Common symptoms of undiagnosed diabetes

What is diabetes?

Diabetes is a common metabolic disorder where chronically high blood sugar levels can cause serious complications if they aren’t controlled. In 90% of cases, the culprit is type 2 diabetes, which primarily is caused by lifestyle problems, such as obesity, an unbalanced high-glucose diet, and lack of physical exercise. Type 1 diabetes is much less common — accounting for less than 10% of all diabetes cases — and it’s triggered by an autoimmune mechanism. Type 1 diabetes typically starts during childhood, while the onset age of type 2 diabetes in the United States is around 45 years.

Diabetes is a serious public health problem, as an estimated 13% of Americans currently are diabetic, and this share keeps rising. Both types of diabetes are lifelong conditions that won’t go away. If left untreated, diabetes, in the long run, can seriously damage a person’s kidneys, cardiovascular system, eyes and nervous system. Ultimately, it can lead to death; some 300,000 Americans die from complications of diabetes every year.

Fortunately, diabetes can be managed well if it receives proper medical attention. Type 1 diabetes is controlled with regular injections of insulin, while type 2 can be managed with a healthy lifestyle and body weight. In some cases, type II diabetes can be managed without medication.

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Why is diabetes often undiagnosed?

It’s estimated that currently there are about 8 million undiagnosed diabetes cases in the US population. According to the US CDC, roughly 2.5% of the US population aged 18 and older have diabetes and don’t know it yet. The number gets even larger when including people who are pre-diabetic (at risk or on the verge of developing full-blown diabetes). The CDC estimates that 90 million Americans aged 18 and older fall into that category. How many of these 90 million aren’t yet aware of their risk isn’t known, but is estimated to be over 50%.

At least 95% of those undiagnosed cases are type 2 diabetes. The reason for this lies in the slow development of type 2 diabetes symptoms. Whereas type 1 diabetes quickly develops noticeable symptoms — sometimes as fast as 3-4 weeks — type 2 diabetes can be nearly free of symptoms for many years.

Even if you have type 2 diabetes symptoms, for the first few years they may only be very subtle, so that you don’t notice them on your own. For example, common early symptoms are an increased frequency of urination and an accompanying increase in fluid consumption. Not only is this a very incremental process, but who really keeps track of how much they drink and urinate over the course of 6 or 12 months?

Even more advanced symptoms, like periodic bouts of blurred vision, dizziness, and a greater appetite, may not be something you pay much attention to or immediately associate with diabetes.

In most cases, diabetes is first diagnosed through a blood test. If you have an annual physical or otherwise need to do routine blood testing, it’s very likely that blood glucose levels are part of the blood test. In other words: your doctor will notice abnormally high blood sugar levels. If an elevated diabetes risk is suspected, follow-up testing will be required.

However, people who don’t regularly get a health examination or don’t have another medical reason for a blood test may not discover that they are pre-diabetic or diabetic for several months or years.

What are the 3 most common symptoms of undiagnosed diabetes?

Since type 2 diabetes is eventually discovered as symptoms get more severe, it’s the early symptoms of diabetes you’ll need to watch out for if you are concerned that you might be at risk. As mentioned above, only a blood test will give you a definitive diagnosis. That said, here are the three most common early symptoms of diabetes (they apply both to type 1 and 2):

Increased frequency and volume of urination: In medical terms, this is known as “polyuria”. Increased urination occurs as excessive blood sugar levels are too much to handle for the kidneys, which then try to get rid of the glucose through the urine. This is why you then have to pee more often, including at night.
Greater thirst and liquid intake: This is tied to the first symptom: the more you pee, the more easily you’ll get thirsty. A typical telltale sign of diabetes is when you frequently get thirsty at night so that you have to get up for a glass of water — especially if that’s a new habit you didn’t have a couple of years ago.
Increased appetite and hunger Diabetes makes you feel hungrier (a condition is known as “polyphagia”), your cells can no longer efficiently absorb glucose, which instead accumulates in your bloodstream. With the glucose no longer reaching the cells, your brain’s response is to request more food.

Eventually, if glucose metabolism breaks down completely, and more and more glucose ends up in the blood, a person can lose weight while eating more food than in the past. Unintentional weight loss thus can also be a sign of diabetes.

If you notice any of the above three symptoms, and if you are overweight and sedentary, you may be at risk of, or may already have diabetes. Getting tested is highly recommended.

What are other diabetes symptoms?

Aside from the early symptoms discussed above, other Type 2 diabetes symptoms that may develop over time include:

Dizziness
Periodic vision problems (blurry vision)
Fatigue
Wounds and sores which heal slowly
Numbness or tingling in the hands and feet
Dark skin areas in the armpits and on the back of the neck

If you are worried that you may have diabetes or are at risk of getting it, talk to your primary physician about getting tested.

References

“Prevalence of Both Diagnosed and Undiagnosed Diabetes | Diabetes | CDC.” Www.Cdc.Gov, 7 Aug. 2020, www.cdc.gov/diabetes/data/statistics-report/diagnosed-undiagnosed-diabetes.html. Accessed 13 Aug. 2020.
You, Wen-Peng, and Maciej Henneberg. “Type 1 Diabetes Prevalence Increasing Globally and Regionally: The Role of Natural Selection and Life Expectancy at Birth.” BMJ Open Diabetes Research & Care, vol. 4, no. 1, Mar. 2016, p. e000161, drc.bmj.com/content/4/1/e000161, 10.1136/bmjdrc-2015-000161. Accessed 13 Aug. 2020.
Marín-Peñalver, Juan José, et al. “Update on the Treatment of Type 2 Diabetes Mellitus.” World Journal of Diabetes, vol. 7, no. 17, 6 Aug. 2020, p. 354, 10.4239/wjd.v7.i17.354. Accessed 13 Aug. 2020.
“Symptoms & Causes of Diabetes | NIDDK.” National Institute of Diabetes and Digestive and Kidney Diseases, Mar. 2019, www.niddk.nih.gov/health-information/diabetes/overview/symptoms-causes. Accessed 13 Aug. 2020.