Signs and Symptoms of Type 2 Diabetes

While 21 million people have been diagnosed with diabetes, there are about 8.1 million people who are walking around with the disease and don't know it (27.8 percent of people with diabetes are undiagnosed). Symptoms of diabetes vary from person to person. But, the earlier you catch them, the better it is for your overall health and diabetes care.

It is worth getting to know, and keeping a lookout for, the symptoms of diabetes—especially if any of the below already apply to you.

• You are above age of 45
• You have been diagnosed with pre-diabetes
• You are overweight and/or inactive
• You are African American, an Alaska native, American Indian, Asian American, Hispanic/Latino, or Pacific Islander American and are experiencing atypical symptoms

​If you are experiencing any of the following, you should be seen by your primary care doctor as soon as possible.

Polyuria (Excessive Urination)
Polyuria is defined as an increase in the frequency of urination. When you have abnormally high levels of sugar in your blood, your kidneys draw in water from your tissues to dilute that sugar, so that your body can get rid of it through the urine. The cells are also pumping water into the bloodstream to help flush out sugar, and the kidneys are unable to reabsorb this fluid during filtering, which results in excess urination.

To meet the clinical definition of polyuria, urine output for an adult must exceed 2.5 liters per day (normal urine output is 1.5 liters per day). As it's pretty hard for you to measure this yourself, simply note if you're visiting the restroom far more often than usual and/if you're staying there longer when you do.

Polydipsia (Excessive Thirst)
Excessive thirst typically goes hand-in-hand with increased urination. As your body pulls water out of the tissues to dilute your blood and to rid your body of sugar through the urine, the urge to drink increases. Many people describe this thirst as an unquenchable one. To stay hydrated, you drink excessive amounts of liquids. And if those liquids contain simple sugars (soda, sweet iced tea, lemonade, or juice, for example) your sugars will skyrocket even higher.

Extreme Fatigue
Your body is like a car—it needs fuel to function. Its primary source of fuel is glucose (sugar), which is gained from foods that contain carbohydrates that get broken down. Insulin, a hormone produced by the pancreas, takes sugar from your blood to your cells to use for energy. However, when you have diabetes, either your pancreas isn't making enough insulin or the insulin that your body is making isn't being used the way it's supposed to be, typically because the cells become resistant to it. This results in your cells becoming deprived of sugar, or fuel. The result: tiredness and extreme fatigue. This often gets misunderstood as hunger, and people eat more.

Polyphasia (Excessive Hunger)
Excessive hunger goes hand-in-hand with fatigue and cell starvation. Because the cells are resistant to the body's insulin, glucose remains in the blood. The cells are then unable to gain access to glucose, which can trigger hunger hormones that tell the brain that you are hungry. Excessive eating can complicate things further by causing blood sugars to increase.

Neuropathy
Numbness, tingling, or "pins and needles" in the extremities is referred to as neuropathy. Neuropathy is usually a symptom that occurs gradually over time as excess sugar damages the nerves. Keeping blood sugars within normal range can help prevent further damage and reduce symptoms. People with severe symptoms may receive medication.

Cuts and Bruises That are Slow to Heal
When the blood is thick with sugar, nerves and circulation can be affected. Adequate circulation is needed to heal. Poor circulation can make it hard for blood to reach affected areas, slowing down the healing process. If you notice that you've had a cut or bruise that is very slow to go away, this could be a sign of high blood sugars.

Blurry Vision
Blurred vision can result from elevated blood sugar. Similarly, fluid that is pulled from the cells into the bloodstream to dilute the sugar can also be pulled from the lenses of your eyes. When the lens of the eye becomes dry, the eye is unable to focus, resulting in blurry vision. It's important that all people diagnosed with type 2 diabetes have a dilated eye exam shortly after diagnosis. Damage to the eye can even occur before a diagnosis of diabetes exists.

These symptoms are not experienced by everyone with diabetes, but they can signal the disease and are worth being aware of:

• Weight loss (usually associated with type 1 diabetes, but it can occur with type 2 diabetes)
• Erectile dysfunction (after years of high sugars)
• Dry, itchy skin
• Frequent infections, such as yeast infections in women
• Acanthosis nigricans: A dark, "velvety" patch of skin can appear in the armpits, groin, and neck folds, and over the joints of the fingers and toes. It is an indicator of high insulin and is seen more commonly in African Americans.
• Irritability
• Dry mouth (a sign of dehydration that can result from increased urination)

The same tests used to screen and diagnose diabetes are used to detect individuals with pre-diabetes. There are a few ways to get diagnosed. Your doctor can choose to do a variety of blood tests, depending on whether or not you have symptoms. Whether you are at low or high risk for diabetes, your physician will use these same tests:

• Random glucose test (if you are symptomatic)
• Fasting glucose test (a test done when you haven't eaten for at least eight hours)
• Two-hour glucose tolerance test
• Hemoglobin a1c test (a three-month average of your blood sugar)

Sometimes people don't experience symptoms of diabetes and the diagnosis is made not because a doctor necessarily suspects the disease, but as the result of a routine check-up.

For someone who is not having any symptoms to be considered to have type 2 diabetes, he or she must:

• Have a fasting blood sugar (no food eaten for eight hours) greater than or equal to 126 mg/dL
• Have a blood sugar of 200mg/dL after two hours during a glucose tolerance test using 75 g of a glucose solution
• Have a hemoglobin A1c of 6.5 percent or higher

For someone who is having symptoms of type 2 diabetes, he or she can have any of the above test results or a random blood sugar of 200mg/dL or higher.

According to the American Diabetes 2016 Clinical Guidelines, unless the patient is experiencing symptoms, tests should be repeated using a new blood sample to confirm a diagnosis.

If you've just been diagnosed with diabetes, it is normal to feel scared, confused, and overwhelmed. There are so many myths out there about diabetes, which can certainly make coping more difficult. Try not to listen to things other people have to say, such as, you can never eat carbohydrates again. Instead, get educated.

Talk with your doctor about connecting with a certified diabetes educator and receiving diabetes self-management education. Learning about what to eat, what your medicines do, and how to test your blood sugars are just some of the things these resources can help with. Educators can also dispel myths, create meal plans, coordinate other doctors appointments for you, and listen to your needs. They are trained to teach using a patient-centered approach. They are your advocates who specialize in diabetes. Ask your doctor today or go to the American Association of Diabetes Educators website to find someone near you. Be sure to call your insurance company to see if these services are covered, too.

We give you special kudos for managing your condition, as it is not always easy. If you've had diabetes for a long time, it's normal to burn out sometimes. You may get tired of your day to day tasks, such as counting carbohydrates or measuring your blood sugar. Lean on a loved one or a friend for support, or consider talking to someone else who has diabetes who can provide, perhaps, an even more understanding ear or ideas that can help you.

If you find that you are a little rusty and could use a refresher course in nutrition or anything else related to diabetes, consider signing up for a diabetes conversation map class. These classes are a good way to re-learn key components of diabetes in a group setting. If you have adequate knowledge and are instead looking for ways to make your life easier, check out some apps, nutrition resources, or fitness trackers that can help you stay moving and cook healthy meals. Keeping up the good work is worth it, as it can help prevent complications.

If, on the other hand, you are already starting to develop complications or your medication regimen has changed because your blood sugars are getting higher, remember that diabetes is a progressive disease—and sometimes these things just happen without any influence from your own actions. As you age, beta cells in the pancreas get tired and stop working. If you've had diabetes for 20 years and now need to start insulin, for example, it doesn't mean you've failed. It just means that your body needs some help. Make sure you continue to receive education and that you continue to have someone to lean on when you need it, and keep the lines of communication open with your doctor. It truly can make a difference.

Getting diagnosed with diabetes can be shocking, but the good news is that, although it is a disease you must deal with daily, it is a manageable one. If you are experiencing any of the above symptoms, especially if you are someone who is at high risk, you should meet with your primary care physician to get tested. The earlier a diagnosis is made, the more likely you can get your diabetes under control and prevent complications.

And remember not to let others scare you into thinking the worst. Getting educated will help you to understand that a diabetes diagnosis, while serious, is not the end of the world. For some people, lifestyle modifications such as weight loss, healthy eating, and exercise can actually get blood sugars below the diabetes threshold. You can control your diabetes and not let it control you.