Early on in the course of prediabetes and diabetes, the fact is that the signs and symptoms can be very subtle and very easily missed. While there is lots going on in your body’s cells, tissues and organs, often there is very little along the lines of signs and symptoms. If you have any of the risk factors for diabetes (see below), yearly check-ups can be critically important for your health.
Technically, signs are objective measured characteristics such as blood glucose levels while symptoms are subjective evidence of a disorder or disease. Symptoms may be pain, frequent thirst and fatigue.
Early Signs and Symptoms of Diabetes
Early diabetes is known as insulin resistance which can proceed to pre-diabetes. Not everyone exhibits these signs and symptoms. If you have any of the risk factors for diabetes, it would be a good idea to stay alert for any of the symptoms.
- A condition known as acanthosis nigricans, a darkening of the skin, particularly at the neck, armpits, elbows, knees and at the knuckles. If you notice any of this skin darkening, call your physician or dermatologist. This can signal prediabetes or diabetes.
- Increased thirst and more frequent urination. If you notice that you are more often thirsty and use the bathroom even more frequently than you might expect, make an appointment with your physician.
- Blurry vision is often a later sign of diabetes, but in some, it may occur early. If you notice any blurry vision, see your ophthalmologist or call your physician. You should also get your eyes checked by an optometrist to see if you need glasses or a new prescription.
The factors or characteristics that you should be aware put you at a higher risk for prediabetes and diabetes include:1
- Obesity or being overweight. This is generally meant as having a “Body Mass Index” or BMI of over 25.
- Your BMI is your weight (in kg) divided by your height (in m) squared. Calculate your BMI here.
- Physical inactivity—if you don’t get much exercise—either formal or informal (ie. walking, gardening, housework, household chores) or if your job has you sitting a good deal of the time, then you may be at higher risk of prediabetes and diabetes.
- Age—the older we get, the more “wear and tear” there is on our bodies, and the risk of diabetes and prediabetes increases
- People of certain ethnic groups and backgrounds have an increased risk. These include those of African, Asian, Hispanic and Northern American Natives.
- Your HDL-cholesterol (commonly referred to as the “good” cholesterol) is less than 35 mg/dL OR your triglyceride levels is more tan 250mg/dL. Both of these values can be tested using a blood sample.
- If your family history includes a close family member (father, mother, aunt, uncle, sister, brother, grandparent) that had or has diabetes.
- If your personal medical history includes high blood pressure, or, if a woman, either gestational diabetes (a form of diabetes that occurs during pregnancy) or polycystic ovary syndrome (PCOS). PCOS is a condition associated with obesity, irregular menstrual periods and hair growth that is excessive and often appears to be male-pattern hair growth (ie. face and chest).
Because the symptoms of prediabetes and diabetes can be non-existent or easily missed, the objective signs of diabetes become more important. This is why yearly check-ups become important because during the yearly check-up, a number of blood tests are usually routinely performed.
These tests should include:2
- Blood Sugar Levels: The main signs of prediabetes and diabetes are an increased blood sugar (blood glucose) level (in either a fasting blood sugar test or a glucose tolerance test). A fasting blood sugar is considered to point to prediabetes if the measured level is between 100-125mg/dL. (Normal is below 100 mg/dL). Fasting blood sugars above 125mg/dL are considered indicative of diabetes.
- A1c Percentage: The A1c test measures how much of the hemoglobin in your red blood cells has glucose (sugar) molecules attached to it. Since red blood cells have an average lifespan of about 120 days, and since the hemoglobin in those red blood cells picks up sugar molecules during its lifespan in the red blood cells, the A1c value indicates how well your body has controlled your blood sugar. Values below 5.7% are generally considered normal, while values between 5.7 and 6.4% are considered to indicate prediabetes. Values greater than 6.4% are considered to indicate that you have diabetes—the higher the A1c value, the worse the control of blood sugar. For examples, an A1c of 12% indicates that your blood sugar levels have been too high for a good part of the last 120 days (3 months) and that you either need to be more careful about your diet or medications to control your blood sugar may need to be changed.
- Lipid Panel: A lipid panel will measure the different forms of cholesterol such as total cholesterol (ideally below 200mg/dL), LDL-cholesterol (ideally below 100mg/dL), HDL-cholesterol (ideally over 40mg/dL in men and 50mg/dL in women) and triglycerides (ideally less than 150mg/dL). You may also see a calculated ratio—the cholesterol ratio. This is the total cholesterol level divided by the HDL cholesterol level. A higher ratio (greater than 3.5) indicates a higher risk of heart disease.
- Special Tests for other disorders: Depending on your specific medical situation, other tests may be ordered. These may include liver or kidney function tests or imaging tests such as CT scans, Ultrasounds (US) or MRIs.
Yearly screening can catch prediabetes and diabetes early—the good news is the earlier you know that you have diabetes, the better your chances are of reversing it.
If you have been diagnosed with Diabetes
If you have been diagnosed with diabetes, there are some symptoms you should never ignore. These include:
Signs of Low Blood Sugar
If you experience any of these symptoms, eat a sugary hard candy, a glucose tablet or a spoonful of honey and call for emergency medical help.
- Feeling dizzy, woozy, confused or losing consciousness.
- Slurring words
Signs of High Blood Sugar
Talk to your doctor if you are experiencing any of these symptoms.
- Urinating more frequently or with larger volumes, especially at night
- Feeling thirsty frequently
- Constant and extreme fatigue
- Wounds or sores that seem to take forever to heal
- Any change in vision
Questions to Ask your Doctor
Any individual with any diagnosis should always come with written questions as needed for their doctors. If you have been diagnosed with diabetes, jot down any questions that occur to you as you go through your treatment and bring them with you for your next appointment (or call into the doctor’s office with them).
Here are some questions that you may want to ask:3
- Foot care: there are a number of complications that can affect your feet if you have diabetes. You may want to ask your doctor about seeing a podiatrist, taking care of your feet and toenails and special shoes and socks you may benefit from.
- Make certain that whatever exercise program you decide on you will be able to safely engage in it. Talk to your doctor about safe exercise programs for you. Ask if you should be checking your blood sugar levels before and after physical activities.
- Eye care: there are also complications that can affect your eyes and your vision. Ask your physician about a referral to an ophthalmologist.
- Make certain you understand how often you need to test your blood sugar levels. This may mean testing morning blood sugar levels (fasting levels) and after meals. Also make sure you understand HOW to test for your blood sugar levels—there are many blood sugar testing meters available—find out which one may work best for you. It is best if you keep track of your blood sugar levels.
Regular Visits to Your Doctor
Diabetes can be controlled and treated, but it does require a working and ongoing relationship with your physician. For most people, this means regular visits, often every 3 months at first and then every 6 months. Working together with your physician will help you adjust your lifestyle as needed to best suit both your medical and your personal needs.