Got questions about navigating life with diabetes? Ask D’Mine! Our weekly advice column, that is, hosted by veteran type 1 and diabetes author Wil Dubois.

This week, Wil offers some advice on what early warnings signs might present themselves when type 2 diabetes is becoming a reality. For those who may have pre-diabetes or be concerned about developing T2D, this is a handy look at “sneaky” symptoms to watch out for…

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Cindy, type 3 from Minnesota, writes: My Uncle was just diagnosed with type 2 diabetes. The doc says he’s probably had it for many years. How on earth is that possible? Aren’t there any warning signs?

Wil@Ask D’Mine answers: Actually, type 2 diabetes doesn’t have any warning signs. It creeps up on people like a thief in the night. Oh. Right. I guess thieves don’t creep up on people in the night anymore, do they? Nowadays thieves hang out in brightly lit coffee shops, using their laptop computers to steal our credit card numbers. 

It’s a damn shame when a great literary device gets too stale to use.

But you get my drift. The sad fact is that you can play host to T2 diabetes for years, decades even, with no clue whatsoever that you’ve got it. But then things get interesting. Although, before I can dig into that for you, I need to lay the groundwork. The first thing you need to know is that type 2 diabetes has a really, really long gestation period.

Ok, Ok, diabetes doesn’t really have a gestation period. It’s not a living thing, but, trust me on this, when you share your life with it, it sure seems to have a mind of its own. Let me try again: The first thing you need to know is that type 2 diabetes has a really, really long incubation period.

Ok, Ok, it doesn’t really have an incubation period, either. It’s not that kind of disease. You can’t catch it from someone else. At least not randomly. You sorta catch it from your parents, because it’s largely genetic. But you can’t get it from a toilet seat or by being sneezed on. Type 2 diabetes comes from within, and is triggered by a combination of age and lifestyle issues: weight, activity levels, eating and drinking patterns, stress, and more. But once the pilot light is lit on the diabetes, there’s a long period—not really a gestation period or an incubation period—where diabetes, just like a fetus or a disease organism, begins to grow and get stronger. In the medical world it’s actually called “a latent, asymptomatic period of sub-clinical stages which often remain undiagnosed.”

Yeah. You can see why I tried to get away with gestation or incubation

Anyway, while “baby” diabetes is growing, it’s sorta like a parasite. A bit at a time, it nibbles away at the host body’s ability to keep blood glucose in proper control. As that ability is lost, blood sugar slowly, ever so slowly, begins to rise. And while the hidden diabetes that’s causing this to happen has no signs or symptoms, high blood sugar does. 

The problem, however, is that because the onset of elevated sugar happens so slowly, so too do the warning signs. They can be easy to miss because it’s not like coming down with the flu where one day you’re fine and then next day you start feeling sick. Instead, people tend to adapt to the warning signs of high blood sugar as they develop. At least until the warning signs get really severe—which they will.

Now, the complete list of high blood sugar warning signs is quite long, but here are the common ones. If you are experiencing three or more of these, it’s time to visit the doctor:


Low Energy

Because the high glucose is interfering with the body’s normal fueling operations, one result is fatigue. The problem here is that most of the people who are developing type 2 diabetes, and thus suffering elevated blood sugar, are middle-aged. And as we become middle-aged, we don’t have as much energy as we used to have. That’s normal, so many times the reduction of energy is not recognized as a warning sign of a medical problem, and is simply written off as “gettin’ old.” The slow onset of reduced energy also makes it easier to fall into this trap. If you woke up one day with half your normal energy, you’d freak out, know that something was wrong, and call your doc. But if you slowly lose steam over a period of three to five years, it’s harder to recognize.


Blurry Vision  

High blood sugar temporarily changes the shape of the eye, resulting in blurred vision. But again, as with energy, the onset of symptoms comes in baby steps. Ah, crap. I don’t see as well as I used to. Probably need to get new glasses. I should do that today, but I’m too damn tired. Gettin’ old is a bitch. 


Increased Thirst and Increased Urination

More correctly, this pair of symptoms should be ordered as increased urination-increased thirst, because that’s what’s really happening. I listed thirst first, because that’s the confusion with this pair of warning signs. Here’s the deal: Your body is smart. It knows all this extra sugar trapped in the blood is toxic. It’s doing all it can to get that junk out! Tons of sugar gets dumped into the urine, which results in some complex chemistry that more or less turns your body into a siphon, and the dehydrating effect of peeing like a race horse triggers epic thirst. Of course, most people plug the facts in backward. I’ve been really thirsty lately for some reason, so I’m drinking too much water before I go to bed. That’s why I’m getting up three times each night to pee.


Weight Loss

When the blood sugar gets really high it causes most of the insulin-producing beta cells in the pancreas to temporally shut down, and without enough insulin, glucose can’t be moved from the blood into the cells to feed them. It’s a case of starvation in the land of plenty. Unable to use the flood of sugar in the bloodstream for fuel, the body turns to its fat reserves to function, and the result is weight loss. The problem here is that most of us in this country are overweight, and we’re delighted if we start losing weight. You might be eating the same, or even more, but magically, the pounds are melting away. This should be a clue that something’s wrong, but no one wants to look a gift horse in the mouth. 

(Oh. I guess that’s another one of those expired literally devices, isn’t it? Most of us don’t even know what to look for in a horse’s mouth to judge its health.)



Is it any wonder that with all these other things going on—low energy, blurry vision, thirst, frequent pit stops—that a person might be a touch grumpy? But because it all happened so slowly, the victim doesn’t even remember what it felt like to feel good. And they won’t even know they are irritable at all.

But their spouse will. 


So there you have it: The constellation of easily recognizable, but not easily recognized, warning signs of high blood sugar—which in turn is a warning sign that diabetes is hiding somewhere below. Sadly, your uncle’s experience is common. Most type 2 diabetes is well-developed before it’s discovered. The warning signs of high blood sugar are there, but it’s easy to ignore them or misinterpret them, largely because they take shape so slowly and over such a great period of time.

But once the high blood sugar is treated most people are amazed at how much better they feel. It’s only then that they realize how sick they were. I hope your uncle has this same experience and is now “feeling years younger.” 

Meanwhile, please be aware that diabetes is a family affair. If anyone swimming in your gene pool has—or gets—type 2 diabetes, you should have yourself checked every year too. Diabetes causes less trouble, and is much easier to take care of, when caught early. And with the proper tests, it can be discovered long before the first sugar symptom raises its ugly head.


This is not a medical advice column. We are PWDs freely and openly sharing the wisdom of our collected experiences — our been-there-done-that knowledge from the trenches. Bottom Line: You still need the guidance and care of a licensed medical professional.