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.
Diabetes is a common health condition that can affect anyone regardless of age, sex, race, or ethnicity. Find updated diabetes statistics here.
Early signs of diabetes include frequent urination, increased thirst, and increased appetite. Other possible early signs include dry mouth, fatigue, and involuntary weight loss.
Serious situations of diabetes such as diabetic coma or insulin shock require immediate medical attention.
Type 1 diabetes is caused by an autoimmune disorder. Type 2 diabetes is caused by several factors including genetics, lifestyle habits, and certain medical conditions such as pancreas problems or hormone disorders. Type 2 diabetes can also be a side effect of certain drugs like corticosteroids. You may be at risk for developing diabetes symptoms if you are 45 years or older, overweight, physically inactive, or have prediabetes, an immediate relative with diabetes, a family history of diabetes, high blood pressure, cholesterol problems, nonalcoholic fatty liver disease, polycystic ovary syndrome, or have had gestational diabetes.
Diabetes requires a medical diagnosis.
Diabetes requires treatment. Diabetes symptoms like thirst and hunger typically resolve with proper treatment, but it may take some time to hit target blood sugar levels. And, maintaining target blood sugar levels requires frequent monitoring and following a treatment plan.
Treatment of Type 2 diabetes usually includes diet, exercise, and medications that lower blood sugar. In certain cases, insulin is also required. All individuals with Type 1 diabetes require insulin. Read more about diabetes treatments.
Untreated diabetes could result in complications like nerve pain, retinal damage, ketoacidosis, cardiovascular disease, kidney disease, blindness, and amputations.
Use coupons for metformin, Glucotrol (glipizide), and Ozempic (semaglutide) to save up to 80% on the cost of your prescriptions.
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 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.
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RELATED: Type 1 vs. Type 2 diabetes: what’s the difference?
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?
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
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
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.
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
Lifestyle and diet do play a prominent role in successfully managing high blood sugar and avoiding the serious complications of diabetes. It’s not easy, but eating healthy foods, losing weight, and exercising are worth the effort. Not only will blood sugar come down, but these lifestyle changes can make you, your health, and your life better in many other ways.
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.
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
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.
Blood tests for diabetes, SingleCare
Diabetes, American College of Emergency Physicians
Type 2 diabetes, StatPearls
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
Reversal and remission of T2DM—an update for practitioners, Vascular Health and Risk Management
After receiving her doctorate from the University of Pittsburgh School of Pharmacy, Karen Berger, Pharm.D., has worked in both chain and independent community pharmacies. She currently works at an independent pharmacy in New Jersey. Dr. Berger enjoys helping patients understand medical conditions and medications—both in person as a pharmacist, and online as a medical writer and reviewer.
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