More than 37 million people in the United States have type 2 diabetes, according to the Centers for Disease Control and Prevention (CDC). But one-fourth of those people don’t know they have the condition.
Getting your annual physical, which typically involves testing your fasting blood sugar levels, is a great first-line screening for type 2 diabetes, no matter how healthy you think your blood sugar levels are, says Dawn Turner, RD, CDCES, a diabetes educator at the Northwestern Medicine Regional Medical Group in suburban Chicago. If your physician finds your levels to be high, they’ll evaluate your A1C, which is a two- to three-month average of your blood sugar levels. In some cases, based on your family history, age, and overall health, your doctor may go ahead and include an A1C test in your yearly workup.
To stay fully on top of your metabolic health, you need to listen to what your body is telling you. Because type 2 diabetes affects every cell in the body, the condition can cause a wide range of symptoms, says Fernando Ovalle, MD, the director of the multidisciplinary diabetes clinic at the University of Alabama at Birmingham School of Medicine. No two people with type 2 diabetes experience the condition in the exact same way, and the number of symptoms and their severity fluctuate from person to person. Dr. Ovalle notes that most symptoms of type 2 diabetes come on and progress gradually.
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What Are the Early Symptoms of Type 2 Diabetes?
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Frequent Urination Could Be Related to Diabetes
When there is excess glucose present in the blood, as with type 2 diabetes, the kidneys are not able to handle all of it and have to flush some out of the blood and into the urine, Ovalle says. This results in more urine production and increased urinary frequency and urgency, called polyuria. Some people may notice they have to get up every couple of hours during the night to urinate and that they produce more urine when they do go.
The presence of excess glucose can also cause the urine to have a sweet smell. This is most common in advanced cases of type 2 diabetes, he says.
Increased Thirst or a Dry Mouth May Signal Diabetes
Excessive thirst, or polydipsia, is another leading symptom of type 2 diabetes. After all, with increased urination, dehydration can result, according to Mayo Clinic. To try to remedy things, the body uses thirst to urge you to rehydrate.
What’s more, a study from 2017 found that people with type 2 diabetes may produce less saliva, exacerbating feelings of dry mouth, or xerostomia.
Uncontrolled Diabetes May Trigger Unexpected Weight Loss
In type 2 diabetes, the body’s cells don’t get enough glucose for energy. As a result, the body can turn to breaking down its fat stores for energy, according to the Cleveland Clinic. Severe, unintended weight loss is most common when the type 2 diabetes goes undetected for a long time, according to research.
Increased urination can also contribute to weight loss. For example, if you are urinating high levels of glucose because of uncontrolled diabetes, you are literally flushing calories down the toilet, says Daniel Einhorn, MD, a diabetes specialist in La Jolla, California. Dehydration involves a significant loss of water weight.
Feeling Hungry All the Time Also May Be a Diabetes Symptom
In people with type 2 diabetes, the body is not able to use insulin properly to help glucose get into cells. As a result, cells throughout the body can lack the energy they need for proper function. In an attempt to get the cells the energy they need, the body increases feelings of hunger, Turner says.
Excessive hunger, or polyphagia, is a common sign of diabetes. This is different from simply having a desire to eat. Polyphagia happens when you have an appetite even after you have eaten a sufficient amount of food.
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Foot Pain and Numbness Can Be Signs of Diabetic Neuropathy
Over time, a prolonged exposure to high blood sugar level can damage the nerves throughout the body through 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.
“Diabetic neuropathy usually starts in the feet and then it progresses upward,” says 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. When it affects the nerves outside the brain and spinal cord, it’s termed peripheral neuropathy.
Numbness in the feet can increase their risk of infection: If you don’t feel a cut or scrape on your foot, you might not notice or properly treat it, he says.
Frequent Urinary Tract and Yeast Infections Can Signal Diabetes
Bacteria and yeast multiply more quickly when blood sugar levels are elevated. Excess glucose in the urine, then, can cause urinary tract infections, according to the Cleveland Clinic.
Furthermore, these microbes thrive in warm, moist environments, such as the genital areas. This increases the frequency and severity of yeast infections, especially in women.
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Blurred Vision Could Be a Result of Rapid Blood Sugar Changes
Blurred vision can occur when there are rapid changes in blood sugar — from low to high or high to low — and the eye muscles have not yet adapted to it, Dr. Einhorn says.
The lens of the eye is a flexible membrane suspended by muscles that change the shape of the lens to focus the eye. In a high-sugar environment, such as with uncontrolled type 2 diabetes, the lens loses some of its ability to bend, he explains, and the muscles of the eye have to work harder to focus.
The good news: Caught early, diabetes-related vision changes can return to normal after about six weeks of healthy blood sugar levels, Turner says.
Oral Health Problems Can Point to Diabetes
Declining oral health is another symptom of type 2 diabetes. “Elevated blood sugar levels can increase the risk of gingivitis, periodontal disease, and inflammation in the mouth,” Turner says. “Any mouth sores can also be slow to heal.”
In fact, in a study published in May 2019, researchers found that people with type 2 diabetes have a higher risk of thick or yellow tongue “fur,” as well as blue-tinged tongues. Researchers note that evaluating tongues is a traditional Chinese practice for diagnosing type 2 diabetes.