Symptoms of type 2 diabetes

Type 2 diabetes is a chronic disease that can cause blood sugar (glucose) to be higher than typical. Many people with type 2 diabetes do not feel symptoms. However, common symptoms do exist and being able to recognize them is important. Most symptoms of type 2 diabetes occur when blood sugar levels are abnormally high.

The most common symptoms of type 2 diabetes include:

If you experience any of these symptoms on a regular basis, talk to your doctor. They may recommend that you be tested for diabetes, which is performed with a basic blood draw. Routine diabetes screening normally starts at age 45.

However, it might start earlier if you are:

  • overweight
  • sedentary
  • affected by high blood pressure, now or when you were pregnant
  • from a family with a history of type 2 diabetes
  • from an ethnic background that has a higher risk of type 2 diabetes
  • at higher risk due to high blood pressure, low good cholesterol levels, or high triglyceride levels
  • have heart disease
  • have polycystic ovary syndrome

If you have diabetes, it can help to understand how your blood sugar levels affect the way you feel. Elevated glucose levels cause the most common symptoms. These include:

Frequent or increased urination

Elevated glucose levels force fluids from your cells. This increases the amount of fluid delivered to the kidneys. This makes you need to urinate more. It may also eventually dehydrate you.

Thirst

As your tissues become dehydrated, you will become thirsty. Increased thirst is another common diabetes symptom. The more you urinate, the more you need to drink, and vice versa.

Fatigue

Feeling worn down is another common symptom of diabetes. Glucose is normally one of the body’s main sources of energy. When cells cannot absorb sugar, you can become fatigued or feel exhausted.

Blurred vision

In the short term, high glucose levels can cause a swelling of the lens in the eye. This leads to blurry vision. Getting your blood sugar under control can help correct vision problems. If blood sugar levels remain high for a long time, other eye problems can occur.

Recurring infections and sores

Elevated glucose levels may make it harder for your body to heal. Therefore, injuries like cuts and sores stay open longer. This makes them more susceptible to infection.

Sometimes, people don’t notice that they have high blood sugar levels because they don’t feel any symptoms. High blood sugar can lead to long-term problems, such as:

People with diabetes are also at risk for serious bladder infections. In people without diabetes, bladder infections are usually painful. However, people with diabetes may not have that sensation of pain with urination. The infection may not be detected until it has spread to the kidneys.

High blood sugar causes long-term damage to the body. However, low blood sugar, called hypoglycemia, can be a medical emergency. Hypoglycemia occurs when there are dangerously low levels of blood sugar. For people with type 2 diabetes, only those who are on medications that increase the body’s insulin levels are at risk for low blood sugar.

Symptoms of hypoglycemia include:

If you are on medicines that increase the amount of insulin in your body, be sure you know how to treat low blood sugar.

According to the National Library of Medicine (NLM), some children with type 2 diabetes may not show any symptoms, while others do. You should talk with your child’s doctor if your child has any of the risk factors—even if they are not showing the common symptoms.

Risk factors include:

  • weight (having a BMI over the 85th percentile)
  • inactivity
  • a close blood relative who has type 2 diabetes
  • race (African-American, Hispanic, Native American, Asian-American, and Pacific Islander are shown to have a higher incidence)

Children who show symptoms experience many of the same symptoms as adults:

  • fatigue (feeling tired and irritable)
  • increased thirst and urination
  • increase in hunger
  • weight loss (eating more than usual but still losing weight)
  • areas of dark skin around the back of the neck, armpits, and groin
  • slow healing sores
  • blurred vision

You may need oral medications and insulin treat type 2 diabetes. Managing your blood sugar through close monitoring, diet, and exercise are also important parts of treatment. While some people are able to control their type 2 diabetes with diet and exercise alone, you should always check with your doctor about the treatment that’s best for you.

Blood sugar monitoring

The only way you can be sure your blood sugar level stays within your target range is to monitor it. You may have to check and record your blood sugar levels multiple times per day or only from time to time. This depends on your treatment plan.

Healthy diet

There is not a specific diet recommended for people with type 2 diabetes. However, it is important that your diet focuses on fruits, vegetables, and whole grains. These are low fat, high fiber foods. You should also reduce sweets, refined carbohydrates, and animal products. Low-glycemic index foods (foods that keep blood sugar more stable) are also for those with type 2 diabetes.

Your doctor or a registered dietician can help create a meal plan for you. They can also teach you how to monitor your diet to maintain a stable blood sugar level.

Physical activity

Regular exercise is important for those with type 2 diabetes. You should make exercise a part of your daily routine. It is easier if you choose activities that you enjoy, like walking, swimming, or sports. Be sure to get your doctor’s permission before starting any exercise. Alternating between different types of exercises can be even more effective than sticking to just one.

It is important that you check your blood sugar levels before exercising. Exercising can lower your blood sugar levels. To prevent low blood sugar, you may also consider eating a snack before exercising.

You may or may not need medications and insulin to maintain your blood sugar levels. This is something that will be decided by many factors, such as other health conditions you have, and your blood sugar levels.

Some medications for treating type 2 diabetes are:

Metformin

This drug is usually the first medication prescribed. It helps your body use insulin more effectively. Some possible side effects are nausea and diarrhea. These generally go away as your body adapts to it.

Recall of metformin extended release

In May 2020, the Food and Drug Administration (FDA) recommended that some makers of metformin extended release remove some of their tablets from the U.S. market. This is because an unacceptable level of a probable carcinogen (cancer-causing agent) was found in some extended-release metformin tablets. If you currently take this drug, call your healthcare professional. They will advise whether you should continue to take your medication or if you need a new prescription.

Sulfonylureas

This drug helps your body secrete more insulin. Some possible side effects are low blood sugar and weight gain.

Meglitinides

These drugs work like sulfonylureas, but faster. Their effect is also shorter. They can also cause low blood sugar, but the risk is lower than sulfonylureas.

Thiazolidinediones

These drugs are similar to metformin. They are not usually a first choice by doctors due to the risk of heart failure and fractures.

Dipeptidyl peptidase-4 (DPP-4) inhibitors

These drugs help reduce blood sugar levels. They have a modest effect but do not cause weight gain. There is a potential for acute pancreatitis and joint pain.

Glucagon-like peptide-1 receptor agonists (GLP-1 receptor agonists)

These medications slow digestion, help lower blood sugar levels, and help with weight loss. The American Diabetes Association (ADA) recommends them in situations where chronic kidney disease (CKD), heart failure, or atherosclerotic cardiovascular disease (ASCVD) predominate.

People experience nausea, vomiting, or diarrhea. There is a possible risk for thyroid tumors or medullary thyroid cancer, though it is rare.

Sodium-glucose transporter (SGLT) 2 inhibitors

These drugs prevent the kidneys from reabsorbing sugar into the blood. It is excreted in the urine instead. They are among the new diabetes drugs on the market.

Like GLP-1 receptor agonists, SGLT2 inhibitors are also recommended by the ADA in cases where CKD, heart failure, or ASCVD predominate.

Possible side effects include yeast infections, urinary tract infections, and increased urination, as well as amputation.

Insulin therapy

Insulin must be injected, as digestion interferes when insulin is taken by mouth. Dosage and number of injections needed each day depend on each patient. There are a number of types of insulin that your doctor may prescribe. They each work a little differently. Some options are:

It is important to check with your doctor if you are having any symptoms of type 2 diabetes. If left untreated, type 2 diabetes can lead to serious health concerns and long-term damage to your body. Once you are diagnosed, there are medications, treatments, and changes to your diet and physical activity that will stabilize your blood sugar levels.

You should also have regular foot and eye exams.