Symptoms of Type 2 Diabetes

Type 2 diabetes is a chronic disease in which blood sugar levels are excessively high. The symptoms of type 2 diabetes vary, but may include excessive thirst, frequent urination, extreme fatigue, excessive hunger, nerve tingling, and blurry vision. While these can be vague, the earlier you notice these symptoms, the better it is for your overall health and diabetes care, as complications may arise.

While 30.3 million people in the U.S. have been diagnosed with type 2 diabetes, there are approximately 7.2 million people who are walking around with the disease unknowingly (23.8 percent of people with diabetes are undiagnosed).

Be on the lookout for the symptoms of type 2 diabetes—especially if any of the below already apply to you:

• You are above the 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 glucose (sugar) in your blood, your kidneys draw in water from your tissues to dilute the glucose, so that your body can get rid of it through the urine. Your cells will also pump 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 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 excess glucose through urine, the urge to drink increases. Many people describe this thirst as unquenchable. To stay hydrated, you may feel the urge to drink excessive amounts of liquids. If those liquids contain simple sugars (such as soda, sweet iced tea, lemonade, or juice, for example) your glucose level will skyrocket even higher.

Extreme Fatigue
Your body is like a car—it needs fuel to function. The body's primary source of fuel is glucose, which is broken down from foods that contain carbohydrates. Insulin, a hormone produced by the beta cells of the pancreas, takes glucose from your blood into 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 used, typically because the cells become resistant to it. This results in your cells becoming deprived of glucose, or fuel. The result: tiredness and extreme fatigue.

Polyphagia (Excessive Hunger)
Excessive hunger is correlated 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 (Nerve Tingling)
Numbness, tingling, or a feeling of "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 the normal range can help prevent further damage and reduce symptoms. People with severe symptoms may require medication.

Cuts and Bruises That are Slow to Heal
When the blood is thick with sugar, nerves and circulation may be negatively affected. Adequate circulation is required for healing: 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 improve, this could be a sign of high blood sugar.

Blurry Vision
Blurred vision can result from elevated blood sugar. Similarly, fluid that is pulled from the cells into the bloodstream to dilute glucose 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 may occur even 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:

• Dry mouth (a sign of dehydration that can result from increased urination)
• Irritability
• Dry, itchy skin and skin tags
• 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.
• Unexplained weight loss (usually associated with type 1 diabetes, but it can also occur with type 2 diabetes)
• Erectile dysfunction (after years of high blood sugar)

Complications of diabetes develop slowly, but may be severe if left untreated. Potential complications include:

• Stroke
• High blood pressure
• Skin conditions
• Foot damage
• Nerve damage (neuropathy)
• Eye damage (retinopathy)
• Ketoacidosis
• Kidney damage (nephropathy)

If you are already starting to develop complications or your medication regimen needed to be changed because your blood sugars are getting higher, remember that diabetes is a progressive disease—sometimes these things happen naturally without any influence from your own actions.

The symptoms outlined above may occur gradually, but they should not be ignored. If you're starting to notice any of the symptoms listed above, call your primary care provider for a full assessment.

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.

Both very high blood sugar, or hyperglycemia, and very low blood sugar, or hypoglycemia, can be considered a medical emergency.

If diabetes is left untreated and blood glucose levels skyrocket above 600 mg/dl, serious complications can occur, such as hyperglycemic hyperosmolar nonketotic syndrome (HHNS). Get urgent medical care if you are experiencing any of the following symptoms related to hyperglycemia:

• Extreme thirst
• Frequent urination
• Warm, dry skin that does not sweat
• High fever (over 101 degrees Fahrenheit)
• Sleepiness or confusion
• Loss of vision
• Hallucinations
• Weakness on one side of the body

Generally, only those being treated with medication to lower blood sugar or improve insulin sensitivity may be at risk for low blood sugar. Get urgent medical care if you are experiencing any of the following symptoms related to hypoglycemia or diabetic ketoacidosis:

• Dizziness
• Shaking
• Headache
• Sweating
• Hunger

Being 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 due to family history or other factors, 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.