What Are the Early Signs of Type 2 Diabetes?

Type 2 diabetes is a chronic condition that affects how your body metabolizes glucose, a type of sugar that your body needs for energy.

The main cause of type 2 diabetes is insulin resistance. This occurs when cells in your muscles, fat and liver don’t respond properly to insulin, a hormone that regulates blood sugar levels. As a result, your body needs more insulin to help glucose enter cells, but the pancreas can’t keep up with the increased demand.

Over time, the pancreas may not make enough insulin. This can cause high blood sugar levels. It can lead to prediabetes and then type 2 diabetes.

High blood sugar over time can cause many problems. These include heart disease, nerve damage, kidney damage and vision issues.

“Type 2 diabetes is more than just a blood sugar disease,” says Dr. Tsimikas. “It is usually accompanied by high blood pressure and high fats, or lipids, in the blood. If this triple threat goes undetected, all three issues can cause health problems.”

Diabetes is the eighth leading cause of death. It is the top cause of kidney failure, amputations and adult blindness. In the past 20 years, the number of adults with diabetes has more than doubled.

More than 38 million people in the United States have diabetes, according to the Centers for Disease Control and Prevention (CDC). One in five of them do not know they have it. Type 2 diabetes makes up about 90% to 95% of all diagnosed cases. Type 1 diabetes accounts for about 5% to 10% of cases.

Some racial and ethnic groups have a higher risk of type 2 diabetes. This is due to genetic, environmental and socioeconomic factors. These groups include African Americans, Hispanics or Latinos and American Indians or Alaska Natives.

You may be at risk for type 2 diabetes if you:

• Have prediabetes
• Are overweight
• Are 45 or older
• Have a parent, brother, or sister with type 2 diabetes
• Exercise less than three times a week
• Had gestational diabetes or gave birth to a baby that weighed 9 pounds or more

Type 2 diabetes symptoms can take years to develop and include:

• Frequent urination: When blood sugar levels are high, the kidneys try to remove the extra sugar. This can lead to more trips to the bathroom, especially at night.

• Increased thirst: Frequent urination helps remove extra sugar from the blood. However, over time, it can lead to dehydration and increased thirst.

• Hunger: People with diabetes often do not get enough energy from their food. As a result, they frequently feel hungry.

• Weakness and fatigue: Not enough sugar moving from the blood into the body’s cells can lower a person’s energy. This can lead to tiredness and fatigue.

• Numbness or tingling in hands, legs or feet: High blood sugar can harm blood circulation and damage nerves. This may cause pain, tingling or numbness in the hands and feet.

• Blurred vision: Too much sugar in the blood can harm small blood vessels in the eyes. This may lead to blurry vision that comes and goes.

• Dry, itchy skin: Poor circulation and losing fluids from frequent urination can lead to dry and itchy skin.

• Slow healing of cuts and bruises: High sugar levels in the blood can harm your circulation. This can lead to slow healing of small cuts and wounds. When wounds heal slowly, the risk of infection goes up.

• In women, frequent yeast infections: Too much sugar in the blood and urine feeds yeast. This can cause infections, often in the mouth, genitals, and armpits.

You’re at risk for type 2 diabetes if you have prediabetes. With this condition, blood sugar levels are higher than normal. However, they are not high enough to be classified as type 2 diabetes.

Nearly 100 million adults in the United States have prediabetes, according to the CDC. Most do not know they have it. Symptoms of prediabetes are usually very mild.

“You may not notice any symptoms, so it’s important to get your blood sugar tested if you think you are at risk,” says Dr. Tsimikas.

If not addressed, it can develop into type 2 diabetes in five years. Factors that lead to prediabetes include being overweight, not exercising, poor eating habits and a family history of diabetes.

You can prevent or reverse prediabetes with simple lifestyle changes. If you are overweight, try losing weight. Eat healthier foods and get regular exercise.

If you have prediabetes, monitoring your blood sugar levels is important. Regular checks can help you see how your diet, lifestyle and other factors affect your blood sugar and help you make changes to prevent type 2 diabetes.

If you need help, consider enrolling in a CDC-recognized diabetes prevention program nearby. These programs offer guidance and support for making lifestyle changes. The Scripps Diabetes Prevention Program is part of the CDC's National Diabetes Prevention Program and has many success stories.

If you have diabetes, you need to eat healthy and exercise. You also need medication and to check your blood sugar regularly. Keep track of your results. Review your blood sugar records with your doctor at each visit.

For a healthy diet:

• Eat balanced meals for your diet
• Watch how foods affect your blood sugar, especially carbohydrates
• Avoid processed foods or foods high in salt, saturated fats, trans fats and sugar
• Plan meals that include lean protein, vegetables, fruits and foods high in fiber
• Drink plenty of water or other unsweetened drinks to help maintain a healthy weight and blood sugar levels

A registered dietitian and diabetes nurse can help you manage your diabetes.

Many people check their blood sugar with a glucose monitor that requires a finger prick. However, continuous glucose monitors (CGMs) are becoming more popular. These devices use a small under-skin sensor to track glucose levels continuously, providing real-time data and trends via a reader or smartphone app, making them a preferred option for many people managing diabetes or prediabetes.

In many cases, health insurance will cover continuous glucose monitoring devices, but they are also available over the counter.