Uncommon Signs of Diabetes Doctors Want You to Know
More than 38 million Americans have diabetes and, of those, up to 95% have type 2 diabetes. Though there are various types of diabetes (yup, there are more than two), the signs something is awry often overlap. And knowing the uncommon symptoms of diabetes may get you closer to a diagnosis, sooner.
The most prevalent kind of diabetes is type 2, and symptoms usually develop over several years, according to the Centers for Disease Control and Prevention (CDC), making it harder to notice them than if they were to come on suddenly.
Of course, the only way to know for sure if you have a form of diabetes is to get an evaluation from a medical professional. But you need to have a healthy suspicion of the condition first for you and your doctor to know what to look for.
Meet the experts: Pouya Shafipour, M.D., a family and obesity medicine physician at Providence Saint John’s Health Center in Santa Monica, CA; Carrie Burns, M.D., an endocrinologist with Penn Medicine; Christoph Buettner, M.D., Ph.D., chief of the division of endocrinology at Rutgers Robert Wood Johnson Medical School
While many people have heard of more common symptoms, like frequent urination and increased hunger or thirst, there are other equally important signs that may signal you have one of the diseases under the diabetes umbrella.
With that in mind, these are some of the less common symptoms of diabetes to keep on the backburner.
Uncommon symptoms of diabetes
Diabetes can manifest in several ways. However, these are some unusual signs that may surface.
Recurrent infections
Unmanaged diabetes causes a condition known as hyperglycemia (high blood sugar), which is when there is too much sugar in your blood. When you have hyperglycemia, white blood cells—which are a vital part of the immune system—have trouble functioning.
As a result, your body has difficulty fighting infections, making you more likely to experience them. “Diabetes generally weakens the immune system, and that puts one at risk of recurrent infections,” says Pouya Shafipour, M.D., a family and obesity medicine physician at Providence Saint John’s Health Center in Santa Monica, CA. The types of infections vary, but may include respiratory infections, skin infections, gastrointestinal infections, and yeast infections.
Dizziness
Diabetes can also cause a condition called hypoglycemia, a.k.a. low blood sugar. This may happen when you miss a meal, are physically active close to bedtime, or drink alcohol at night, according to the CDC. One of the symptoms of hypoglycemia is dizziness.
Hyperglycemia (again, high blood sugar) can also indirectly cause dizziness through dehydration. If you’re peeing often and don’t replace those fluids, it could cause you to feel lightheaded.
Vision issues
Vision changes can happen independently of diabetes, but they may also be a sign of high blood sugar. Hyperglycemia raises the risk of vision changes, including causing blurry vision, Dr. Shafipour says.
Sexual dysfunction
Research shows that the risk of developing erectile dysfunction is about 3.5 times higher in men with diabetes compared to those who don’t have the disease. While some lifestyle changes may help, specific treatments for erectile dysfunction may be needed.
Crankiness
Having untreated diabetes can lead to swings in blood sugar. And, unfortunately, those highs and lows can make you feel off, leading to irritability, Dr. Shafipour says.
Unexplained weight loss
If you’re losing weight without trying, diabetes could be the culprit. “This is usually one of the first signs of diabetes,” Dr. Shafipour says. With diabetes, the body doesn’t make enough or any insulin, which is a hormone that helps to escort glucose (sugar) to your body’s cells, where it can be used for energy, Dr. Shafipour explains. But when glucose can’t get to your cells, your body will burn fat and even muscle for energy. As a result, you may lose weight, he says.
Itchiness in the hands and feet
Undiagnosed and unmanaged diabetes may increase the risk of nerve fiber damage in the body, including in the hands and feet. That can feel like itchiness, sensitivity to temperature, numbness, and a tingling feeling, Dr. Shafipour says.
Fruity-smelling breath
Breath that smells fruity can be a sign that your body is using fat for energy. This creates an acid called ketones, which leads to that fruity smell.
But this can also signal that you’re dealing with a severe complication of diabetes known as diabetic ketoacidosis (DKA), according to the American Diabetes Association (ADA), which may lead to death if untreated. Alert your doctor as soon as possible if you’re experiencing this.
Nausea
Diabetes can cause gastropathy, or stomach issues, Dr. Shafipour says. Among other things, it can slow down the transit of food in your stomach and raise the risk of acid reflux—and both of those may cause nausea, he says.
Dry mouth
This is another indirect symptom. Having diabetes can cause high blood sugar—and that can decrease the flow of saliva in your mouth, Dr. Shafipour explains. As a result, you may struggle with dry mouth.
Dry mouth can also be a result of dehydration from peeing too much, he says.
Does everyone have symptoms of diabetes?
Unfortunately, no. “Not everyone has symptoms—and that does continue to surprise me,” says Carrie Burns, M.D., an endocrinologist with Penn Medicine. “Some people explain it away, like saying, ‘I just thought it was because I was drinking more water.’”
But Dr. Burns says she also sees patients with really high blood sugar who have no detectable symptoms. “We don't know why that happens, but I see it a lot,” she says.
When to see a doctor for a diabetes evaluation
Diabetes is a condition that won’t go away on its own, and it will only get worse with time, especially if it’s left untreated, says Christoph Buettner, M.D., Ph.D., chief of the division of endocrinology at Rutgers Robert Wood Johnson Medical School.
“Diabetes, if left undiagnosed or untreated, can lead to diabetic complications over time, including heart disease, kidney damage, nerve damage, and retina problems,” he says. “Diagnosis and treatment to manage blood sugar levels reduce the risk of these complications.”
So, if you suspect that you have a type of diabetes, it’s important to contact a doctor for a thorough evaluation.
During that evaluation, your doctor will likely give you a blood test, including an A1C test that measures your blood sugar average over the last two to three months and a glucose tolerance test, which measures your blood sugar levels before and after you drink glucose, per the CDC.
From there, your physician can make a diagnosis and help create a treatment plan that works for you.
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