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Diabetes Symptoms: Early Signs, Advanced Symptoms, and More

Understanding the onset

Fast facts

  1. Diabetes symptoms can vary from person to person.
  2. Type 1 diabetes tends to come on abruptly and dramatically. 
  3. Type 2 diabetes typically develops more gradually and often goes unnoticed.

Diabetes symptoms may occur when blood sugar levels in the body become abnormally elevated. The most common symptoms of diabetes include:

  • increased thirst
  • increased hunger
  • excessive fatigue
  • increased urination, especially at night
  • blurry vision

Symptoms can vary from one person to the next. They also depend on which type of diabetes you have. 

Symptoms of type 1 diabetes tend to begin abruptly and dramatically. Type 1 diabetes is most often seen in children, adolescents, and young adults. However, type 1 diabetes can develop at any age. In addition to the symptoms listed above, people with type 1 diabetes may notice a quick and sudden weight loss.   

Type 2 diabetes is the most common type. Although it primarily develops in adults, it’s beginning to be seen more frequently in younger people. Risk factors for type 2 diabetes include being overweight, being sedentary, and having a family history of type 2 diabetes. Many people with type 2 diabetes don’t experience any symptoms. Sometimes, these symptoms are slow to develop.

What diabetes symptoms are most common?

Symptoms

Oftentimes, your symptoms may seem harmless. The most common symptoms of diabetes, such as persistent thirst and fatigue, are often vague. When experienced on their own, symptoms such as these may not be anything to worry about.

If you’re experiencing one or more of these symptoms, you should speak with your doctor about being screened for diabetes.

Frequent thirst

You’ve had glass after glass of water, but you still feel like you need more. This is because your muscles and other tissues are dehydrated. When your blood sugar levels rise, your body tries to pull fluid from other tissues to dilute the sugar in your bloodstream. This process can cause your body to dehydrate, prompting you to drink more water.

Frequent urination

Drinking excessive amounts of water can cause you to urinate more. This may lead you to drink more fluids, which compounds the problem. Your body may also try to eliminate excess sugar through urination.

Extreme hunger

You may still feel hungry even after you’ve had something to eat. This is because your tissues aren’t getting enough energy from the food you’ve eaten. If your body is insulin resistant or if your body doesn’t produce enough insulin, the sugar from the food may be unable to enter your tissues to provide energy. This can cause your muscles and other tissues to raise the “hunger flag” in an attempt to get you to eat more food.

Unexplained weight loss

You may eat normally and constantly feel hungry, yet continue to lose weight. This can be seen with type 1 diabetes. If your body isn’t getting enough energy from the foods that you eat, it will break down other energy sources available within the body. This includes your fat and protein stores. When this happens, it can cause you to lose weight.

Fatigue

Sugar is one of your body’s main sources of energy. If you have diabetes, your body’s inability to convert sugar into energy can lead to fatigue. This can range from a general worn-down feeling to extreme exhaustion.  

Blurry vision

Abnormally high blood sugar levels can also lead to blurry vision. This is because fluid can shift into the eye duct. This typically resolves once your blood sugar levels are normalized. This isn’t the same as diabetic retinopathy, which occurs over time in people with chronically high blood sugar.

According to the National Eye Institute (NEI), diabetic retinopathy is the leading cause of blindness in American adults. People with diabetes are also at higher risk for cataracts and glaucoma.

Infections or wounds that are slow to heal

What about gestational diabetes?
Some women develop gestational diabetes during pregnancy. This can cause high blood sugar levels that affect both you and your baby’s health. Women are usually screened for gestational diabetes between 24 and 28 weeks of pregnancy. Gestational diabetes typically doesn’t cause any symptoms, and your blood sugar will likely return to normal after you give birth.

If you have type 2 diabetes, your body may have a hard time fighting off infection. This is because bacteria can thrive when your blood sugar levels are too high. Women in particular may experience frequent vaginal yeast infections or bladder infections.  

High blood sugar levels can also hinder your body’s ability to heal cuts and scrapes. This is because high blood sugar levels can have a negative impact on your white blood cells. Your white blood cells are responsible for healing wounds.

What happens if diabetes goes undetected?

Warning

Although some people with diabetes have no symptoms or only mild symptoms that seem relatively harmless, untreated diabetes can be very dangerous.

If your blood sugar levels become too high, you may develop ketoacidosis. This is more common in people who have type 1 diabetes. People with type 2 diabetes are less likely to experience ketoacidosis because insulin is still being produced. This is an acute complication and can happen quickly. It’s considered a medical emergency.

This condition can cause:

  • deep, rapid breathing
  • nausea or vomiting 
  • stomach pain
  • flushed complexion
  • confusion
  • fruity smelling breath
  • coma

Over time, complications can develop due to chronically high blood sugar levels. These include:

  • kidney disease (nephropathy)
  • eye disease (diabetic retinopathy)
  • nerve damage (diabetic neuropathy)
  • vessel damage
  • amputations, due to nerve and vessel damage
  • dental issues
  • skin issues

If you’re on medications that increase insulin levels in the body, you may be at risk for an acute complication called hypoglycemia, or low blood sugar. With hypoglycemia, you may experience:

  • fainting
  • rapid heartbeat
  • sweating
  • dizziness and trembling
  • confusion
  • anxiety
  • drowsiness
  • loss of consciousness

Treating hypoglycemia quickly is important. Talk to your doctor to learn what to do if you are at risk for hypoglycemia.

When to see your doctor

when to see a doctor

If you’re experiencing symptoms of diabetes, you should make an appointment with your doctor. During this time, you should ask your doctor if there’s anything you need to do before your appointment, such as prepare for any labs tests. This may be necessary if your doctor wants to perform a fasting blood sugar test.

You should also write down any symptoms you’re experiencing or recent life changes that you’ve gone through. Your doctor can use this information to help make a diagnosis, if needed.

How is diabetes diagnosed?

Diagnosis

Your doctor may use one or more tests to screen for diabetes. The glycated hemoglobin (A1C) test is most common. This is a blood test that indicates your average blood sugar level during the previous two to three months. It measures the amount of blood sugar attached to hemoglobin. The higher your blood sugar levels are, the more hemoglobin is attached to sugar.

If you receive an A1C level of 6.5 percent or higher on two separate tests, your doctor will diagnose diabetes. Your doctor will diagnose prediabetes if your A1C level is between 5.7 and 6.4. Anything below an A1C level of 5.7 is considered to be normal.

If these results aren’t consistent, your doctor will move on to other testing options. But your doctor may skip these tests if you have certain conditions, such as pregnancy, that will render the results inaccurate.

Other testing options include:

  • Random blood sugar test: Your doctor will take your blood sample at a random time. If your blood sugar levels are 200 milligrams per deciliter (mg/dL) or higher, you likely have diabetes.
  • Fasting blood sugar test: Your doctor will take your blood sample after a period of fasting. If your blood sugar levels are 126 mg/dL or higher, you will be diagnosed with diabetes.

You should have these readings confirmed on a separate day. Your doctor may also recommend an oral glucose tolerance test. This test is used exclusively to diagnose gestational diabetes.

During an oral glucose tolerance test your doctor will first ask you to perform a fasting blood sugar test. Then, they will give you a sugary liquid to drink and will measure your blood sugar levels periodically over the next two hours. You will be diagnosed with diabetes if there is more than 200 mg/dL.

Speak with your doctor about which screening method is right for you and what you can do to prepare. 

Check out: A complete list of diabetes medications »

Outlook

Outlook

If you’re diagnosed with diabetes, your doctor will likely connect you with a diabetes educator and a dietitian. They can work with you to develop a diabetes management plan suited to your individual needs.

Your management plan will likely include a combination of nutritional guidelines, an exercise regimen, and medications designed to keep your blood sugar levels in check. They may also suggest regular blood sugar testing. It may take some trial and error to settle on a treatment plan that works the best for you. Be sure to talk to your healthcare team about any questions or concerns that you may have.

Keep reading: 10 tips for starting insulin therapy »

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