Diabetes is a serious and all-too-common disease. Almost 10 percent of the U.S. population has it, and over a third of adults have prediabetes, a condition that often leads to full-blown diabetes—and many don’t even know it. Type 2 diabetes, marked by high blood sugar, can sneak up on you, often with few or mild symptoms you may not notice. You might have heard that diabetes can make you thirsty or lead to frequent urination, but there are other subtle signs your metabolism is not quite right.
Here’s what to look for—if you have any of these surprising diabetes symptoms, contact your doctor for a blood sugar test.
Diabetes makes you hungry for the same reason it makes you thirsty. Insulin, a hormone made by the pancreas, helps the body process and use glucose, or blood sugar. As your blood sugar levels rise, your pancreas has to produce more and more insulin to keep up, and eventually it can’t. “With diabetes, the blood glucose cannot enter the body cells where it is needed for energy due to a lack of insulin, or ‘insulin resistance,’” says Agnes Weaver, a diabetes educator at Piedmont Fayette Hospital in Fayetteville, Georgia. “As a result, the body is starved of energy and it sends a message to the brain that it needs food to refuel; hence, the feeling of hunger.”
Although type 2 diabetes is associated with being overweight, ironically a symptom of the development of the disease is actually losing weight. This is also because your body is not absorbing glucose to use as energy. “In uncontrolled diabetes, high glucose levels in the blood are sensed by the kidney, which is forced to filter the glucose and excrete it in the urine,” says Reshmi Srinath, MD, director of the weight and metabolism management program at The Mount Sinai Hospital in New York City, and assistant professor of medicine in the Division of Endocrinology, Diabetes and Bone Diseases, Icahn School of Medicine at Mount Sinai. “When glucose is lost in the urine, it can’t act as fuel for muscles and other vital parts of the body, leading to loss of muscle.” If you see the number on the scale dipping even though you know you’re not eating healthier or exercising more, talk to your doctor.
Although type 2 diabetes is associated with being overweight, losing weight is actually a common symptom.
Because your body isn’t absorbing glucose for fuel, it’s not surprising that you become tired when you develop diabetes. “A person can feel fatigue as the body is not getting enough energy it needs from the foods he eats,” Weaver says. Plus, blood sugar highs and lows can put a strain on the body. “In uncontrolled diabetes there can be severe fluctuations in glucose throughout the day, which can make someone feel tired,” Dr. Srinath says. “This is why we recommend eating every four to six hours and not going for a prolonged period of time without eating.”
Hunger and tiredness are also linked with being irritable—hello, “hangry.” With diabetes, these mood dips can be even more severe. “Mood changes such as irritability can be caused by blood sugar swings,” Weaver says. In addition, “if the brain does not get enough glucose to do its job, it can affect the emotional center of the brain. High sugars can make you emotionally out of balance.” Managing diabetes over time is also associated with depression, as the stress of symptoms, treatment, and diabetes complications can take its toll on your mental health. And in a vicious cycle, this stress response may also actually raise blood glucose in the body, making diabetes control worse. Here’s more info on how to manage stress with diabetes.
You probably tend to think of yeast infections as simply a “female problem,” but if you’re a woman with who keeps getting these infections and your hygiene or other habits haven’t changed, diabetes could be an underlying culprit. “Recurring yeast infections can occur as the increase in sugar level cause yeast to overgrow, because yeast feeds on sugar,” Weaver says.
All that sugar in your urine is also a breeding ground for bacteria, which can raise your risk for urinary tract infections. (These are other clear signs of a UTI.) “High glucose levels in the urine also allow certain bacteria to thrive, which increases the risk of a urinary tract infection,” Dr. Srinath says. In addition, “high sugar levels reduce the ability of the immune system to fight off any infection,” Weaver says.
High levels of sugar in the urine allow bacteria to thrive, which can make urinary tract infections more likely.
Wondering why that cut on your finger is still there, or that bruise on your arm just won’t go away? It could be a subtle sign diabetes is taking hold. “In uncontrolled diabetes, high glucose levels affects blood flow to the skin and vital organs, which can impair local healing processes,” Dr. Srinath says. This happens because elevated blood sugar stiffens the arteries, causing them to narrow and decrease blood flow, which is required for healing, says Weaver.
Your skin may go through other changes as well, which could be the first surprising sign you have diabetes. “People with diabetes can experience dry, itchy skin, and they are more prone to getting skin infections such as boils and nail fungus,” Weaver says. (Here's more on the link between athlete's foot and diabetes.) To avoid them, keep skin moisturized and clean with gentle products. In addition, if you notice any strange, raised or brown areas of skin, it could be other dermatologic conditions associated with diabetes, such as acanthosis nigricans, so see your doctor.
Another condition you might not associate with diabetes is eye problems. Eye doctors commonly suspect diabetes in patients who come in because of blurry vision. When they do a retinal exam and see the state of the blood vessels in the back of the eye, they may suspect the damage is due to diabetes and recommend you see a primary care doctor for further testing. “Elevated blood sugar causes fluid to seep into the lens of the eye and cause swelling; thus altering its ability to focus properly,” Weaver says. Luckily, once your blood sugar is under control, your vision should return to normal. However, “when prolonged and untreated, high blood glucose levels can also increase the risk for other eye conditions such as retinopathy, cataracts, and glaucoma,” Dr. Srinath says. Here’s more info on preventing eye problems with diabetes.
The poor circulation associated with diabetes can lead to a pins and needles sensation. “High glucose levels can cause irritation to the nerves, which leads to numbness and tingling and sometimes pain,” Dr. Srinath says. It’s estimated that 60 to 70 percent of people with diabetes will develop some of this nerve damage, called neuropathy. Another danger of this loss of feeling might be that you don’t know if you’ve injured your foot. “This can lead to serious complications if untreated,” Weaver says, since such wounds can be slow to heal in people with diabetes and may become infected. Close daily inspection of your feet (as well as these tips for maintaining healthy feet with diabetes) can help prevent this.
Suspect you might have diabetes? Read these next:Reviewed by: Preeti Parikh, MD, . Review date: April 4, 2018