Recognizing Type 2 Diabetes Symptoms

The symptoms of type 2 diabetes can be very gradual in their development and often mimic a variety of other possible medical conditions. Since type 2 diabetes prevalence increases as people age, some of the symptoms are attributed to part of the normal aging processing. Having routine blood glucose testing during annual physical examinations or when a cluster or several symptoms occur, can confirm the diagnosis and allow the doctor and patient to begin to make changes in diet and exercise that can reduce the symptoms or decrease the need for medications to control blood glucose levels.

Type 1 diabetes and type 2 diabetes symptoms are very similar although type 2 diabetes symptom progression is much slower in most cases. Typically the symptoms of type 1 diabetes will be noted in late childhood and early teen years with a diagnosis most common after the age of nine. With type 2 diabetes the mean age at diagnosis is actually decreasing from a mean of 52 years in 1988 to a mean of 46 years in 2000. 1 This change is reported by the researchers to be a combination of a true population trend as well as an increased awareness by the public as well as physicians about the early symptoms of type 2 diabetes and the importance of routine blood testing in high risk groups.

The Most Common Symptoms of Type 2 Diabetes

There are many different symptoms of type 2 diabetes which range in expression from very mild to very severe. Since they can develop over a long period of time it is often very difficult for the individual to pinpoint in time exactly when the symptoms were first noted. As the diagnosis is often years after the development of the symptoms it is possible that considerable damage to various tissues in the body may have already occurred by the time of diagnosis. Early and regular checking of blood glucose levels through the glycosylated hemoglobin (A1C), random blood sugar, glucose tolerance or fasting blood sugar tests are recommended for those that have a family history of diabetes or one or more risk additional risk factors.

Urination

The most commonly noted symptom of type 2 diabetes is increased frequency of urination combined with increased urine volume. This occurs because the elevated blood glucose overwhelm the kidney’s ability to reabsorb the glucose and it begins to spill into the urine. When this happens, the glucose in the urine pulls additional water into the urine, which causes frequent and large volumes urination. Unfortunately many people assume that the change in frequency and volume of urine is a product of aging, dismissing this symptom if it develops slowly.  The urine is not dilute but typical in color. Highly dilute urine in large quantities is a symptom of a less common condition known as diabetes insipidus.

Along with increased urine production, the individual showing symptoms of type 2 diabetes will have problems with chronic thirst. Becuase the kidneys are abnormally losing additional water, the body becomes dehydrated and stimulates thirst. Patients will feel thirsty all the time, including during food consumption and immediately after drinking.

Weight Loss

Weight loss is typical in individuals with type 2 diabetes although the weight may rise and fall in a random pattern. Weight loss that is not accompanied by decreased caloric intake or increased exercise levels may be attributed to type 2 diabetes. Weight loss occurs because the blood glucose in the circulatory system cannot be accessed by the cells due to the insulin resistance or low insulin levels. This triggers the hormone glucagon to cause the stored glucose in muscle and fatty tissue to be broken down by the body. Since the body mistakenly thinks that glucose is not available, hunger responses are triggered. People with type 2 diabetes often have chronic feelings of hunger or cravings for foods that are high in sugars, processed carbohydrates or fats.

Additional glucose from this breakdown adds to the elevated levels in the blood, leading to increased stress on the kidneys and the cardiovascular system. As the body continues to break down the muscles and fatty tissue weight loss occurs, often very rapidly. Ironically, high levels of adipose tissue are considered to be one of the major causes of insulin resistance in body cells.

New studies now show that weight loss and increased physical activity, even after diagnosis of type 2 diabetes, can increase insulin sensitivity and create a healthy increase in the density of skeletal muscle. In these studies the amount of energy expended during exercise was an effective predictor in the amount of improvement that was noted, even over short term lifestyle modifications. 3

Exhaustion

The increased demand for energy of the cells, despite high levels of the glucose in the body, causes feelings of fatigue and exhaustion. Cells cannot function at optimum levels because of the unavailability of the glucose, so metabolic processes are slowed or incomplete. Muscle mass is also depleted which can lead to increased muscle weakness and lack of stamina and muscle strength. Excessive sleeping or fatigue is typically a sign of significant blood glucose irregularities.

Blurred Vision

When blood glucose levels rise to very high levels, they can lead to a swelling of the lens in the eye. Because of this, it can be difficult to focus and a person’s vision can become blurry. This can be mistaken for a normal process of aging, except that it occurs much more rapidly than would be expected. Sometimes, this is manifested only at night by halos around lights, which makes driving very difficult. In essence, any rapid change in your vision may be a sign of diabetes, especially if accompanied by one or more of the other symptoms listed here.

Wound Healing

Since the body is not functioning properly naturally healing may be impaired. Many people with type 2 diabetes have problems with lesions, wounds and scratches that do not heal or become infected. Small wounds may become very easily infected, particularly wounds to the feet and lower legs. If numbness occurs in the toes and feet, increased blistering and numbers of sores on the feet may increase, posing a risk for infection and possible complications.

Skin discoloration, a condition known as acanthosis nigricans, is seen in some people with type 2 diabetes. In a study in the United Kingdom it was found that 57% of children diagnosed with type 2 diabetes had the darkening of the skin in the joints and neck area with this most common in darker skinned individuals of Black, South Asian and mixed race. 4

Other conditions such as skin rashes, dry patches on the skin and numbness of the limbs may be seen in some patients. The good news for individuals is that often these symptoms can be eliminated once a diagnosis has been made by making changes in lifestyle and diet and taking advantage of medication options used to regulate blood glucose levels.

References

1 Koopman, R. J., Mainous, A. G., Diaz, V. A., & Geesey, M. E. (2005). Changes in Age at Diagnosis of Type 2 Diabetes Mellitus in the United States, 1988 to 2000. The Annals Of Family Medicine , 60-63.

2 Chandna, S., Bathla, M., Madaan, V., & Kalra, S. (2010). Diabetes Mellitus – A Risk Factor For Periodontal Disease. The Internet Journal of Family Practice .

3 Toledo, F. G., Menshikova, E., & Ritov, V. B. (2007). Effects of Physical Activity and Weight Loss on Skeletal Muscle Mitochondria and Relationship With Glucose Control in Type 2 Diabetes. Diabetes , 2142-2147.

4 Haines, L., Chong Wan, K., Lynn, R., & etal. (2007). Rising Incidence of Type 2 Diabetes in Children in the U.K. Diabetes Care , 1097-1101.

This article was originally published July 12, 2012 and last revision and update of it was 9/10/2015.