Diabetes Symptoms May Be Subtle But Not Absent

"Diabetes is essentially a silent process," notes Milli Gupta, MD, an endocrinologist with the Franciscan Physician Network. "People cannot feel their sugars being high or low unless it's more severe. However, there are some signs of uncontrolled diabetes which people may not realize until they it checked."

While many may not feel their blood sugar levels fluctuate, recognizing the potential signs of uncontrolled diabetes is vital. This article will explore the distinct types of diabetes – type 1, type 2, and gestational diabetes, along with prediabetes – and explain symptoms associated with each.

What Is Diabetes?

"Diabetes is a disease of a group of cells in the tail of the pancreas," said Dr. Gupta, who practices at Franciscan Physician Network Munster Medical Center. "The cells in there that produce insulin are called beta cells. And there are different types of problems with those beta cells that lead to different types of diabetes."

In general, the types of diabetes include:

• Type 1 diabetes
• Type 2 diabetes
• Gestational diabetes

In addition, there is a condition called prediabetes that may develop before a person fully develops type 2 diabetes.

Type 1 Diabetes & Its Symptoms

The U.S. Centers for Disease Control and Prevention explains that for those with type 1 diabetes, the pancreas either produces insufficient insulin or none at all.

With type 1 diabetes, the onset may be sudden. 

Dr. Gupta said that type 1 diabetes happens when beta cells die from immune attacks during childhood or young adulthood.  Yet, insulin plays a crucial role in ushering blood sugar into the body's cells, providing them with the necessary energy.

The absence of sufficient insulin causes blood sugar to accumulate in the bloodstream, giving rise to the various symptoms and complications associated with diabetes. A person with type 1 diabetes does not produce insulin in their body and must take insulin every day to keep their blood glucose at healthy levels.  

Symptoms of type 1 diabetes

Symptoms of type 1 diabetes in children may include:

• Frequent urination
• Insatiable thirst
• Weight loss
• Tired more than usual
• Bedwetting after being fully trained and dry at night 

Signs of type 1 diabetes in adults may include:

• Frequent urination
• Constant thirst
• Hunger despite eating
• Extreme fatigue
• Vision that is blurry at times
• Cuts and bruises that take long to heal
• Weight loss despite eating more

Type 2 Diabetes & Its Symptoms

Development of type 2 diabetes primarily involves two main issues. First, the pancreas fails to produce sufficient insulin, a hormone responsible for regulating the entry of sugar into cells. Second, the cells respond poorly to insulin, resulting in decreased sugar absorption.

A person with type 2 diabetes can produce insulin, however, they may not make enough, or they may experience insulin resistance, causing their blood glucose to rise to higher-than-normal levels

Symptoms of type 2 diabetes

Symptoms of type 2 diabetes may include:

• Frequent urination
• Constant thirst
• Hunger despite eating
• Extreme fatigue
• Vision that is blurry at times
• Cuts and bruises that take long to heal
• Tingling, pain or numbness in your hands and feet

"One other interesting early sign of diabetes can be a black velvety rash at the back of the neck, or sometimes on the face," Dr. Gupta said. "It's called acanthosis nigricans. People sometimes feel it's like dry skin, but it just doesn't go away. It's a thickened skin that's dark in color. And that's a sign of insulin resistance. Skin tags are also sometimes associated with a risk for diabetes."

Prediabetes & Its Symptoms

Prediabetes is a serious health condition in which blood sugar levels are higher than normal, but not yet high enough to be diagnosed as diabetes, according to the CDC."Some people can also experience prediabetes," Dr. Gupta said. "It revolves around someone who's not quite there, but a little higher than the normal values in terms of blood glucose, then they are labeled as pre-diabetic."

She explained that finding a pre-diabetic condition and taking steps to treat it with some lifestyle changes or medication can help slow the progression towards type 2 diabetes.

Symptoms of Prediabetes

Most people with prediabetes are unlikely to have any clear symptoms of prediabetes.

It’s important to talk with your healthcare provider about being screened if you have any risk factors for diabetes.

Gestational Diabetes & Its Symptoms

Gestational diabetes, which is diagnosed in the second or third trimester during pregnancy for a person who did not have diabetes before the pregnancy, arises from hormone shifts and the process by which the body converts food into energy.

"Gestational diabetes is diagnosed in pregnant women," Dr. Gupta said. "This condition is very important because it has a bearing on the child. The baby could have congenital malformations."

She explained that if the mother has gestational diabetes, she has a 50% higher risk of developing regular type 2 diabetes later in life.

"All of these conditions need to be caught in time and treated," Dr. Gupta said. "There's value in that."

Symptoms of gestational diabetes

Gestational diabetes doesn’t typically cause symptoms. But some pregnant women with it experience:

• Frequent urination
• Nausea
• Thirst
• Tiredness

How Is Diabetes Diagnosed?

"Diagnosis of diabetes is essentially performed with a blood test," Dr. Gupta said. "And all the diabetes symptoms that we mentioned, they are not definitive, as in somebody could be feeling those things due to other reasons."

Dr. Gupta explained that she checks the blood levels of sugar at certain times for a diagnosis.

"If we check it in the morning before somebody has had their coffee or breakfast, it's called fasting blood glucose," she said. "And usually, there is a cutoff of like 126 mg/dL- or more. That point is when it's recognized as diabetes."

Dr. Gupta also explained hemoglobin A1c as another option for monitoring blood sugar levels over time.

"Hemoglobin A1c is an average of your blood sugars over three months," Dr. Gupta said. "We use this method often in clinical practice. The level needs to be 6.5 or higher to be diagnosed as diabetes. If it's between 5.7 to 6.5 it's considered prediabetes, with less than 5.7 being normal levels."

How Is Diabetes Treated?

New medications and blood sugar monitoring options, as well as lifestyle changes, are helping people with diabetes better control their blood sugar levels.

HealthDay News contributed information to this article.