Diabetes symptoms: What are the early signs of diabetes?

Overview: What does diabetes feel like?

Diabetes mellitus is a condition of high levels of sugar in the blood. Normally, sugar is removed from the blood by being absorbed by the body’s cells for use as energy. This process is regulated by a hormone called insulin. Some people have a medical condition that destroys their ability to make insulin (Type 1 diabetes). In other people, the body’s cells lose their sensitivity to insulin. Eventually, the body can’t make enough insulin to overcome this resistance. This is the problem for people with prediabetes, Type 2 diabetes, and gestational diabetes. In all cases, sugar, called glucose, builds up in the blood and slowly but steadily damages blood vessels. If left unchecked, the cumulative blood vessel damage can lead to serious and life-threatening health problems including organ dysfunction. In many cases, people with diabetes do not have symptoms at first, or even for many years. However, there are clues that blood sugar is a problem before it starts doing too much damage. Knowing the diabetes risk factors and the early signs of diabetes can prompt you to see a healthcare professional and take the steps to bring blood sugar under control at the early stages.

What are the early signs of diabetes?

The earliest signs of diabetes are the classic signs of diabetes:

• Urinating frequently

• Extreme thirst

• Increased hunger

Frequent urination is one of the earliest signs of high blood sugar. That’s because the body’s immediate response to high blood sugar is to pee it out. This increased urination leads to dehydration, so thirst is another early sign. Dry mouth and weight loss are follow-on symptoms of dehydration.

Other early signs of diabetes could include:

• Dry mouth

• Weight loss

• Tiredness

• Sweating

• Weakness

• Cuts and bruises that don’t heal as quickly as they used to

• Yeast infections

• Unexplained weight loss (Type 1 diabetes)

• Nausea (Type 1 diabetes)

• Vomiting (Type 1 diabetes)

• Abdominal pain (Type 1 diabetes)

Eventually, if high blood sugar levels are not controlled, diabetes will start damaging blood vessels. Decreased blood flow will damage the body’s tissues, particularly nerves in the extremities. At this point, early symptoms could include:

• Pain or numbness in the hands and feet

• Vision changes

RELATED: 10 early signs of diabetes and when to see a healthcare provider

Type 1 diabetes vs. Type 2 diabetes symptoms

Type 2 diabetes is what most people think of as diabetes. It involves the slow onset of insulin resistance until the body can’t make enough insulin to get past this resistance. Type 1 diabetes is an autoimmune condition in which the immune system attacks the pancreas cells that make insulin. The end result of both processes is high blood sugar, so the symptoms are more or less identical. However, symptoms of Type 1 diabetes usually start during childhood and progress very rapidly, while Type 2 diabetes is more often a disease of people who are 45 years and older (although it’s becoming more common in children, teenagers, and young adults) and can take years to worsen.

RELATED: Type 1 vs. Type 2 diabetes: what’s the difference?

Types of diabetes: How can I tell which one I have?

Healthcare professionals distinguish between three types of diabetes as well as prediabetes, an early stage that can be reversed with lifestyle changes before developing into diabetes. How can you tell what type you have? It’s usually pretty easy: the doctor will tell you.

• Type 1 diabetes is an autoimmune condition in which the immune system attacks and destroys the pancreas cells that make insulin. It generally starts during childhood and symptoms worsen rapidly. The good news is that once diagnosed, the patient is generally able to get blood sugar levels controlled fairly quickly with insulin. People with Type 1 diabetes will always require insulin. 

• Type 2 diabetes usually results from insulin resistance. Cells in the body absorb less blood sugar, so the pancreas makes more insulin. Eventually, the pancreas can’t meet the increased insulin demand and blood sugar goes up. Type 2 diabetes usually happens in people older than 45, and/or those with other weight-related medical conditions, though it can occur earlier. It comes on slowly and symptoms often develop over years. People with Type 2 diabetes will be advised to make lifestyle changes (such as a healthy diet and exercise) and take medication. In some cases, insulin may be required. 

• Gestational diabetes is also the result of insulin resistance, but it’s caused by the release of placental hormones. Affecting 2% to 10% of pregnancies in the US, gestational diabetes usually manifests in the second or third trimester. 

• Prediabetes is also the result of insulin resistance and is an early stage of Type 2 diabetes. Excess sugar is in the blood, but not enough to qualify as diabetes. Prediabetes usually comes on silently, usually has no symptoms, and is discovered on a routine blood test.

These are the common types of diabetes, but there are less common types:

• Maturity-onset diabetes of the young (MODY) is a genetic disorder in which the pancreas does not make insulin very well. Less than 5% of diabetes cases are due to MODY. Usually, it’s first diagnosed between the ages of 10 and 40 years old. The treatment is based on the gene mutation. Some patients will require diet and exercise, while others will also require medication and/or insulin.

• Secondary diabetes describes high blood sugar that’s either a complication of another medical condition or a side effect of a drug. It can be due to either insulin resistance or poor insulin production. Sometimes, secondary diabetes goes into remission when the problem is resolved, but not always. 

• Neonatal diabetes is a rare and severe genetic form of diabetes that affects newborns due to problems with the function of the pancreas. 

RELATED: How many types of diabetes are there? 

When to see a doctor for diabetes symptoms

If any of the signs of diabetes are noticed, see a healthcare professional. The only way to identify high blood sugar is through a blood test. Many people ignore the early signs of diabetes because they do not seem serious, or they may seem like general symptoms that can be explained by other causes. Know the early signs and the risk factors and get screened if they add up. 

Emergency treatment is needed when symptoms of insulin shock or diabetic coma are noticed. 

Diabetic coma may occur when blood sugar levels get dangerously high or dangerously low. Symptoms include:

• Slow heartbeat

• Weak pulse

• Deep breathing

• Flushed, warm skin

• Dry skin

• Confusions

• Drowsiness

• Unconsciousness

• Nail polish breath or fruity breath odor

Insulin shock is a form of severely low blood sugar, which can occur when insulin levels are imbalanced. This can happen if you use too much insulin or take too much diabetes medication, or if you miss meals. Symptoms of insulin shock include:

• Weakness

• Fast heartbeat

• Fast breathing

• Pale skin

• Headache

• Sweaty skin

• Numbness

• Hunger

• No breath odor

RELATED: How I got the right diabetes diagnosis—and learned to live with it

Complications of diabetes

If blood sugar is not well-controlled, diabetes can cause damage over time. Complications of persistently high blood sugar may include:

• Heart disease and stroke

• Coronary artery disease

• Peripheral artery disease

• Kidney disease

• Kidney failure

• Limb amputations

• Retinal damage (diabetic retinopathy)

• Vision loss

• Nerve damage (diabetic neuropathy)

• Diabetic ketoacidosis (more common in people with Type 1 diabetes)

• Diabetic coma

RELATED: Your guide to diabetes complications—and how to avoid them

How to treat diabetes symptoms

Diabetes should be treated by a healthcare professional. The goal of diabetes care is to lower blood glucose levels into a target range. Your healthcare professional will tell you what your target range should be. You will also need to monitor your blood sugar. You can discuss monitoring with your healthcare provider. Some individuals prefer to manually finger stick to test blood sugar, while others prefer continuous glucose monitoring, which is a sensor worn on the skin that continuously monitors blood sugar levels. 

Type 1 diabetes is treated with insulin, which can be administered by injections or through a pump. Healthcare professionals may also recommend diet and exercise changes if needed. However, lifestyle changes cannot reverse Type 1 diabetes. People with Type 1 diabetes will always require insulin. 

Type 2 diabetes is typically treated with diet, exercise, lifestyle changes, and drugs that reduce blood sugar. In some cases, regular insulin injections may also be needed.

Gestational diabetes is typically treated with diet, exercise, and lifestyle changes. Some women will require insulin or oral medications to lower blood sugar.

Prediabetes is usually treated with diet, exercise, and lifestyle changes. In some cases, drugs that lower blood sugar may be prescribed, such as metformin or acarbose.

Living with diabetes

Diabetes is a diagnosis, not a disaster. With the right treatment, lifestyle changes, and regular testing, blood sugar levels can be reduced. Even remission is possible in some people. The best way to live with diabetes is to take control of it: 

• Keep all appointments with healthcare providers

• Get regular blood tests

• Perform all needed home blood tests (or use a continuous glucose monitor such as the Freestyle Libre or Dexcom)

• Take all medications (and/or insulin) as instructed

• Lose weight, if needed

• Eat healthy, balanced meals (consult a registered dietician for an eating plan that works with your lifestyle and needs)

• Be physically active (consult your healthcare provider before beginning an exercise program)

• Manage stress 

Losing weight and eating healthy meals are the cornerstone of managing diabetes. The American Diabetes Association has a simple set of guidelines for healthy eating:

• Eat fruits and vegetables

• Eat lean meats and plant protein

• Avoid added sugar

• Avoid processed foods

FAQs about diabetes symptoms

What are the 3 most common symptoms of undiagnosed diabetes?

The three classic symptoms of diabetes are frequent urination, increased thirst, and increased hunger. Though people may notice these problems, they don’t always connect the dots with diabetes.

How long can you have diabetes without knowing?

The only way to know if you have diabetes is through a blood test. Theoretically, that means you can have diabetes for years, decades, or a lifetime and not know it. To avoid having diabetes without knowing:

• Visit a doctor regularly

• Know the risk factors for diabetes

• Know the earliest signs of diabetes

• Get screened for diabetes if you have any of the risk factors or early signs

What are the warning signs of prediabetes?

There usually aren’t any warning signs for prediabetes. Blood sugar levels are too low to start causing problems. If there are symptoms, the most common are having to urinate often and feeling thirstier or hungrier than usual.

What’s next? Additional resources for people with diabetes symptoms

Test and diagnostics

• Blood tests for diabetes, SingleCare

• Diabetes, American College of Emergency Physicians

• Type 2 diabetes, StatPearls

Treatments

• Diabetes treatments and medications, SingleCare

• Gestational diabetes, StatPearls

• Prediabetes, StatPearls 

• Type 2 diabetes: a STEPS approach, American Family Physician

• Type 2 diabetes treatments and medications, SingleCare

Scientific studies and clinical trials

• Reversal and remission of T2DM—an update for practitioners, Vascular Health and Risk Management

More information on related health conditions

• What’s the difference between insulin resistance and prediabetes?, SingleCare

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