Urinating more frequently
Perhaps the most well-recognized sign of diabetes, more frequent urination is a hallmark of both Type 1 and Type 2 diabetes. It’s the result of the body’s efforts to rid itself of the rising sugar levels that typify the disease. And, as well as more frequent urination, the volume of liquid excreted also increases.
Without the correct treatment, diabetes has the potential to damage many parts of the body. Blurry vision is caused by high blood sugar levels damaging the sensitive light-detecting cells of the retina. The issue usually resolves with correct treatment although may recur if blood sugar levels rise uncontrollably.
Wounds that don’t heal
High blood sugar levels impair the function of the white blood cells. These are body’s chief defence against invading bacteria and they also play a part in wound healing. If they can’t do their job properly, wounds – even small ones – may take a long time to heal and are also more prone to bacterial infections.
Getting up at night
The propensity to increased urination continues throughout the night. This means that someone with early stage or poorly-controlled diabetes can expect to be up multiple times in the night for bathroom trips. Unfortunately, restricting liquid intake close to bedtime is unlikely to help and instead result in dehydration.
Another very common symptom of undiagnosed (or badly-controlled) diabetes – especially Type 2, or diabetes insipidus – is increased thirst. It’s caused by the body’s fruitless efforts to regulate blood glucose levels. However, without appropriate medical and dietary intervention, the sufferer will continue to experience this extreme thirst.
The insufficient insulin levels that characterize diabetes mean that the body cannot extract sufficient energy from the high levels of glucose circulating in the blood. Instead, it extracts stored energy first from fat and then from muscle. This causes weight loss, which can be extreme, especially in Type 1 diabetics.
Uncontrollably high blood glucose levels can cause itching across the body. For some unlucky sufferers, the itching is extreme and cannot be alleviated. The feet, ankles and legs are most commonly affected. However, genital itching, caused by yeast overgrowths, is also a problem for many people.
High blood sugar levels create the ideal conditions for fungal infections, such as thrush, to thrive. Thrush can affect men as well as women, although signs of the infection are more obvious in women. Topical treatments can alleviate the symptoms and oral or internal medication may quell an infection but, without appropriate treatment for the diabetes, the thrush is likely to return.
Studies show that diabetics, including those on appropriate treatment regimes, are more likely to experience excessive tiredness when compared to the general population. For some, it’s extreme enough for them to classify it as “fatigue”, whilst others describe it as a sort of “fogginess”. In undiagnosed diabetics, the cause is most likely to be high blood sugar levels.
Insufficient insulin causes glucose levels to rise in the bloodstream. However, without sufficient insulin, the body is unable to access the circulating glucose and use it for energy. Although it seeks energy from alternative sources, such as stored fat, the sufferer will begin to experience hunger. Eventually, without medical treatment, this may be extreme and impossible to satiate.
The high blood sugar levels of early stage or uncontrolled diabetes affect saliva production. As a result, many diabetics, whether they’re aware of their condition or not, experience an uncomfortably dry mouth. Without the right care, this can lead to gum disease, other dental issues and mouth infections, such as ulcers.
High fasting plasma glucose test
Early stage diabetes is sometimes detected via a fasting plasma glucose test carried out as part of a routine health check. Fasting blood glucose levels of 126mg/dl usually indicate diabetes. However, to rule out anomalies or errors, a healthcare provider will probably repeat the test before confirming the diagnosis.
Very pale urine
Someone suffering from early stage diabetes Type 2 is very likely to experience increased urination. However, as they’re also likely to be very thirsty, they will also be drinking more than normal. The result will be unusually pale urine. Healthy urine is often described as straw-colored. However, a diabetic may struggle to discern any color in their urine.
Although pregnancy itself is not an indication of diabetes, it is a sign to watch out for it. This is because some pregnant women are considered to be at risk from developing a form of diabetes known as gestational diabetes. Usually appearing in the second or third trimesters, it generally disappears after giving birth.
Both Type 1 and Type 2 diabetics may experience cloudy urine for a number of reasons. These include excess blood sugar that leads to dehydration, which, in turn, causes cloudy urine. More advanced cases may result in kidney damage, which can also cause clouded urine.
People suffering from diabetes sometimes notice that their urine smells sweet or even “fruity”. This is caused by the body’s efforts to get rid of the excess glucose building up in the blood stream. Some of it is excreted via the urine, resulting in the characteristic sweet smell.
Headaches are not a direct result of diabetes. However, poorly-controlled diabetes may result in a headache as a consequence of blood sugar levels that are either too high or too low. In early stage, and perhaps undetected diabetes, it’s high blood sugar levels that might cause a headache.
It’s not well-known among the general population but diabetes can cause mood swings. In early stage or undetected diabetes, when blood glucose levels are likely to be becoming dangerously high, the sufferer may feel angry or sad for no apparent reason. Conversely, blood sugar levels that are too low are associated with feelings of nervousness.
Although excess weight is not a diagnostic criterion for diabetes, it provides a heads up that someone is at higher than average risk of developing it. This is because excess weight increases insulin resistance in the body, making Type 2 diabetes more likely. Consequently, healthcare providers may encourage weight loss via healthy eating and appropriate exercise.
Lack of exercise
As with excess weight, a lack of exercise is not on the diagnostic checklist for diabetes. However, a person who takes little or no exercise may be at greater risk of developing the condition. This is because a less active lifestyle is generally associated both with a diet more likely to predispose someone to diabetes and to weight gain.
Healthy diets that are low in sugar, fat and salt, and high in fiber, lean protein and wholegrains are considered protective against the risk of developing diabetes. Conversely, a high sugar, high fat, high cholesterol diet increases the risk of the condition as a result both of weight gain and of frequent spikes in blood glucose.
Some mood disorders are not the mental health conditions that they mimic. Instead, because the brain is fuelled largely by glucose, they are the result of the brain struggling to cope with the raised (or depleted) blood sugar levels that characterize diabetes. Anxiety and irritability are common symptoms among some early stage diabetics.
It’s fairly well-known that late-stage diabetics may experience limb problems that, at their worst, can cause gangrene and necessitate amputation. However, even early stage diabetics can suffer from numbness – and this most usually affects the hands and feet. However severe the damage, the cause is the same: high blood sugar levels that damage the nerves.
Very dry skin
Very dry skin is a common complaint of diabetics. It’s also something that someone who hasn’t yet been diagnosed with the condition may notice. The scaly, flaking and itching patches of skin require careful treatment with appropriate emollients as the damaged skin is prone to infection.
Tingling hands and feet
The blood glucose-induced nerve damage that sometimes causes numb limbs can also result in less severe, albeit still annoying, symptoms. For many people, this manifests itself as a tingling sensation, or pins-and-needles. Sometimes, gentle stretching will temporarily alleviate the issue but, ultimately, proper management of the diabetes is the only lasting solution.
High blood sugar levels sometimes cause an issue called gastroparesis. It’s a condition that affects the digestion – and, for the sufferer, it usually means uncomfortable symptoms that can include bloating, heartburn, nausea, and pain. As a result, otherwise unexplained stomach pains are considered as one of the warning signs of diabetes.
More infections than usual
Uncontrolled diabetes, even in its early stages, is a major cause of infections. For instance, diabetics are particularly prone to urinary tract infections. They are also susceptible to certain types of fungal nasal and throat infections that are very rarely seen in anyone without diabetes.
South-east Asian heritage
Some ethnic groups are at higher risk of developing diabetes. These include those of south-east Asian heritage. As a result, most healthcare providers will take care to monitor the blood glucose levels of these patients from a younger age than would be the case if they belonged to a different ethnic group.
Nausea and vomiting
Nausea and vomiting are relatively common among people with undiagnosed diabetes or those with poorly-controlled disease. The causes vary but, for undiagnosed diabetics, are most likely to relate to high levels of blood glucose. Other related causes include blood pressure problems (high blood sugar levels can raise blood pressure), pancreatitis and ketoacidosis.
Type 2 diabetes has some hereditary element. The risk of developing the condition is about 30% for someone whose father also has it. That risk is higher if their mother has the condition. If both parents are diabetic, the risk for their offspring rises to around 70%. Familial history is even more significant for those of certain ethnic groups, including south-east Asians and Pacific Islanders.
Diabetes frequently affects the circulation, making it slower and less effective. High blood glucose levels also thicken the blood and increases the likelihood of plaque-formation on the inside of major blood vessels. All of this makes it harder for blood, and the healing white blood cells it contains, to travel around the body and reach wound sites.
Diabetes causes changes to the body’s blood vessels. This affects how blood flows around the body and how effectively the various parts of the body can do their jobs. For the gums, this may result in a reduced blood supply. Eventually, this can weaken the gums, causing them to bleed and recede, and even loosen the teeth.
Diabetics, or those around them, sometimes notice that their breath smells of pear drops. This fruity smell isn’t the result of anything they’ve eaten. Instead, it’s a consequence of a process called ketoacidosis. This occurs when the body burns fat for energy instead of glucose. The ketones are the waste product of this process and are what gives the breath its characteristic smell.
High blood sugar levels sometimes cause a condition called polyuria. This is the name for what happens when the body produces more than three litres of urine per day (one or, at most, two litres is the usual maximum). Producing urine in these quantities can lead to such low fluid levels in the body that brain function is affected, causing light-headedness.
Men with diabetes are likely to experience sexual dysfunction. This usually manifests as problems getting or maintaining an erection. The causes vary but may include limited blood flow, nerve damage or damage to the blood vessels. Medication taken to treat diabetes can also sometimes cause sexual dysfunction. If this happens, the affected individual should consult their health care provider.
Darker neck skin
One of the less well-known signs of diabetes concerns changes to the pigmentation of the skin. Most commonly noticed on the neck, it’s a condition called acanthosis nigricans. It may also result in skin that feels thicker or more velvety than usual. People with naturally darker complexions are most likely to notice they have the condition.
High sugar levels in the blood can cause nerve damage. This is something that long-term patients and their health advisers know to watch out for. However, if diabetes goes undiagnosed for too long, nerve damage can also present problems in these patients. The condition is called diabetic neuropathy and it can affect the limbs, digestive system, heart, urinary tract, and blood vessels.
If diabetic neuropathy – caused by high blood glucose levels – is allowed to go unchecked, the sufferer may experience limb pain. Frequently beginning as increased sensitivity, it’s often noticed first at night. As time goes on, it progresses from sensitivity to pain. It’s considered one of the long-term complications of diabetes.
Diabetes often exacerbates pre-existing urologic conditions. This means that if you had a tendency towards urinary tract infections before developing diabetes, you may suffer them more frequently or more severely. However, it can also predispose even those who’ve never had a urinary tract infection towards suffering their first bout.
Frequent or poorly-controlled bladder infections, which are common in diabetics, have the potential to damage the kidneys. In addition to this, high blood glucose levels can damage the small blood vessels in the kidneys, meaning that they work less effectively. Furthermore, the high blood pressure that some diabetics develop can also negatively affect kidney functioning.