You could have diabetes and not know it. The chronic disease in which blood sugars are elevated because the pancreas either doesn’t make enough insulin or doesn’t make any at all is one of the most common chronic health conditions in America.
However, not everyone who has diabetes knows it. Of the 32.2 million people in the U.S. who have the disease, 7.3 million are undiagnosed, according to the Centers for Disease Control and Prevention’s National Diabetes Statistics Report 2020.
That’s because the symptoms of diabetes can be very mild. Although symptoms are similar for both Type 1 and Type 2 diabetes, Type 2 diabetes symptoms can be especially hard to pinpoint, because they can be vague or are often symptoms of other chronic conditions.
“In many patients with Type 2 diabetes, the disease progresses slowly, and they may not realize that they have developed it without screening,” says Dr. Asha M. Thomas, an endocrinologist with Sinai Hospital of Baltimore. “There are millions of patients who have diabetes who aren’t aware they have it.”
8 Most Common Symptoms of Diabetes
You can’t know for sure whether you have diabetes just based on symptoms — you’ll need to see a doctor who can check your blood sugar levels and make a definitive diagnosis.
Dr. Kathleen Wyne, an endocrinologist specializing in Type 1 diabetes and a professor of medicine in the division of endocrinology, diabetes and metabolism with the Ohio State University Wexner Medical Center in Columbus, notes that while the symptoms listed below are among the most common, “it’s not usually just one of the items on this list, but the combination that makes us look for diabetes.”
You have to urinate more often.
This is because your kidneys are working harder to process extra sugar in your urine. The color of the urine you produce if you’ve got diabetes is usually clear or very lightly colored.
You feel thirsty more often than usual.
As you urinate more, you’ll feel more dehydrated, and that makes you want to drink more liquids. Some people also feel hungrier than usual.
>You develop urinary tract, yeast or vaginal infections frequently.
>Sometimes, OB-GYNs help to diagnose diabetes based on an increased frequency of UTI infections or yeast infections, says Lucille Hughes, a certified diabetes educator and director of diabetes education at South Nassau Communities Hospital in Oceanside, New York.
Diabetes causes changes to the body’s immune system that can increase your risk of developing other infections. Wyne adds that irregular menstrual cycles or miscarriages can also be signs of diabetes.
You experience unintentional weight loss.
While many people want to lose weight, the weight loss that occurs when you have uncontrolled diabetes is not a healthy way to lose weight. It happens because your body can’t properly use insulin to help process glucose, a sugar found in food, for fuel. So your body starts to process fat and muscle for fuel, says Susan M. De Abate, a nurse, certified diabetes educator and team coordinator of the diabetes education program at Sentara Virginia Beach General Hospital.
You have flu-like symptoms or feel more fatigued.
If your spouse starts complaining that you used to love to do stuff, but now you just want to say home and sleep, that could be a sign that your health is compromised.
“They’ll say, ‘I knew something was different about them,'” Hughes says, describing the fatigue. The fatigue comes from a lack of glucose, your body’s No. 1 energy source. “It’s as if you’re a car and you run on gasoline, but the gas is outside the car and can’t make it in,” Hughes says. And waking up frequently at night to urinate can also contribute to tiredness during the day, Wyne says.
You experience occasional blurred vision.
Uncontrolled diabetes can lead to a condition called diabetic retinopathy, which affects your vision. Eye doctors sometimes play a role in helping to diagnose diabetes because of the vision symptoms that can arise.
You experience erectile dysfunction.
Wyne says that in men under age 50, erectile dysfunction can be a sign of diabetes.
You need longer to heal.
If you notice that it seems to take a lot longer for cuts and scrapes to heal, that could be a sign of diabetes, Wyne says.
How Symptoms Differ Between Type 1 and Type 2 Diabetes
The symptoms of Type 1 diabetes are usually similar to those of Type 2, but they come about more suddenly. For example, a child may have flu-like symptoms that move quickly and send the family to the emergency room where a Type 1 diabetes diagnosis is made, Hughes says.
In contrast, the symptoms for Type 2 diabetes can be drawn out over several years before they become bad enough to be noticeable.
Why Diabetes Symptoms Are Confusing
The symptoms of diabetes, particularly Type 2, can be hard to track because they appear slowly over time and because the signs of aging and the signs of diabetes can overlap. “People have dry skin or they use the bathroom a lot (when they’re older). It’s hard to tell which is which,” De Abate says.
Your symptoms could also overlap with the effects of certain drugs. For instance, if you take a diuretic, which are often prescribed to help control blood pressure but makes you urinate more, you might think your increased urination is only from the medication. There might be something else going on too.
Some patients get so used to living with certain symptoms — be it fatigue or increased urination — it never occurs to them that it could indicate a health problem, De Abate says. “Some people go undiagnosed for years, and their bodies handle it because they still produce some insulin.” Still, that doesn’t mean they are producing enough insulin or processing it properly, and it needs to be addressed before the disease progresses and complications arise.
[See: 10 Myths About Diabetes.]
Get Checked by Your Doctor
Making a definitive diagnosis means having your blood sugars checked in a lab, not via an at-home finger stick, Wyne says. The machinery at a diagnostic center is more precise and when guided by a doctor, you’ll be able to get started right away on managing the condition if you have it.
Therefore, “if you have symptoms, “I would recommend seeking medical therapy as soon as possible,” Thomas says.
Wyne agrees that if you’re concerned you might have diabetes, see your doctor “immediately.”
If you’re high risk, you should also undergo screening for diabetes. Risk factors are listed below.
“Although current guidelines recommend screening starting at age 45 (or younger if you’re high risk), the U.S. Preventive Services Task Force has draft guidelines under review that recommend screening starting at age 35,” Wyne says. This is in response to the growing number of young people who are developing diabetes.
“Screening can start younger, even below age 18, if multiple high-risk factors are present,” Wyne adds, so talk with your doctor about your risk levels.
If diabetes is suspected, your doctor will check your fasting blood sugar and run a hemoglobin A1C check, which measures your average blood sugar over the previous three months.
The A1C test could also reveal if you have prediabetes — which means you still have time to change your eating habits and increase physical activity so you don’t develop full-blown Type 2 diabetes.
If you’ve been told that you have prediabetes, Wyne says that means “you have the warning signs that you’re at risk of progressing to diabetes in the next few years.” You can slow down this process by losing weight and keeping it off. The National Institute of Diabetes and Digestive and Kidney Diseases recommends shedding 5% to 10% of your current weight. So if you weigh 200 pounds, a 10% weight loss goal means losing 20 pounds.
In addition to dropping weight, increasing activity and staying as active as possible helps. Some people are successful in never progressing from prediabetes to full-blown Type 2 diabetes, but it takes sustained effort and self-care.
Am I at Risk of Developing Diabetes?
Although anyone can develop Type 2 diabetes, your risk is higher if:
— You have a family history of diabetes.
— You’re African-American, Latino, Pacific Islander or Native American.
— You have cardiovascular disease.
— You have high blood pressure.
— You have high cholesterol or high triglyceride levels.
— You’re overweight, obese or have an increased waist circumference. Belly fat is a warning flag for diabetes.
— You have signs of insulin resistance such as acanthosis nigricans, a condition in which folds or creases in the skin turn dark and velvety.
— You smoke.
— You have a history of gestational diabetes. For women who’ve had gestational diabetes, Wyne says your risk of developing diabetes is especially high, but losing the baby weight, eating healthy and staying active can help you avoid or delay that onset. She also says you’ll need to monitor your blood glucose levels in the 3 to 6 months after delivering and then annually for the rest of your life.
— You have a history of polycystic ovarian syndrome.
— You had a baby that weighed more than 9 pounds at birth.
— You’re over age 45.
“These are the patients we routinely counsel on the importance of prevention for Type 2 diabetes,” Thomas says. Visit your doctor regularly to keep a closer eye on possible symptoms and risk factors, especially if you have one or more of the risk factors above.
“Once you’re diagnosed with diabetes, or even prediabetes, please don’t try to pretend it’ll go away,” Wyne says, “because it won’t. It’s very hard to accept that you have a chronic disease that will be there for the rest of your life, but it’s up to you whether it’s controlled or wreaks havoc on your life.”
Diabetes means you need to take even better care of yourself as time goes on, because the disease can progress. So, “the sooner you come to terms with the diagnosis, and take charge of it, the more likely you’ll be able to slow it down and prevent the devastating complications,” she adds. “The longer it goes untreated or only partially treated, the sooner you’ll develop the complications.”
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