagnosed with diabetes but are concerned about symptoms that may be the result of complications related to diabetes?
Find out more

Learn more

Do you have questions or concerns about diabetes symptoms? Want to connect with others? Join the American Diabetes Association Community to find support.

If you’ve recently been diagnosed with type 2 diabetes, enroll in the free Living With Type 2 Diabetes Program to get more information and support.

High blood sugar can sneak up on you without any obvious symptoms. In fact, most people don’t know they have high blood sugar until they have type 2 diabetes – and probably have had it for some time.

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The telltale signs of type 2 diabetes, such as frequent urination and excessive thirst, are often subtle, especially early on. But ignoring them can cause worse health problems down the road.

Even mild blood sugar elevation can damage your nerves, kidneys and retinas. And the higher your blood sugar levels and the longer you go without treatment, the worse the damage can get.

“When we diagnose someone, we assume they have probably already had diabetes for about five years,” says endocrinologist Kevin Pantalone, DO. “During screenings, a certain number of people who are newly diagnosed already have kidney problems and retinal issues, so they’ve had it for some time.”

Dr. Pantalone says there are several symptoms that can occur early on with diabetes. Even if they’re subtle, they’re worth mentioning to your doctor.

1. You’re making more trips to the bathroom

Having to go to the bathroom more than normal, particularly at night, is a sign that your blood sugar might be out of whack.

Dr. Pantalone says one of his patients came in for a diagnosis after a family member noticed that he was using the bathroom during each commercial break when they watched TV.

2. You’re getting frequent urinary or yeast infections

When your blood sugar is high and your kidneys can’t filter it well enough, sugar ends up in the urine. More sugar in a warm, moist environment can cause urinary tract and yeast infections, especially in women.

3. You’re losing weight without trying

If you have diabetes, your body isn’t able to use glucose (sugar) as effectively for its energy. Instead, your body will start burning fat stores, and you may experience unexpected weight loss.

4. Your vision is getting worse

High sugar levels can distort the lenses in your eyes, worsening your vision. Changes in your eyeglass prescription or vision are sometimes a sign of diabetes.

5. You’re feeling fatigued or exhausted

Several underlying causes of fatigue may relate to diabetes/high sugar levels, including dehydration (from frequent urination, which can disrupt sleep) and kidney damage.

This feeling of exhaustion is often persistent and can interfere with your daily activities, Dr. Pantalone says.

6. You’re noticing skin discoloration

Something that Dr. Pantalone often sees in patients before a diabetes diagnosis is dark skin in the neck folds and over the knuckles. Insulin resistance can cause this condition, known as acanthosis nigricans.

Regular testing can put you in the know

“Often what happens is people minimize the symptoms or rationalize them and they get worse until they become severe enough that they have to see someone,” Dr. Pantalone says. “They have excessive weight loss or are really tired of peeing all night.”

Because symptoms of diabetes are often subtle or nonexistent, especially around the onset, it’s important to see your doctor regularly for a checkup and testing. This is particularly vital if you are overweight or have risk factors — if diabetes runs in your family, for instance.

The U.S. Preventive Services Task Force recommends screening for type 2 diabetes if you are between the ages of 40 and 70. If results are normal, you should repeat the testing every three years. If you have a risk factor, the task force recommends beginning screening at a younger age and testing more frequently.

The Surprising Truth About Prediabetes

It’s real. It’s common. And most importantly, it’s reversible. You can prevent or delay prediabetes from developing into type 2 diabetes with simple, proven lifestyle changes.

Amazing but true: approximately 84 million American adults—more than 1 out of 3—have prediabetes. What’s more, 90% of people with prediabetes don’t know they have it. Could this be you? Read on to find out the facts and what you can do to stay healthy.

Prediabetes Is a Big Deal

Don’t let the “pre” fool you—prediabetes is a serious health condition where blood sugar levels are higher than normal, but not high enough yet to be diagnosed as diabetes. Prediabetes puts you at increased risk of developing type 2 diabetes, heart disease, and stroke.

Type 1 and Type 2: Not the Same

Many people don’t realize that type 1 and type 2 are different kinds of diabetes.

  • About 90%-95% of people with diabetes have type 2; about 5% have type 1.
  • Type 1 is caused by an immune reaction and can’t yet be prevented; type 2 can be prevented or delayed through lifestyle changes.
  • Type 1 often starts quickly and has severe symptoms; type 2 is a gradual disease that develops over many years.
  • Type 1 occurs most often in children, teens, and young adults; type 2 occurs most often in older people (though increasingly children, teens, and young adults are developing the disease).
  • People with type 1 must use insulin every day to survive.
  • Prediabetes can develop into type 2 diabetes, but not type 1.

Learn more about different diabetes types and treatments.

Prediabetes Flies Under the Radar

You can have prediabetes for years but have no clear symptoms, so it often goes undetected until serious health problems show up. That’s why it’s important to talk to your doctor about getting your blood sugar tested if you have any of the risk factors for prediabetes, which include:

  • Being overweight
  • Being 45 years or older
  • Having a parent, brother, or sister with type 2 diabetes
  • Being physically active less than 3 times a week
  • Ever having gestational diabetes (diabetes during pregnancy) or giving birth to a baby that weighed more than 9 pounds

Race and ethnicity are also a factor: African Americans, Hispanic/Latino Americans, American Indians, Pacific Islanders, and some Asian Americans are at higher risk.

Ready to find out your risk? Take the quiz at DoIHavePrediabetes.orgExternal and be sure to share the results with your doctor.


Recipe for prevention: healthy eating and physical activity.

Diabetes Is Harder to Live with Than Prediabetes

Though people with prediabetes are already at a higher risk of heart disease and stroke, they don’t yet have to manage the serious health problems that come with diabetes.

Diabetes affects every major organ in the body. People with diabetes often develop major complications, such as kidney failure, blindness, and nerve damage (nerve damage can lead to amputation of a toe, foot, or leg). Some studies suggest that diabetes doubles the risk of depression, and that risk increases as more diabetes-related health problems develop. All can sharply reduce quality of life.

Prediabetes = Preventdiabetes

Think of prediabetes as a fork in the road: Ignore it, and your risk for type 2 diabetes goes up. Lose a modest amount of weight and get regular physical activity, and your risk goes down. Modest weight loss means 5% to 7% of body weight, just 10 to 14 pounds for a 200-pound person. Regular physical activity means getting at least 150 minutes a week of brisk walking or similar activity. That’s just 30 minutes a day, five days a week.

The CDC-led National Diabetes Prevention Program has been proven to help people make the lifestyle changes needed to prevent or delay type 2 diabetes. Through the program, participants:

  • Work with a trained coach to make lasting lifestyle changes.
  • Discover how to eat healthy and add more physical activity into their day.
  • Find out how to manage stress, stay motivated, and solve problems that can slow progress.

If you’re told you have prediabetes, ask your doctor or nurse if there is a National Diabetes Prevention Program offered in your community. The best time to prevent type 2 diabetes is now.

How to Identify Prediabetes (And How to Prevent It From Becoming Full-On Diabetes)

According to the CDC, 86 million Americans – more than 1 in 3 – have a condition known as prediabetes. What’s more, 90% of people with prediabetes don’t even know they have it. Despite the rising incidence of this disease (1.4 million Americans are diagnosed with diabetes every year), education and diagnosis are still sorely lacking, giving diabetes free reign to wreak havoc on our health as the 7th leading cause of death in the United States. But we can help make a change! Read on to discover the facts and learn what you can do to stay healthy.

What is prediabetes?

Prediabetes occurs when your blood glucose level (blood sugar level) is higher than normal, but not high enough to be classified as full-blown diabetes.

Your body begins to have trouble producing and/or processing insulin, resulting in a buildup of glucose in your blood. This condition is sometimes referred to as “borderline” diabetes, and it’s a warning sign that you’re on your way to a very serious disease.

What are the signs?

The difficulty is, prediabetes generally has no signs or symptoms; it can be diagnosed by your doctor with a simple blood test (either a fasting plasma glucose test, an oral glucose tolerance test, or a haemoglobin A1C test) but there isn’t a list of definitive symptoms that will alert you as to when you should be tested. Instead, the best thing to do is familiarize yourself with the risk factors, and if any apply, follow up with your doctor to learn more.

Risk factors for prediabetes

Researchers aren’t exactly sure what causes the insulin process to go awry in some people. However, there are several risk factors that increase the likelihood of developing prediabetes. They are:

  • Weight. Being overweight is a primary risk factor for prediabetes. The more fat you carry — particularly around your midsection — the more likely you are to develop insulin resistance.
  • Waist size. A large waist size can also indicate insulin resistance. For men, the risk factor increases with a waist measurement larger than 40 inches, for women it’s larger than 35 inches.
  • Diet. Eating red meat and drinking sugar-sweetened beverages has been shown to increase the risk of prediabetes. Conversely, a diet rich in fruits, vegetables, nuts, whole grains, and olive oil is associated with a lower risk of the disease.
  • Inactivity. The less active you are, the greater your risk of prediabetes. Physical activity can help control your weight, use up excess glucose, and increase your cell’s receptivity to insulin.
  • Age. While diabetes can develop at any age, the risk of prediabetes increases after 45. This may be attributed to lower levels of activity, loss of muscle mass, and weight gain as people age.
  • Family history. Your risk of prediabetes increases if you have a family history of Type 2 diabetes.
  • Race. People of certain races – including African-Americans, Hispanics, Native Americans, Asian-Americans and Pacific Islanders – are more likely to develop prediabetes.
  • Gestational diabetes. Women who developed gestational diabetes (diabetes during pregnancy) or who gave birth to a baby that weighed more than 9 pounds are at higher risk of developing prediabetes.
  • Sleep. People who work changing shifts, night shifts, or who suffer from certain sleep disorders may have an increased risk of insulin resistance.
  • Other health problems. High blood pressure (hypertension) and high cholesterol may increase your risk of prediabetes.

Do I have prediabetes?

As mentioned above, it can be difficult to diagnose prediabetes without a blood test, however, there are some resources that you might find helpful, including from the CDC.

DoIHavePrediabetes.org provides a whole host of information on the condition, the risks, and lifestyle tips to help you take control of your health. Take the Risk Test today, it will only take a minute and may make a huge difference in how you live your life!

Can it be reversed?

If you do have risk factors for prediabetes, or show some of the signs (as determined by your doctor), it’s not too late to turn things around.

Think of prediabetes as a fork in the road: ignore it, and your risk of developing Type 2 diabetes goes up. But heed the warning signs and through a few small lifestyle changes, you can turn your prognosis around.

Three key lifestyle changes to make now

Implement the following changes into your current lifestyle and you’ll be well on your way to a drastic reduction in the odds of developing diabetes (science says it’s true):

  1. Lose weight. If you’re overweight, losing as little as 5% to 10% of your body weight can greatly reduce your risk of developing Type 2 diabetes. Avoid drastic diets and instead, focus on permanent, sustainable changes to your eating and exercise habits. Motivate yourself by reviewing the benefits of life at a healthy weight, including a healthy heart, more energy, and improved self-esteem.
  2. Exercise. If you want to lower your risk of developing diabetes then get out and get moving. Aim for 30 to 60 minutes of moderate physical activity every day. Don’t be intimidated, we’re not talking about smashing it in a spin class or taking a pounding in the boxing ring; physical activity can include cycling, swimming, or even a brisk walk with the dog; anything that gets your heart rate up will do the trick.
  3. Eat right. Have you seen the film Fed Up? How about Supersize Me or That Sugar Film? If the answer is no, allow us to summarize: eating processed foods high in sugar is a sure fire route to obesity and disease. Instead, focus on fruits, vegetables, protein, and whole grains and your body will thank you. Sugar is 8x more addictive than cocaine, so give up the habit ASAP.

Dietitians at Home provides in-home medical nutrition therapy for patients suffering from diabetes and other diseases. Contact us today for a personalized nutrition plan that will improve your quality of life and help you reach your health and wellness goals.

Type 2 diabetes doesn’t usually appear all of a sudden. Many people have a long, slow, invisible lead-in to it called prediabetes. During this period, blood sugar levels are higher than normal. However, they’re not high enough to cause symptoms or to be classified as diabetes. It’s still possible at this stage to prevent the slide into full-blown diabetes. Think of prediabetes as a wake-up call.

Unfortunately, few people ever hear the alarm. A new report from the Centers for Disease Control and Prevention shows that among Americans age 20 and older, only 10% of those with prediabetes know they have it. Given that as many as 73 million Americans have prediabetes, that’s a lot of missed opportunities to prevent the ravages of diabetes.

One reason many people don’t know that they may be headed toward diabetes is they’ve never had their blood sugar tested. This simple test isn’t part of routine preventive care. The U.S. Preventive Services Task Force recommends blood sugar “screening” only in individuals with high blood pressure. (Screening means hunting for hidden disease in the absence of any outward signs or symptoms.) That’s important, because recommendations from the Task Force, an independent panel of experts, are used by many health-care organizations to determine preventive care. In addition, Task Force recommendations will help determine what services are covered under the Affordable Care Act.

Expanding the net

The American Diabetes Association and other organizations recommend routine blood sugar testing in people at high risk for developing diabetes. These include:

  • everyone over age 45
  • younger people who are overweight and who also have one of these diabetes risk factors:
    • little or no physical activity
    • family history of diabetes
    • high blood pressure or high cholesterol
    • previous diagnosis of heart disease or polycystic ovary syndrome
    • diabetes during pregnancy (gestational diabetes) or having delivered a baby weighing more than nine pounds

Some experts are encouraging the U.S. Preventive Services Task Force to expand its recommendation on blood sugar screening.

Why bother?

Not everyone with prediabetes will go on to develop diabetes. Over the short term (three to five years), about 25% of people with prediabetes develop full-blown diabetes. The percentage is significantly larger over the long term.

Getting the wake-up call of prediabetes can be very useful. A three-part strategy can keep many people with it from ever getting diabetes. The strategy includes modest weight loss, increased physical activity, such as walking 30 minutes a day, and choosing a healthier diet. In addition to helping stave off diabetes, these lifestyle changes can also help protect against heart attack, stroke, bone-thinning osteoporosis, and a host of other chronic conditions.

Those efforts are worth it, because diabetes can cause damage throughout the body. Extra glucose (blood sugar) can change the way blood vessels behave, increasing the chances of having a heart attack, stroke, or other form of cardiovascular disease. Diabetes-related damage to small blood vessels can lead to blindness, kidney disease, and loss of feeling. It is a leading cause in the United States of hard-to-treat infections and amputations.

Providing more people with a wake-up call that diabetes may be looming, and heeding that call, could help battle the epidemic of diabetes.

5 Strange Symptoms That Could Be Early Signs of Diabetes

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Many people who develop type 2 diabetes have no idea they’re sick until a blood test shows abnormal blood sugar levels, or until their disease progresses and serious complications start to occur. “For the most part, diabetes is silent and insidious,” says Ronald Tamler, MD, director of the Mount Sinai Clinical Diabetes Institute. “Most of the time people have no symptoms early on.”

In some cases, though, there are sneaky signs. Some early diabetes symptoms are well-known: constant thirst, excessive urination, or sudden weight gain or loss, for example. Others, like the ones below, are more easily missed—by medical professionals and patients alike. If you’re experiencing any of these, be sure to bring them up with your doctor.

Inflamed or infected gums

Periodontitis—also known as gum disease—may be an early sign of type 2 diabetes, according to new research published in the journal BMJ Open Diabetes Research & Care. The study found that people with gum disease, especially those with severe cases, had higher rates of diabetes (both diagnosed and undiagnosed) and pre-diabetes than those without.

The connection between gum disease and diabetes isn’t new, says Dr. Tamler, and it appears to go both ways: Having either condition seems to increase the risk of developing the other. “Inflammation caused by gum disease eggs on the same factors that are responsible for high blood sugar that cause diabetes,” he says.

Skin discoloration

“Long before you actually get diabetes, you may notice a dark discoloration on the back of your neck,” says Dr. Tamler. This is called acanthosis nigricans, and it’s usually a sign of insulin resistance—a loss of sensitivity to the hormone the body uses to regulate glucose—that can eventually lead to full-blown diabetes.

In rare cases, acanthosis nigricans can also be caused by ovarian cysts, hormonal or thyroid disorders, or cancer. Certain drugs and supplements, including birth control pills and corticosteroids, can also be responsible.

RELATED: Could You Have Type 2? 10 Diabetes Symptoms

Strange sensations in your feet

About 10% to 20% of people who are diagnosed with diabetes already have some nerve damage related to the disease. In the early stages, this may be barely noticeable, says Dr. Tamler: “You may feel a strange, electric tingling in your feet, or have decreased sensation or decreased balance.”

Of course, these strange sensations could be caused by something as simple as wearing high heels or standing in one place for too long. But they could also be caused by other serious conditions—like multiple sclerosis—so it’s important to mention them to your doctor.

RELATED: 15 Ways High Blood Sugar Affects Your Body

Hearing or vision loss

Elevated blood sugar levels can damage your retinas and cause fluid levels around your eyeballs to fluctuate, leaving you with blurry or impaired vision. Once blood sugar levels return to normal, eyesight is usually restored—but if diabetes goes unmanaged for too long, the damage could become permanent.

Likewise, high blood sugar can also affect nerve cells in the ear and cause impaired hearing. “It’s something that few people talk about, but experienced audiologists know to look for the connection,” says Dr. Tamler. “It’s definitely something I check for during my physical exams.”

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Long naps

In a scientific review presented last year at the European Association for the Study of Disease annual meeting, people who took daytime naps longer than an hour were 45% more likely to have type 2 diabetes compared to those who napped less or not at all.

It’s not likely that snoozing during the daytime actually causes diabetes, say the study authors. But they say that it can be a warning sign of an underlying problem like sleep deprivation, depression, or sleep apnea—all conditions associated with an increased risk of diabetes.

Complications of Type 2 Diabetes

It’s important to get your blood sugar under control to avoid these serious conditions:

  • Hypoglycemia . If your blood sugar falls below 70 milligrams per deciliter (mg/dL), it can lead to accidents, coma, and death.
  • Hyperglycemia . Blood sugar that goes above 180 to 200 mg/dL can give you heart, nerve, kidney, and vision problems. Over the long term, it also can cause coma and death.

Over time, people with type 2 diabetes may have other health problems:

  • Diabetic ketoacidosis . When you don’t have enough insulin in your system, your blood sugar rises, and your body breaks down fat for energy. Toxic acids called ketones build up and spill into your urine. It can cause coma and death if you don’t treat it.
  • Heart and blood vessel diseases. People with diabetes are more likely to have conditions like high blood pressure and high cholesterol, which play a role in heart disease. Also, high blood sugar can damage your blood vessels and the nerves that control your heart.
  • High blood pressure. Diabetes doubles your risk of high blood pressure, which makes you more likely to have heart disease or stroke.
  • Nerve damage (diabetic neuropathy) . This can cause tingling and numbness, most often in your feet and legs. But it can also affect your digestive system, urinary tract, blood vessels, and heart.
  • Eye damage. Diabetes can cause:
    • Glaucoma, a buildup of pressure in your eyes
    • Cataracts, a cloudiness of your lens
    • Retinopathy, which is damage to the blood vessels in your eyes
  • Kidney disease . Your kidneys may have to work harder to filter out the extra sugar, along with all the other waste products in your blood.
  • Hearing problems. Doctors aren’t sure why this happens, but they think high blood sugar levels damage the small blood vessels in your ears.
  • Skin problems . Diabetes can cause:
    • Infections. You’re more likely to get bacterial and fungal infections.
    • Itching. Causes include infections, dry skin, and poor circulation. You might notice it on your lower legs.
    • Acanthosis nigricans. These velvety darker areas can appear on your neck, armpits, groin, hands, elbows, and knees.
    • Diabetic dermopathy. Changes to small blood vessels that look like red or brown scaly patches. They often show up on your feet and the fronts of your legs.
    • Necrobiosis lipoidica diabeticorum. This rare condition also affects your blood vessels. It starts as a dull, red, raised area, but winds up as a shiny scar with a violet border. Your skin could itch or crack open. Women are more likely to get this than men.
    • Allergic reactions. You could get these in response to insulin or another diabetes medication.
    • Diabetic blisters(bullosis diabeticorum). These sores look like burn blisters and can show up on the backs of your fingers, hands, toes, feet, and sometimes legs or forearms.
    • Disseminated granuloma annulare. You might get red, brown, or skin-colored rings or arc-shaped raised areas on your fingers, ears, or trunk.

The UK currently ranks as the country with the highest level of obesity in Europen, with more than 1 in 4 (28.1%) adults obese and nearly two out of three (63.4%) overweight.

Over the next 20 years, the number of obese adults in the country is forecast to soar to 26 million people.

According to health experts, such a rise would result in more than a million extra cases of type 2 diabetes, heart disease and cancer

Obesity is also no longer a condition that just affects older people, although the likelihood does increase with age, and increasing numbers of young people have been diagnosed with obesity.

Data from Public Health England suggests that nearly a third (31.2%) of children aged 2 to 15 years old are obese.

Links between obesity and type 2 diabetes

While the exact causes of diabetes are still not fully understood, it is known that factors up the risk of developing different types of diabetes mellitus.

For type 2 diabetes, this includes being overweight or obese (having a body mass index – BMI – of 30 or greater).

In fact, obesity is believed to account for 80-85% of the risk of developing type 2 diabetes, while recent research suggests that obese people are up to 80 times more likely to develop type 2 diabetes than those with a BMI of less than 22

How does obesity cause type 2 diabetes?

It is a well-known fact that if you are overweight or obese, you are at greater risk of developing type 2 diabetes, particularly if you have excess weight around your tummy (abdomen).

Inflammatory response

Studies suggest that abdominal fat causes fat cells to release ‘pro-inflammatory’ chemicals, which can make the body less sensitive to the insulin it produces by disrupting the function of insulin responsive cells and their ability to respond to insulin.

This is known as insulin resistance – the hallmark of type 2 diabetes.

Having excess abdominal fat (i.e. a large waistline) is known as central or abdominal obesity, a particularly high-risk form of obesity.

Transcript

Diabetes and obesity are closely linked. Charity Diabetes UK states that obesity accounts for between 80 and 85% of the risk of developing type 2 diabetes. The charity notes that central obesity, having a large waistline, is a better predictor of type 2 diabetes than BMI values.

Being obese raises the risk of developing type 2 diabetes. With this said, there are other risk factors involved as well, such as genetics, ethnicity and age. Not all people who are obese are diabetic and not all people with type 2 diabetes are, or have bee, obese.

There are a number of factors which can contribute to becoming obese:

  • Eating a high calorie diet
  • Not getting enough physical exercise
  • Genetics
  • Medical conditions
  • Medications

The NHS states that, for those that are obese, a loss of 5% of body weight along with regular exercise can reduce your risk of developing diabetes by over 50%.

Loss of body weight has been shown to improve blood glucose levels and has allowed people with type 2 diabetes to come off or avoid going onto insulin.

The following steps are listed by the NHS and Diabetes UK to help with losing weight:

  • Avoid reliance on refined carbohydrates
  • Base main meals around vegetables
  • Be wary of misleading food packaging – low fat does not necessarily mean low calorie
  • Don’t rely on processed foods and takeaways for regular meals
  • Watch your alcohol intake – alcohol is highly calorific
  • Watch portion sizes – many of us in the UK are eating larger portions than we need
  • Take regular physical activity – find ways to avoid reliance on motorised transport

Download a FREE blood glucose chart for your phone or as a printout.

Disruption in fat metabolism

Obesity is also thought to trigger changes to the body’s metabolism These changes cause fat tissue (adipose tissue) to release fat molecules into the blood, which can affect insulin responsive cells and lead to reduced insulin sensitivity.

Another theory put forward by scientists into how obesity could lead to type 2 diabetes is that obesity causes prediabetes, a metabolic condition that almost always develops into type 2 diabetes.

Preventing obesity

The links between obesity and type 2 diabetes are firmly established – without the intervention of a healthy diet and appropriate exercise, obesity can lead to type 2 diabetes over a relatively short period of time.

The good news is that reducing your body weight, by even a small amount, can help improve your body’s insulin sensitivity and lower your risk of developing cardiovascular and metabolic conditions such as type 2 diabetes, heart disease and types of cancer.

According to the NHS, a 5% reduction in body weight followed up by regular moderate intensity exercise could reduce your type 2 diabetes risk by more than 50%.

For information on how to lose weight safely, how to stay motivated, and the benefits of shedding weight, see our guide on diabetes and weight loss.

Cost of obesity

In the UK, the cost to the NHS of obesity and related conditions such as type 2 diabetes is putting a huge, unsustainable drain on NHS resources.

Treating obesity, type 2 diabetes and diabetic complications such as nephropathy, heart disease and amputation is very costly, and with new cases of obesity-related type 2 diabetes soaring each year in the UK, these costs are expected to keep rising.

To tackle this problem, there is a need for widespread and far-reaching culturally appropriate educational literature that informs the population of the risk of eating badly and not taking exercise.

Making lifestyle changes

Making healthy lifestyle changes can often prevent obesity, and in order to avoid a healthcare crisis the UK needs to spread information that highlights the importance of doing just that, especially amongst children.

Obesity facts

  • According to the World Health Organization (WHO), at least 2.8 million people dying each year as a result of being overweight or obese
  • In 2008, over 40 million preschool children were overweight worldwide
  • The WHO suggests that more than 1 in 4 (28.1%) of adults in the UK are obese (has a BMI of 30 or more).
  • The UK has the highest level of adult obesity in Europe
  • Copeland in Cumbria is the most overweight local authority in England
  • Studies into obesity prevention have shown that giving up watching television for a week reduces a child’s waist size by an average 2.3cm (just under 1 inch)

What are the early signs of type 2 diabetes?

The early signs and symptoms of type 2 diabetes can include:

1. Frequent urination

When blood sugar levels are high, the kidneys try to remove the excess sugar by filtering it out of the blood. This can lead to a person needing to urinate more frequently, particularly at night.

2. Increased thirst

The frequent urination that is necessary to remove excess sugar from the blood can result in the body losing additional water. Over time, this can cause dehydration and lead to a person feeling more thirsty than usual.

3. Always feeling hungry

Share on PinterestConstant hunger or thirst can be early signs of type 2 diabetes.

People with diabetes often do not get enough energy from the food they eat.

The digestive system breaks food down into a simple sugar called glucose, which the body uses as fuel. In people with diabetes, not enough of this glucose moves from the bloodstream into the body’s cells.

As a result, people with type 2 diabetes often feel constantly hungry, regardless of how recently they have eaten.

4. Feeling very tired

Type 2 diabetes can impact on a person’s energy levels and cause them to feel very tired or fatigued. This tiredness occurs as a result of insufficient sugar moving from the bloodstream into the body’s cells.

5. Blurry vision

An excess of sugar in the blood can damage the tiny blood vessels in the eyes, which can cause blurry vision. This blurry vision can occur in one or both of the eyes and may come and go.

If a person with diabetes goes without treatment, the damage to these blood vessels can become more severe, and permanent vision loss may eventually occur.

6. Slow healing of cuts and wounds

High levels of sugar in the blood can damage the body’s nerves and blood vessels, which can impair blood circulation. As a result, even small cuts and wounds may take weeks or months to heal. Slow wound healing also increases the risk of infection.

7. Tingling, numbness, or pain in the hands or feet

High blood sugar levels can affect blood circulation and damage the body’s nerves. In people with type 2 diabetes, this can lead to pain or a sensation of tingling or numbness in the hands and feet.

This condition is known as neuropathy, and it can worsen over time and lead to more serious complications if a person does not get treatment for their diabetes.

8. Patches of dark skin

Patches of dark skin forming on the creases of the neck, armpit, or groin can also signify a higher risk of diabetes. These patches may feel very soft and velvety.

This skin condition is known as acanthosis nigricans.

9. Itching and yeast infections

Excess sugar in the blood and urine provides food for yeast, which can lead to infection. Yeast infections tend to occur on warm, moist areas of the skin, such as the mouth, genital areas, and armpits.

The affected areas are usually itchy, but a person may also experience burning, redness, and soreness.

What Is Prediabetes? Here’s What You Need to Know

What Is Prediabetes?

You can think of Pprediabetes as an early warning sign that you might be headed toward diabetes. The telltale sign is a blood test that show your blood sugar (blood glucose) level is higher than normal but not yet high enough to be considered diabetes.

Why might this matter? Prediabetes is an indication that you could develop type 2 diabetes (T2D) if you don’t make some immediate and lasting lifestyle changes.

The Good News Is—You Can Take Steps to Reduce Your Risks

it is very possible to prevent prediabetes from developing into type 2 diabetes. The most obvious is taking a look at your food choices. By eating whole (minimally or unprocessed) foods (ie, whole wheat vs blanched white flour-based products, white rice, potato chips—which are a far cry from a baked potato), addressing overweight and staying at a healthy weight, and committing to some physical activity—which can be a walk or two daily—is enough to help get your blood glucose level back into the normal range. That’s the key to assuring you avoid not only the onset of diabetes but all the related complications including heart disease, vision, loss, nerve damage, and kidney failure. How much do you know about this condition and what it might mean for you? Take this Quiz: How Much Do You Know About Prediabetes

What Are the Symptoms that Suggest You May Be Heading Toward Diabetes?

Diabetes develops very gradually, so when you’re in the prediabetes stage—when your blood glucose level is higher than it should be—you may not have any symptoms at all. You may, however, notice that:

  • you’re hungrier than normal
  • you’re losing weight, despite eating more
  • you’re thirstier than normal
  • you have to go to the bathroom more frequently
  • you’re more tired than usual

All of those are typical symptoms associated with diabetes, so if you’re in the early stages of diabetes, you may notice them.

Recognizing Prediabetes: Common Causes and Risk Factors

Prediabetes develops when your body begins to have trouble using the hormone insulin. Insulin is necessary to transport glucose—what your body uses for energy—into the cells via the bloodstream. In pre-diabetes, your body either doesn’t make enough insulin or it doesn’t use it well (that’s called insulin resistance). If you don’t have enough insulin or if you’re insulin resistant, you can build up too much glucose in your blood, leading to a higher-than-normal blood glucose level and perhaps prediabetes. Researchers aren’t sure what exactly causes the insulin process to go awry in some people. There are several risk factors, though, that make it more likely that you’ll develop pre-diabetes. These are the same risk factors related to the development of type 2 diabetes:

  • Weight: If you’re overweight (have a body mass index—a BMI—of higher than 25), you’re at high risk for developing prediabetes, especially if you carry a lot of extra weight in your abdomen, you may develop prediabetes. The extra fat cells can cause your body to become more insulin resistant.
  • Lack of physical activity: This often goes hand-in-hand with being overweight. If you aren’t physically active, you’re more likely to develop prediabetes.
  • Family history: Prediabetes has a hereditary factor. If someone in your close family has (or had) it, you are more likely to develop it.
  • Race/ethnicity: Certain ethnic groups are more likely to develop prediabetes, including African-Americans, Hispanic Americans, Native Americans, and Asian Americans.
  • Age: The older you are, the more at risk you are for developing prediabetes. At age 45, your risk starts to rise, and after age 65, your risk increases exponentially.
  • Gestational diabetes: If you developed diabetes while you were pregnant, that increases your risk for developing prediabetes later on.

Other health problems: High blood pressure (hypertension) and high cholesterol (the “bad” LDL cholesterol) increase your risk of getting type 2 diabetes.
Polycystic ovary syndrome (PCOS) also raises the risk of prediabetes because it’s related to insulin resistance. In PCOS, many cysts form in your ovaries, and one possible cause is insulin resistance. If you have PCOS, that means you may be insulin resistant and therefore at risk for developing prediabetes.

If you have hypothyroidism (low thyroid function; not enough circulating thyroid hormone), and you have prediabetes, then your risk of developing T2D more than doubles in comparison to individuals with normal thyroid function.

How Is Prediabetes Diagnosed?

Your doctor may want to test your blood glucose levels if you’re overweight (have a body mass index—BMI—of over 25) and if you have one or more of the risk factors listed above. Even if you aren’t overweight and don’t have any of the risk factors, your doctor may want to start testing your blood glucose level every three years beginning when you’re 45. That’s a smart thing to do because the risk of developing prediabetes (and therefore type 2 diabetes) increases with age. Because there are so many possible complications of diabetes (e.g., heart problems and nerve problems), it’s a good idea to be vigilant about detecting blood glucose abnormalities early. To diagnose you with prediabetes, the doctor can run one of two tests—or he or she may decide to do both. The tests are:

  • Fasting plasma glucose test (FPG): You can’t eat anything for eight hours leading up to an FPG test. That’s why this test is often done in the morning. The doctor checks your blood glucose level (blood sugar level) after drawing a small blood sample.
    If your blood glucose level is between 100 and 125mg/dL, you have prediabetes. You may hear the doctor use the phrase “impaired fasting glucose” or IFG, which is another term for prediabetes when it’s diagnosed with the fasting plasma glucose test.
    If your blood glucose level is above 126mg/DL with the FPG test, you may have diabetes.
  • Oral glucose tolerance test (OGTT): This is another test used to diagnose prediabetes. The doctor will give you instructions on how to prepare for the test, but you won’t be able to eat anything for eight hours before the test; you’ll be fasting. In that way, the oral glucose tolerance test, abbreviated OGTT, is similar to the fasting plasma glucose test.
    On the day of the test, the doctor will test your blood glucose level at the beginning of the appointment; that’s called your fasting blood glucose level. Then, you’ll drink 75g of a very sugary mixture. Two hours later, your blood glucose level will be measured.
    If your blood glucose level is between 140 and 199mg/dL two hours after drinking the sugary mixture, you have pre-diabetes. You may hear the doctor use the phrase “impaired glucose tolerance” or IGT, which is another term for pre-diabetes when it’s diagnosed with the OGTT.
    If your blood glucose level is above 200mg/DL with the oral glucose tolerance test, you may have diabetes.

Know the Lifestyle Recommendations for Taking Control of Prediabetes

The American Diabetes Association says that serious lifestyle changes are effective in preventing type 2 diabetes after you’ve been diagnosed with pre-diabetes. Your doctor will walk you through what you need to change, but typical recommendations are:

  • Evaluate Your Food Choices: A registered dietitian (RD) or certified diabetes educator (CDE) can help you create a meal plan respects your preferred foods and also reflects good-for-your-blood-glucose-level foods. The goal of the healthy food plan is to assure that you are controlling your blood glucose level by keeping it in a healthy, normal range. Your meal plan should be adjusted to be comfortable and satisfying to you, taking into account your overall health, physical activity, and what you like to eat. There are no diets out there that will work nearly as well as one that has been worked out with your likes and dislikes, cultural preferences,
  • Exercise: When you exercise, your body uses more glucose, so exercising can lower your blood glucose level. Also when you exercise, your body doesn’t need as much insulin to transport the glucose; your body becomes less insulin resistant. Since your body isn’t using insulin well when you have prediabetes, lower insulin resistance is a very good thing.
    And of course, there are all the traditional benefits of exercise: it can help you lose weight, keep your heart healthy, make you sleep better, and even improve your mood.
    The American Diabetes Association recommends at least 150 minutes of moderate activity a week—that’s 30 minutes five days a week. You can get that through activities such as walking, bike riding, or swimming.
  • Lose weight: If you’re overweight, you should get started on a weight loss program as soon as you’re diagnosed with prediabetes. Losing just 5 to 10% of your weight can significantly reduce your risk of developing type 2 diabetes. The combination of eating well and exercising more is a great way to lose weight—and then maintain your new, healthy weight.
  • Metformin: For people who are at very high risk of developing type 2 diabetes after being diagnosed with prediabetes, the doctor may recommend medication. The American Diabetes Association says that metformin should be the only medication used to prevent T2D. It works by keeping the liver from making more glucose when you don’t need it, thereby keeping your blood glucose level in a better range.

Your doctor will keep a close watch on your blood glucose levels, monitoring them to make sure that your prediabetes doesn’t progress to type 2 diabetes. If needed, he or she may suggest adjustments (e.g., different diet or more exercise) to better control your blood glucose levels. Updated on: 10/29/19 Continue Reading Treatment of Diabetes: The Diabetic Diet View Sources

  • American Diabetes Association. Standards of Medical Care in Diabetes—2009. Diabetes Care. 2009;32:S13-61.

Top things to know:

  • Diabetes is a lifelong disease that impacts the way glucose is used in the body
  • Long, irregular menstrual cycles and heavy periods can be symptoms of diabetes as it progresses
  • Unmanaged, it can lead to serious consequences that affect many areas of the body, including the heart, eyes, kidneys, blood vessels, nerves, and teeth

What is diabetes?

Diabetes, also known as diabetes mellitus, is a lifelong disease that affects the way the body uses glucose (sugar). Glucose is very important. When it isn’t regulated properly, glucose builds up in the blood, causing symptoms and, eventually, health problems.

Glucose is regulated by a hormone called insulin, which is produced in the pancreas (1). When a person has diabetes, their bodies either do not produce enough insulin, or do not respond normally to the insulin that their body is producing. When too much glucose is in the blood, this is known as hyperglycemia. People with untreated diabetes experience hyperglycemia. When too little glucose is in the blood, this is known as hypoglycemia.

Globally, about 9 in 100 adults have a form of diabetes (1,2). Unmanaged diabetes can lead to serious problems affecting the heart, eyes, kidneys, blood vessels, nerves, and teeth (3-5). Uncontrolled diabetes can also affect the menstrual cycle (6,7).

Early diagnosis and treatment can help reduce these risks, and some forms of diabetes are preventable. Diagnosis happens through blood tests from a healthcare provider.

Tracking the length of your menstrual cycle and any other symptoms in Clue can help your healthcare provider in forming a diagnosis and a treatment plan.

Blood sugar, insulin, and the menstrual cycle

Some studies have suggested that people may be more sensitive to insulin during the first half of the cycle (follicular phase), and less sensitive during the second half (luteal phase) (8-10). Other studies found no difference (11-13). More research is needed (14,15).

In any case, tracking blood sugar levels along with the cycle can help someone know if their insulin needs fluctuate with their cycle. Diabetics who experience changes in cravings might also be conscious of how these changes impact what they eat, and how that then affects their insulin needs.

Diabetes and Polycystic Ovary Syndrome (PCOS)

Diabetes and PCOS are related diseases. In some cases this could be due to body weight, but many other factors may play a role, such as genetics (16-18). It’s therefore important for people with either disease to keep an eye out for any symptoms of the other. People with diabetes might pay special attention to any excess hair growth on the body or face (hirsutism) (19). People with PCOS may benefit from regular screenings for diabetes or prediabetes. New symptoms can provide important information for the diagnosis and management of either condition.

Types of Diabetes

There are different types of diabetes.The three most common forms of diabetes are type 1, type 2, and gestational diabetes.

Type 1 diabetes

Type 1 diabetes is usually diagnosed in childhood, but may also be diagnosed in adults (20-22). It happens when the pancreas doesn’t function properly and can’t produce enough insulin to regulate blood sugar. Research isn’t clear on what causes type 1 diabetes, but factors include family history, genetic predisposition, and environmental exposures, such as exposure to certain viruses (3,23,25).

Type 2 diabetes

Type 2 diabetes is usually diagnosed in adulthood, but is becoming more common in children and adolescents due to childhood obesity (1,22,25). Type 2 diabetes develops when cells lose their ability to use insulin properly. This is called insulin resistance. The body then adjusts by making more insulin. With type 2 diabetes, the pancreas may lose the ability to make insulin.

Type 2 diabetes is usually triggered by lifestyle factors. Weight gain, being overweight or obese, having excessive abdominal fat, having a diet high in fat and sugar, and not getting enough exercise can all heighten the risk of developing type 2 diabetes (25-28). People may also be more likely to develop this type of diabetes if they have a family history of the disease, or if they have polycystic ovary syndrome (PCOS) or menstrual periods that are infrequent or highly unpredictable (6,29).

Gestational diabetes is temporary and occurs during pregnancy. The hormones produced during pregnancy make the body’s cells more resistant to insulin (30). Gestational diabetes usually goes away when pregnancy ends, but it should be monitored during pregnancy to protect the health of the pregnant person and their baby. Gestational diabetes occurs in about 7 in 100 pregnancies in the USA, but can be as common as 14 in 100 pregnancies in some populations (3). Someone is more likely to develop it if they have a family history of it or if they are overweight or obese (22). People with gestational diabetes have a higher risk of developing type 2 diabetes after their pregnancy, and should be regularly screened for diabetes throughout their adult lives (30,31).

Symptoms of diabetes: what you might notice

Types 1 and 2 symptoms

In the early stages of diabetes, symptoms may be mild and easy to ignore. They tend to become progressively worse over time. In any case, it’s important to discuss any early symptoms with a healthcare professional, even when they aren’t bothersome. Common symptoms of diabetes include:

  • Increased hunger and thirst
  • Frequent urination
  • Unexplained weight loss (type 1)
  • Weight gain (type 2)
  • Blood sugar fluctuations, which can lead to irritability, feeling unwell, and fainting (1,3,22).

Other symptoms that may develop as the disease progresses include:

  • Long, irregular menstrual cycles
  • Very heavy and long periods
  • Fatigue
  • Cuts and bruises that heal slowly
  • Blurred vision
  • Recurrent yeast infections (1,7,32-36).

Symptoms of type 1 diabetes tend to appear suddenly in young people, and more gradually in adults (3). Type 2 diabetes usually begins mildly in everyone, becoming more noticeable over time (3).

Adolescents with type 1 diabetes may experience their first menstrual period (menarche) about 1-2 years later than average (7,32,37-39). Adults with type 1 diabetes may also experience the end of their cycles (menopause) about six years earlier than average (7,16,37).

Gestational diabetes symptoms

A person may not experience any symptoms of gestational diabetes or may confuse them with normal pregnancy symptoms (3,30,40). A healthcare provider should check for it as part of basic pregnancy care (3,30). If you are planning to become pregnant, talk to your healthcare professional to know if you are at an increased risk.

Why get it checked out

Unmanaged diabetes can damage the body, but getting diagnosed early on and receiving proper treatment can prevent much of this damage.

Getting diagnosed early may prevent the development of “full-blown” type 2 diabetes. Some people may get diagnosed with “prediabetes” or “intermediate hyperglycemia,” which means that their blood glucose levels are high but not high enough for them to be considered diabetic. People with prediabetes may be able to prevent type 2 diabetes (41). A pre-diabetic phase might also happen in type 1 diabetes, but research on this is less clear (42).

Early symptoms of diabetes may be very mild, and not seem like a concern. Left untreated, the disease usually progresses and complications can become serious. Unmanaged diabetes may lead to diseases affecting the heart, eyes, kidneys, blood vessels, nerves, and teeth (3,4). Some cases of unmanaged diabetes may lead to disability and even death (43). Early treatment and careful management of blood sugar levels will help to minimize symptoms and prevent complications.

People with diabetes are at risk for certain complications during pregnancy if their blood sugars are not well managed. People with diabetes looking to become pregnant should postpone pregnancy until their blood sugars are tightly controlled, as uncontrolled diabetes is associated with an increased risk to the baby such as birth defects. Poor control of diabetes during pregnancy is associated with hydramnios (a condition where amniotic sac contains too much fluid), or macrosomia (being a very large baby), and risks to the mother such as high blood pressure and preterm labor. It is important to talk to your healthcare provider if you are planning on becoming pregnant if you have diabetes or prediabetes (44).

How diabetes is diagnosed

A healthcare provider will probably ask questions about symptoms and medical and menstrual history, and perform a simple physical exam. If they think diabetes or pre-diabetes may be present, they will likely perform a blood test. Tests for diabetes can include testing blood sugar when you have been fasting (not eating for 8 hours), a random test unrelated to meals, or measurement of a test called hemoglobin A1C, which assess the average blood glucose over the past 2-3 months.

Diabetes treatment and management

Diabetes type 1 is a lifelong disease; type 2 diabetes is typically a chronic, on-going condition, but weight loss (if overweight or obese) and exercise can potentially reverse the course of the disease. Careful management can help to minimize symptoms and prevent future complications. Many cases of diabetes can also be prevented with lifestyle changes.

Medications

Type 1 diabetes—and sometimes type 2—are managed with injections of the hormone insulin. These injections help to regulate the blood sugar. For type 2 diabetes, most people require prescription oral medications to help the body regulate blood sugar.

For people with irregular periods and cycles, hormonal birth control might be prescribed to regulate the cycle (7). If irregular periods are associated with excess body hair, the diagnosis of polycystic ovary syndrome (PCOS) should be considered. Medications are always used in combination with diet and weight management (45,46).

Lifestyle changes

Diet and exercise can be extremely helpful in the prevention of type 2 diabetes (1,3,47). Moderate weight loss has been shown to cut the risk of type 2 diabetes in half for those who are overweight (26). For those who already have diabetes (type 1 or 2), eating healthy food and engaging in regular exercise can help reduce the risk of complications (1,3). Replacing simple carbohydrates and processed food with whole grains, vegetables, some fruits, fish, lean cuts of meat, and low-fat dairy can help keep blood sugar in balance and help with weight reduction. Exercise can also help regulate weight and blood sugar (38). If you are diabetic or at risk of diabetes, you and your healthcare provider should come up with a personalized plan that will fit your needs (48).

Self-regulation

People with diabetes should commit to monitoring many aspects of their own day-to-day health. For those with diabetes type 1, this will mean checking blood sugar several times a day. For those with diabetes type 2, blood sugar is also regularly monitored. It also means paying close attention to food and to the symptoms of low versus high blood sugar. It is important not to smoke or to consume alcohol in excess as these activities can exacerbate symptoms and make their diabetes more difficult to manage (49,50). Paying close attention to oral, eye, and foot health is also important for diabetics, as people with poorly controlled blood sugar are prone to gum disease, foot sores, and eyesight problems that should be addressed as early as possible (3,51).

What to track

Essential to track

  • Cycle length
  • Period length and heaviness
  • Cravings

Helpful to to track

  • Fatigue
  • Blood sugar
  • Weight
  • Any other symptoms you might be concerned about

to track your menstrual cycle and symptoms

Some of the symptoms of type 2 diabetes are not always obvious. Paying attention to changes in your body and telling your physician about areas of concern can help you stay healthy. Some of the warning signs of diabetes include:

  • Frequent urination
  • Increased thirst
  • Unexplained weight loss
  • Weakness and fatigue
  • Numbness or tingling in hands, legs or feet
  • Blurred vision
  • Dry, itchy skin
  • Frequent infections
  • Slow healing of cuts and bruises
  • In women, frequent yeast infections

You can decrease the chance of developing type 2 diabetes by making your health a top priority today. The sooner you take an active approach to eating healthy, exercising and maintaining a healthy weight, the lower your risk of developing diabetes.

“By the time someone is diagnosed with diabetes, the pancreas will have lost 50-80 percent of its ability to produce insulin,” says Decker. “It’s not just a blood sugar disease; it’s usually accompanied by high blood pressure and high fats, or lipids, in the blood. If this triple threat goes undetected, all three issues can cause health problems. As many as 50 percent of people already have complications by the time they are diagnosed with diabetes. This includes increased risk of eye, kidney or heart disease, stroke and circulation problems.”

Early Symptoms of Diabetes

Types of diabetes

Type 1 diabetes is an autoimmune disease where the pancreas stops producing insulin—a hormone that allows the body to get energy from food. Its onset has nothing to do with diet or lifestyle.

With type 2 diabetes your body doesn’t use insulin properly—which is known as insulin resistance. As a result, your pancreas makes extra insulin to compensate, but over time it is unable to keep up.

What are the symptoms of diabetes?

T1D is identified in children and adults as they show signs of the following symptoms:

  • Headaches
  • Weight Loss
  • Blurry Vision
  • Extreme Thirst
  • Frequent Urination
  • Increased Appetite
  • Fruity Breath Odor
  • Fatigue and Weakness
  • Rapid Deep Breathing

Although the signs of diabetes can begin to show early, sometimes it takes a person a while to recognize the symptoms. This often makes it seem like signs and symptoms of diabetes appear suddenly. That’s why it’s important to pay attention to your body, rather than simply brushing them off. To that end, here are some type 1 and type 2 diabetes symptoms that you may want to watch out for:

If you’re experiencing frequent urination your body might be telling you that your kidneys are trying to expel excess sugar in your blood. The resulting dehydration may then cause extreme thirst.

Along the same lines, the lack of available fluids may also give you dry mouth and itchy skin.

If you experience increased hunger or unexpected weight loss it could be because your body isn’t able to get adequate energy from the food you eat.

High blood sugar levels can affect blood flow and cause nerve damage, which makes healing difficult. So having slow-healing cuts/sores is also a potential sign of diabetes.

Yeast infections may occur in men and women who have diabetes as a result of yeast feeding on glucose.

Other signs of diabetes

Pay attention if you find yourself feeling drowsy or lethargic; pain or numbness in your extremities; vision changes; fruity or sweet-smelling breath which is one of the symptoms of high ketones; and experiencing nausea or vomiting—as these are additional signs that something is not right. If there’s any question, see your doctor immediately to ensure that your blood sugar levels are safe and rule out diabetes.

Not every case of type 2 diabetes symptoms presents the obvious—unquenchable thirst, nonstop bathroom trips, and numbness in your hands or feet. Look out for these other subtle signs that something may be amiss with your blood sugar:

1. You’ve noticed unpleasant skin changes
Dark, velvety patches in the folds of skin, usually on the back of the neck, elbows, or knuckles, are often an early warning sign of too-high blood sugar levels and diabetes symptoms. Although genetics or hormonal conditions can cause the skin disorder, called acanthosis nigricans, “when I notice the patches, the first thing I do is test my patient’s blood sugar,” says Sanjiv Saini, MD, a dermatologist in Edgewater, Maryland. “High insulin levels promote the growth of skin cells, and melanin, a pigment in these cells, makes the patches dark.” The test may show that the patient already has diabetes, but, more likely, it will detect higher-than-normal blood sugar levels, suggesting the patient is on the way to developing the disease, explains Saini. Losing weight—as little as 10 pounds—will likely lower blood sugar levels and help the condition clear up. Otherwise, he says a dermatologist can treat it with laser therapy or topical retina A.

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2. Your vision improved out of nowhere
Sorry, suddenly being able to ditch your glasses probably isn’t good news: “You’ll often read that blurry vision is as a diabetes symptom when, in fact, vision can change for better or worse,” says Howard Baum, MD, an assistant professor of medicine in the diabetes division at Vanderbilt University. “I’ve had patients tell me that their vision has improved when their blood sugars were elevated, and then after they start treating their diabetes, they needed their glasses again.” What gives? Diabetes causes fluid levels in the body to shift around, including inside your eyes, which leads to the erratic eyesight. (If you have diabetes, it doesn’t mean you’re stuck with it forever. Rodale’s new book, The Natural Way To Beat Diabetes, shows you exactly what you need to do to get off the meds and take your life back.)

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3. You have unrelenting itchiness
Think it’s silly to mention scratchy skin to your doctor? Not so. Diabetes impairs blood circulation, which can lead to dryness and itchiness. “Some of my newly diagnosed diabetes patients mention they’re itchy on their extremities—the hands, lower legs, and feet—so it’s something doctors should consider in conjunction with other diabetes symptoms,” says Baum. If regular use of a moisturizer doesn’t fix the itch, bring it up at your next appointment.

4. Your hearing isn’t what it used to be
If you find yourself cranking the volume on the TV or you can’t get through a conversation without asking people to repeat themselves, tell your doctor you need a blood sugar test. One study by the National Institute of Health suggested hearing loss could be an early diabetes symptom: People with higher than normal blood sugar who didn’t yet meet the criteria for diabetes were 30% more likely to have hearing damage than those with healthy glucose levels. The researchers believe that diabetes damages the blood vessels and nerves of the inner ear, leading to sub-par hearing.

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5. You snore like a chainsaw
“About half of type 2 diabetics have sleep-disordered breathing,” says Osama Hamdy, MD, director of inpatient diabetes management at Joslin Diabetes Center in Boston. So if you’re diagnosed with the condition—characterized by loud snoring and daytime sleepiness—it’s a good bet to get your blood sugar levels checked, too. One recent Canadian study showed that 23% of patients diagnosed with mild or moderate obstructive sleep apnea, a common sleep disorder, went on to develop diabetes within 5½ years. The connection isn’t completely understood, but there’s one important link between the two: Patients with sleep-disordered breathing tend to release stress hormones during sleep, which can raise blood sugar levels.

Karen Cicero Karen Cicero writes about nutrition and health from her home in Bethlehem, PA.

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