Diabetes is a disease that occurs when your body doesn't
make enough of a hormone called insulin, or if your body doesn't use insulin
the right way. If left untreated, it may result in blindness, heart attacks,
strokes, kidney failure and amputations. Only half of the people who have
diabetes are diagnosed because in the early stages of diabetes, there are few
symptoms, or the symptoms may be the same as in other health conditions.
How to
know if you might have Diabetes
"Most people are unaware that they have diabetes in
its early or even middle phases." says Aaron Cypess, MD, assistant
professor of medicine at Harvard Medical School and staff physician at Joslin
Diabetes Center.
"It's not like you wake up one day and all of a
sudden you're thirsty, hungry, and [going to the bathroom] all the time"
says Melissa Joy Dobbins, RD, a certified diabetes educator in Illinois and a
spokesperson for the American Association of Diabetes Educators.
Diabetes is a metabolic disorder that affects your body's
ability to either use or produce insulin, which how your body can use blood
sugar for energy. When your cells become resistant to insulin or your body
doesn’t make enough of it, your blood sugar levels rise, causing many of the
short-term and long-term symptoms of diabetes.
There are four different types of “sugar” diabetes: pre-diabetes,
type 1, type 2, and gestational, although the majority of cases diagnosed each
year are type 2 diabetes. In each of these types, there are both similar
symptoms and symptoms that distinguish each type from the others.
Some
common symptoms of diabetes: The following symptoms of
diabetes are typical. However, some people with type 2 diabetes have symptoms
so mild that they go unnoticed.
You're
taking more bathroom breaks
When you have diabetes, your body becomes less efficient at breaking food down
into sugar, so you have more sugar sitting in your bloodstream, says Dobbins.
"Your body gets rid of it by flushing it out in the urine. That’s why
you’re going to the bathroom a lot." Most patients aren't necessarily
aware of how often they use the bathroom, says Dr. Cypess. "When we ask
about it, we often hear, 'Oh yeah, I guess I’m going more often than I used
to,'" he says. But one red flag is whether the need to urinate keeps you
up at night. Once or twice might be normal, but if it's affecting your ability
to sleep, that could be a symptom to pay attention to.
You're
thirstier than usual
Urinating
a lot will also make you feel parched. A common symptom Dobbins sees with
patients is that they use drinks like juices, soda, or chocolate milk to quench
their thirst. These sugary beverages then pack the bloodstream with excess
sugar, which can lead to the problem all over again.
You've
lost a little weight
Considering
that being overweight is a risk factor for diabetes, it sounds counterintuitive
that shedding pounds could be a sign of the disease. "Weight loss comes from
two things," says Dr. Cypess. "One, from the water that you lose
[from urinating]. Two, you lose some calories in the urine and you don’t absorb
all the calories from the sugar in your blood."
Once people learn they have diabetes and start
controlling their blood sugar, they may even experience some weight gain—but
"that's a good thing,” says Dr. Cypess, because it means your blood sugar
levels are more balanced.
You
feel shaky and hungry
It's
not uncommon for patients to suddenly feel unsteady and immediately need to
reach for carbs, says Marjorie Cypress, a nurse practitioner at an
endocrinology clinic in Albuquerque, New Mexico, and 2014 president of health
care and education for the American Diabetes Association.
“When you have high
blood sugar, your body has a problem regulating its glucose,” she explains. “If
you’ve eaten something high in carbohydrates, your body shoots out a little too
much insulin, and your glucose drops quickly. This makes you feel shaky, and
you tend to crave carbs or sugar. This can lead to a vicious cycle.”
You're
tired all the time
Of
course you're exhausted every now and then. But ongoing fatigue is an important
symptom to pay attention to; it might mean the food you’re eating for energy
isn’t being broken down and used by cells as it’s supposed to. “You’re not
getting the fuel your body needs,” says Dobbins. “You’re going to be tired and
feel sluggish.” But in many cases of type 2 diabetes, your sugar levels can be
elevated for awhile, so these symptoms could come on slowly.
Foot
Pain and Numbness
Over
time, a prolonged exposure to high blood sugar can damage the nerves throughout
the body — a condition called diabetic neuropathy. Some people may not have any
symptoms of the damage, while others may notice numbness, tingling, or pain in
the extremities. “At the beginning, [diabetic neuropathy] usually starts in the
feet and then it progresses upward,” says Dr. Ovalle.
Although most
common in people who have had type 2 diabetes for 25 years or more, it can
occur in people who have prediabetes as well. In some studies, almost 50
percent of unexplained peripheral neuropathy [in the extremities], whether
painful or otherwise, turns out to be caused by prediabetes or diabetes, says
Dr. Einhorn.
You're
moody and grumpy
When
your blood sugar is out of whack, you just don't feel well, says Cypress, and
might become more short-tempered. In fact, high blood sugar can mimic
depression-like symptoms. "You feel very tired, you don’t feel like doing
anything, you don’t want to go out, you just want to sleep," Cypress says.
She'll see patients who think they need to be treated for depression, but then
experience mood improvement after their blood sugar normalizes.
Skin problems
Itchy skin, perhaps the result of dry skin or poor circulation, can often be a warning sign of diabetes, as are other skin conditions, such as acanthosis nigricans. "This is a darkening of the skin around the neck or armpit area," Dr. Collazo-Clavell says. "People who have this already have an insulin resistance process occurring even though their blood sugar might not be high. When I see this, I want to check their blood sugar."
Yeast
infections
"Diabetes
is considered an immunosuppressed state," Dr. Collazo-Clavell explains.
That means heightened susceptibility to a variety of infections, although the
most common are yeast (candida) and other fungal infections, she says. Fungi
and bacteria both thrive in sugar-rich environments. Women, in particular, need
to watch out for vaginal candida infections.
Your
vision seems blurry
Don’t
be alarmed—this is not diabetic retinopathy, where the blood vessels in the
back of the eye are getting destroyed, says Dr. Cypess. In the early stages of
diabetes, the eye lens is not focusing well because glucose builds up in the
eye, which temporarily changes its shape. "You're not going blind from
diabetes,” Dr. Cypess says he assures patients. "In about six to eight
weeks after your blood sugars are stabilized, you’re not going to feel it
anymore; the eye will adjust."
Your
cuts and scrapes heal more slowly
The
immune system and the processes that help the body heal don't work so well when
your sugar levels are high, explains Dr. Cypess.
Slow
healing
Infections,
cuts, and bruises that don't heal quickly are another classic sign of diabetes.
This usually happens because the blood vessels are being damaged by the
excessive amounts of glucose traveling the veins and arteries. This makes it
hard for blood—needed to facilitate healing—to reach different areas of the
body.
You're
more prone to urinary tract and yeast infections
Higher
levels of sugar in urine and the vagina can become a breeding ground for the
bacteria and yeast that cause these infections. Recurrent infections are
particularly worrisome. "Usually when you keep getting infections, doctors
will check for diabetes if you don't already have it," says Cypress.
"Even women who go to the emergency room for urinary tract infections are
often checked."
Frequent Infections
Since
both yeast and bacteria multiply more quickly when blood sugar levels are
elevated, women with type 2 diabetes may be more susceptible to vaginal
infections, says Einhorn. Foot infections are also common because diabetes can
damage the architecture of the foot, including the skin, blood vessels, and
nerves. However, Einhorn says, foot problems are usually seen more frequently
in those with advanced diabetes.
Fatigue
and irritability
"When
people have high blood sugar levels, depending on how long it's been, they can
get used to chronically not feeling well," says Dr. Collazo-Clavell.
"Sometimes that's what brings them into the office." Getting up to go
to the bathroom several times during the night will make anyone tired, as will
the extra effort your body is expending to compensate for its glucose
deficiency. And being tired will make you irritable.
"We see
people whose blood sugar has been really high, and when we bring the blood
sugar down, it's not uncommon that I hear, ‘I didn't realize how bad I
felt,'" she says.
Blood
tests
Several tests are used to check for diabetes,
but a single test result is never enough on its own to diagnose diabetes (the
test has to be repeated). One is the fasting plasma glucose test, which checks
your blood sugar after a night (or eight hours) of not eating. Blood glucose
above 126 milligrams per deciliter (mg/dL) on two occasions means you have diabetes.
The normal cutoff is 99 mg/dL while a blood sugar level of 100 to 125 mg/dL is
considered prediabetes, a serious condition on its own.
Tips
& Warnings
1. Early
diagnosis of this disease is vital to protect your organs from damage.
2. Exercise and healthful
diets are known to have beneficial effects for diabetics.
3. Any of the
symptoms mentioned above warrant further testing to rule out diabetes.
