Uncontrolled diabetes puts you at risk for many serious health conditions—heart disease, heart attack, stroke, nerve damage, blindness, kidney failure and foot or leg amputation—which is why it’s so important to work with your healthcare provider to manage high blood sugar.
Unfortunately, many people have very few warning signs that they have diabetes.
“It’s really important to see your primary care provider regularly for screening,” says UNC Health endocrinologist Brooke Matson, MD, PhD. “About 25 percent of people who have diabetes don’t know they have it.”
The various forms of diabetes, which include type 1, type 2 and gestational diabetes, are all diagnosed with a blood test. It’s important to remember that diabetes can affect anyone, but the risk increases when you have a family history of the disease or have overweight or obesity.
If you’re experiencing a symptom on this list, make an appointment with your healthcare provider promptly. Don’t wait for more symptoms to appear.
“It’s better to get things under control quickly rather than letting it linger,” Dr. Matson says. “It will be worse if you put off seeing your doctor than if you get the diagnosis and start treatment.”
1. Frequent urination.
If you notice a sudden jump in the number of times you’re going to the bathroom in a day, talk to your healthcare provider.
As blood sugar rises, that excess sugar leaves the body via urine, Dr. Matson says. “The sugar in the urine pulls in extra water from your body, causing you to urinate much more frequently.”
That increase in urination causes the next symptom.
2. Excessive thirst.
Because you’re losing so much of your body’s water via urination, you will feel very thirsty.
“The frequent urination and the excessive thirst go hand-in-hand,” Dr. Matson says. “If you turn to a sugar-sweetened beverage, like soda or sweet tea, to treat increased thirst, it’s going to compound the problem.”
Reaching for water is a healthier option because it will help you stay hydrated, but it’s not the solution to these symptoms.
“Water can help bring blood sugar down, but it’s not a treatment, and it won’t change the diagnosis,” Dr. Matson says. “You still need to be evaluated if you have excessive thirst.”
3. Sudden and unintentional weight loss.
If your body changes drastically without a corresponding change in what you’re eating, talk to your doctor.
“Unintentional weight loss is a concerning sign,” Dr. Matson says. “The body needs insulin to use sugar for energy. When the body can’t make enough insulin, or insulin isn’t working well, it can’t use carbs for energy, so it starts burning fat and muscle, and you lose a lot of weight without trying.”
This type of quick weight loss is a common sign of type 1 diabetes, though it can also occur with type 2.
“Type 1 represents a minority of the cases of diabetes, but it’s a common misconception that type 1 diabetes is diagnosed exclusively in children,” Dr. Matson says. “In fact, the majority of type 1 diabetes is actually diagnosed in adulthood.”
4. Skin changes.
High levels of blood sugar can affect your skin. You might notice spots called acanthosis nigricans.
“This is a sign of insulin resistance, when there are dark and velvety patches of skin, usually around the neck and the armpits,” Dr. Matson says.
Other diabetes-related skin changes include dry skin, reddish or reddish-brown spots on your shins, hard or thickening skin, unexplained small bumps and skin tags.
5. Slow-healing wounds and numbness.
Uncontrolled diabetes can affect the strength of your immune system, which means that even minor cuts or scrapes can take longer to heal and have a greater chance of becoming infected.
Diabetes can eventually impact your blood vessels and the nerves in your body. One early warning sign that this damage is taking place is numbness or tingling in your toes, fingers, feet and hands, or neuropathy.
“People who have neuropathy in their feet sometimes have wounds they even don’t know about because they can’t feel it,” Dr. Matson says. “Neuropathy is usually associated with longer duration of disease.”
6. Blurry vision.
If you notice that your vision goes blurry and then returns to normal, that could be a sign that your body’s blood sugar spiked, causing the fluid in your eye to swell. While the symptom may resolve on its own, don’t ignore it.
People with diabetes are at a higher risk of blindness because of the damage that diabetes can do to the small blood vessels supplying blood to the eye. Typically, it takes years for blindness to occur, and it can be prevented if you keep your diabetes controlled.
“Once you have a diagnosis, it’s important to get annual eye exams to screen for diabetic retinopathy,” Dr. Matson says. “It’s correlated with how high your blood sugar is, so undiagnosed, asymptomatic diabetes can cause a lot of complications at the microvascular level.”
Steps That May Help Prevent Diabetes
You can’t always prevent diabetes. Still, there are steps you can take to minimize long-term complications and keep your blood sugar controlled:
- See your primary care provider regularly.
Not everyone will have symptoms of diabetes, or if they do, it’s only after living with the disease for a while. When you see your healthcare provider regularly, they can be sure you’re up-to-date on screenings, and if you do have high blood sugar, they will work with you on a plan for control.
- Eat a healthy, well-balanced diet.
You can lower your blood sugar with a diet that emphasizes fruits and vegetables, lean proteins and whole grains. Overhauling your diet can seem like an overwhelming task, so Dr. Matson provides two simple ways to get started.
“Eliminate sugar-sweetened beverages, and get in the habit of looking at nutrition labels and ingredient lists at the grocery store,” she says. “Prioritizing foods with recognizable ingredients, or fewer ingredients, can help minimize your consumption of ultraprocessed foods, which have been shown to have adverse effects on metabolism.”
- Exercise regularly.
Aim for 150 minutes of physical activity a week. That doesn’t mean you have to start training for a marathon, though.
“You can move your body in any way you like to move it,” Dr. Matson says. “Movement and strength training can lower blood sugar.”
Regular exercise has also been shown to help you sleep at night, which provides additional benefit.
“One night of bad sleep can increase insulin resistance,” Dr. Matson says. “Getting quality sleep is a really underappreciated part of a healthy lifestyle.”
If you’re concerned about your risk for diabetes, talk to your doctor. If you need a doctor, find one near you.