Diabetes symptoms - when to pay attention

The symptoms of diabetes can be subtle, develop over time, and are often mistaken for other common conditions like dehydration, fatigue, or ageing. This is particularly true for type 2 diabetes, where high blood glucose may go unnoticed for years.

In many cases, people only discover they have diabetes after experiencing a complication such as blurry vision, infections, or cardiovascular symptoms. Early detection and treatment can reduce the risk of long-term complications and significantly improve quality of life and longevity¹.

Some of the most commonly overlooked diabetic symptoms include:

• Unexplained fatigue
• Dry or itchy skin
• Increased thirst or hunger
• Frequent urination
• Slight vision changes

Even if these symptoms seem minor, they may indicate abnormal blood glucose levels or early stages of diabetes. Hyperglycaemia symptoms, for instance, can progress from thirst and fatigue to nerve or kidney issues if ignored².

If you notice recurring or unexplained symptoms, even if they seem minor, speak to your doctor. A simple blood sugar test can provide clarity and guide next steps.

One of the most challenging aspects of type 2 diabetes is that symptoms often appear gradually and can be very mild. You might adjust to changes in your body, such as gaining weight or needing to urinate more frequently, without suspecting a health condition. This makes type 2 diabetes difficult to detect without proactive monitoring.

Many people with type 2 diabetes have in fact already developed complications by the time they are diagnosed, due to delays in recognising the symptoms³.

Symptoms that develop slowly may include:

• Persistent tiredness
• Frequent bladder or skin infections
• Slow-healing cuts or sores
• Numbness or tingling in hands and feet
• Blurry vision

Because these signs can be attributed to everyday life or other illnesses, regular checkups and blood tests are important, even if symptoms feel manageable. Doctors often diagnose diabetes during unrelated checkups or routine screening.

If you’ve adapted to subtle bodily changes over time, consider discussing them with a doctor. Regular screening can uncover hyperglycaemia symptoms early and help prevent complications.

While diabetes symptoms can overlap, different types of diabetes often present in different ways.

This is an autoimmune condition in which the pancreas produces little or no insulin. It often develops quickly and is commonly diagnosed in children and young adults. Symptoms usually appear suddenly and may include:

• Rapid weight loss
• Extreme thirst and hunger
• Nausea and vomiting
• Fruity-smelling breath
• Fatigue

Without treatment, type 1 diabetes can lead to diabetic ketoacidosis, a potentially life-threatening condition⁴.

In contrast, type 2 diabetes develops gradually and is more common in adults, although it's increasingly seen in younger people due to lifestyle and dietary changes. The body becomes resistant to insulin, or doesn't produce enough of it. Symptoms may include:

• Fatigue
• Blurry vision
• Frequent infections
• Tingling or numbness in extremities

This type is often managed through lifestyle changes, medication, and monitoring.

This occurs during pregnancy and typically disappears after childbirth, although it raises the risk of developing type 2 diabetes later in life. Most women don’t notice symptoms, but those who do may experience:

• Unusual thirst
• Frequent urination
• Fatigue
• Nausea

Gestational diabetes is usually diagnosed through screening in the second trimester of pregnancy⁵.

It’s important to note that each type of diabetes has its own symptom profile. Be aware of how symptoms may present differently depending on the context and stage of life.

If you suspect that something isn’t right, preparing for your healthcare appointment can make your visit more productive.

• Symptoms: what are they? When did they start?
• Frequency: are they constant or intermittent?
• Triggers: does anything make them better or worse?
• Family history: has anyone in your family been diagnosed with diabetes?

Keep a symptom diary for at least a week before your appointment to help provide clear information. You might also be asked about your diet, exercise routine, stress levels, and whether you've experienced weight changes.

• Have you experienced increased thirst or hunger?
• Are you urinating more than usual?
• Have you had frequent infections or slow-healing wounds?
• Are you feeling more tired than usual?

Your doctor may recommend diagnostic tests such as:

• HbA_1c test: indicates your average blood glucose over the past 2–3 months
• Fasting blood glucose test
• Oral glucose tolerance test

These tests help determine if your symptoms are due to high blood sugar levels and whether you meet the criteria for prediabetes or diabetes6.

Your own appointment preparation helps your doctor make a quicker and more accurate diagnosis. Don’t downplay your concerns - early intervention is key for diabetes management.

When diabetes symptoms are recognised, either by you or your doctor, the next step is a structured evaluation to confirm a diagnosis and determine the most appropriate treatment plan. Please remember this article offers general guidance only, not a medical diagnosis. If you’re experiencing any symptoms, speak to your doctor.

Upon recognising potential symptoms of diabetes, your doctor may recommend one or more of the following blood glucose tests:

• HbA_1c  (glycated hemoglobin test): measures your average blood sugar over the past 2–3 months. An HbA_1c  level of 6.5% or higher on two separate tests indicates diabetes¹.
• Fasting plasma glucose (FPG): measures blood sugar after an overnight fast. A result of 126 mg/dL (7.0 mmol/L) or higher suggests diabetes¹.
• Oral glucose tolerance test (OGTT): measures your body’s ability to process glucose after drinking a sugary solution. A 2-hour blood sugar level of 200 mg/dL (11.1 mmol/L) or higher indicates diabetes¹.
• Random plasma glucose test: may be used in symptomatic individuals. A reading of 200 mg/dL or higher can confirm diabetes¹.

These tests help determine whether the individual has type 1, type 2, gestational diabetes, or prediabetes, each of which requires a different treatment strategy.

If diabetes is diagnosed, your doctor or other healthcare professionals will conduct a thorough assessment to check for any early signs of complications, such as:

• Kidney function tests (e.g., eGFR and urinary albumin)
• Eye examination for diabetic retinopathy
• Blood pressure and cholesterol screening
• Foot exams to assess sensation and circulation

This evaluation helps build a baseline for treatment planning and long-term monitoring.

Once diagnosed, patients are typically referred to a multidisciplinary team that may include:

• A primary care physician or endocrinologist
• A diabetes educator
• A registered dietitian
• A pharmacist or clinical nurse specialist

This team helps develop a personalised care plan, which may include:

• Lifestyle modifications (nutrition, physical activity, weight management)
• Blood sugar monitoring
• Medication, including insulin if necessary
• Patient education for self-management

Studies show that early intervention and structured self-management education can improve outcomes and reduce the risk of complications for living with diabetes⁷.

But recognising symptoms is only the beginning. Diagnosis requires testing, and to ensure safe and effective management, treatment should always be guided by your doctor or other qualified healthcare professionals.

There are many persistent myths about who can get diabetes and how the condition presents. These misconceptions can delay diagnosis and discourage people from seeking help. Let’s clarify a few of the most common ones.There are many persistent myths about who can get diabetes and how the condition presents. These misconceptions can delay diagnosis and discourage people from seeking help. Let’s clarify a few of the most common ones.

Understanding the symptoms of diabetes and knowing when to seek help can protect your long-term health. Many diabetes signs and symptoms are manageable when caught early, but ignoring them can lead to serious issues involving your heart, kidneys, nerves, and eyes.

Even if your symptoms seem insignificant, take action. Early recognition of diabetic symptoms can make the difference between short-term discomfort and long-term complications.

Concerned about symptoms? Start a conversation with your doctor.