Written by Denise Schipani
Diabetes — a chronic condition that affects how your body uses food for energy — is a fact of life for more than 34 million people in the U.S., according to the latest data from the Centers for Disease Control and Prevention (CDC). [1, 2] But did you know that in the early stages, the symptoms of diabetes could be easily missed?
The CDC also reports that more than one in three American adults have prediabetes — and the vast majority of them (84%) don’t even know they have it.  Prediabetes can evolve into type 2 diabetes over time. This can increase your risk of serious health problems such as heart disease, vision loss, and kidney disease if left unmanaged. [1, 2]
“Prediabetes means you have elevated glucose levels, but not at the level to be diagnosed with type 2 diabetes,” says George “Joe” Trotter, Jr., R.N., a nurse clinician and certified diabetes care and education specialist with the Diabetes Management Program at Emory Healthcare in Atlanta.[3, 4]
Diabetes screening is done with a blood test called the hemoglobin A1C test. You can get it at your provider’s office or through a home test, and a diagnosis may be confirmed through additional testing.[3, 5, 6] How do you know if you should be tested for diabetes? Some guidelines:
- If you’re age 45 or older, it’s a good idea to get tested now. Do results indicate no problem? Great — keep up with screenings every three years, unless your health status changes.[3, 7, 8]
- If you’re overweight and have one or more of the risk factors below, you should get tested more often.
- You have a first-degree relative (parent, sibling) with diabetes
- You are African American, Hispanic/Latino American, American Indian, Asian American, or Pacific Islander
- You have a history of cardiovascular disease, high blood pressure, or high cholesterol/high triglycerides and are physically inactive
- You’re a woman who has polycystic ovary syndrome (PCOS).[3, 7, 8, 9]
- If you’re a woman who’s ever had gestational diabetes (diabetes during pregnancy), get tested every three years.[3, 4, 7, 9, 10]
If you don’t fit these categories but have symptoms that could signal diabetes, don’t wait. Any one or more[3a] of the warning signs below should prompt you to schedule a screening.
Diabetes Sign: Excessive Thirst
A hallmark of type 2 diabetes is an inability to process glucose (blood sugar), and by being perpetually thirsty, your body may be sending the signal that you have extra glucose to “flush out,” says Trotter. If you’ve been drinking fluids normally and have no other reasons (hot weather, a major workout) to feel parched, consider your thirst a possible sign of diabetes.[3, 11, 12]
Diabetes Sign: Frequent Urination
You might think you’re hitting the bathroom more often because you’re drinking more water (see above). But taken together, elevated thirst and a frequent need to pee could signal diabetes, because as noted, voiding urine is one way your body tries to rid itself of excess glucose.[3, 11, 12]
Diabetes Sign: Constant Hunger
“It’s easy to excuse persistent hunger by saying, ‘Well, I didn’t have a big lunch today,’” says Trotter, who calls hunger one of the more ignored signs of diabetes. “Hunger is your body telling you that it needs more glucose for energy. Even though you’re eating plenty and may also have elevated glucose levels because your body isn’t efficiently processing glucose, your body keeps ‘asking’ for more.”[3, 11, 12]
Diabetes Sign: Extreme Fatigue
Glucose is your body’s main energy source. When it’s not properly used, you can feel run-down. This is another overlooked symptom, because who isn’t tired? Try to pay attention to your body’s cues to decide if you feel unusually tired, and get tired more often, without a good alternative explanation.[3, 11, 12]
Diabetes Sign: Blurry Vision
“If your vision gets blurry or decreases, it’s easy to think it’s just a sign of aging,” says Trotter. But it could be the result of excess glucose “floating” in the veins in your eyes. “Vision can be greatly affected by diabetes; untreated, it can result in permanent blindness,” he says. So don’t ignore changes in vision. In fact, this can be one of the earlier signs of type 2 diabetes.[3, 11, 12, 13]
Diabetes Sign: Slow Wound Healing
Proper glucose absorption aids in the body’s healing process, says Trotter. If you have cuts or abrasions that seem to be taking a long time to heal (which also leaves you more prone to infection), you should get checked. For someone with diabetes, those cuts or abrasions may lead to an infection, which can increase the risk of a toe or even foot amputation.[3, 11, 12, 14]
Diabetes Sign: Numbness in Hands or Feet
Thinking you just slept funny or your shoes are too tight? Be careful, says Trotter because higher glucose levels can lessen nerve sensation, especially in your extremities. “That may lead you to hurt or burn yourself without realizing it, and numb feet could lead to trips and falls.”[3, 11, 12]
Diabetes Sign: Frequent Yeast Infections
Both men and women can be prone because the bacteria that cause infections have more sugar (glucose) to feed on and a warm environment to grow. Men may notice an itchy, scaly rash on their penis.[3, 15, 16]
Related article: 3 Possible Reasons Why It Hurts to Pee
Use Your Test Results to Spur Healthy Changes
If your A1C result is in the 5.7% to 6.4% range, that indicates prediabetes. [3, 17] There’s great value in knowing you’re prediabetic because it can be your prompt to take steps to stop or slow the progression to type 2 diabetes, such as lifestyle changes, says Trotter. Making even modest healthier eating choices, such as focusing on portion sizes, limiting excess carbs and fat, and adding more fiber, goes a long way. Moderate daily physical activity — a half hour or so a day, most days of the week — can also lower your risk.[3, 18, 19]
Related article: Diabetes-Friendly Food: 10 Foods That Help to Control Blood Sugar
CDC/What is Diabetes?
CDC National Diabetes Statistics Report, 2020
https://www.cdc.gov/diabetes/library/features/diabetes-stat-report.html#:~:text=34.2 million Americans—just over,Asians and non-Hispanic whites.
The number of symptoms: More than half (56%) of type 2 diabetic respondents reported experiencing one or more of the ADA symptoms in the previous 12 months (Table 2), and therefore, 44% of those with type 2 diabetes had none of the seven ADA symptoms. The frequency at which symptoms were reported was similar for type 1 (52%) and type 2 (56%) diabetic respondents. The low-risk group had 31% reporting one or more symptoms and 69% reporting no symptoms. In the high-risk group, 45% reported one or more symptoms and 55% reported none.
CDC/Diabetes Risk Factors
USPSTF/AFP/Diabetes Mellitus: Screening and Diagnosis
USPSTF/AFP/ Screening for Abnormal Blood Glucose and Type 2 Diabetes Mellitus: Recommendation
USPSTF/AFP/Gestational Diabetes Mellitus
https://www.aafp.org/afp/2015/0401/p460.html#:~:text=Women with GDM should be,thereafter%2C for abnormal glucose metabolism.&text=GDM %3D gestational diabetes mellitus%3B USPSTF,U.S. Preventive Services Task Force.
UCLA Health/For diabetics, blurry vision is cause for concern
By uclahealth • November 29, 2017
https://connect.uclahealth.org/2017/11/29/for-diabetics-blurry-vision-is-cause-for-concern/#:~:text=Increased blood sugar (or%20blood,can%20progress%20to%20diabetic%20retinopathy.&text=In%20order%20to%20prevent%20permanent,yearly%20eye%20exam%20with%20dilation.
American College of Foot and Ankle Surgeons
Medical News Today/Diabetes and Yeast Infections (candidiasis)/ Medically reviewed by Deborah Weatherspoon, Ph.D., R.N., CRNA — Written by Alyse Wexler on May 7, 2019
American Diabetes Association/Skin Complications
American Diabetes Association/Diagnosis
American Diabetes Association/Lifestyle Change Programs