10 sneaky signs of diabetes

Here’s the tricky thing about spotting signs of diabetes: It’s entirely possible that you won’t experience any symptoms early on — or if you do, you may not necessarily associate them with diabetes. That’s because diabetes symptoms can seem random, disconnected, and vague. But the earlier you realize you have symptoms of diabetes, the sooner you can start treatment, reducing your risk of some of the more serious side effects of uncontrolled high blood sugar. Keep reading for the nine unusual symptoms you need to know about.

Acanthosis nigricans

Acanthosis nigricans (AN) is a condition where discolorations occur on certain parts of the body. The dark areas — which can look tan or brownish and might be slightly raised or velvety in texture — are most commonly found on the back of the neck, but can also appear on the armpits, elbows, and groin.

AN is associated with insulin resistance (when your body doesn’t respond correctly to the insulin it makes, causing your body to make higher amounts of insulin to overcome the resistance). It’s why people with AN are twice as likely to get diagnosed with type 2 diabetes than those without it.

There are no specific treatments for the condition, though a prescription gel or cream, antibiotics, or laser treatments could help. “There is limited data about using prescription creams to treat AN, so a dermatologist can provide guidance with this,” notes Dr. Ari Geliebter, M.D., chief of endocrinology at Holy Name Medical Center in Teaneck, New Jersey. The main way to treat AN is to treat your diabetes and improve your insulin resistance, says Dr. Amy Warriner, M.D., a professor who specializes in endocrinology, diabetes, and metabolism at the University of Alabama at Birmingham and the director of the UAB Weight Loss Medicine program.

Reactive hypoglycemia

​​If you feel shaky or weak or break out in a cold sweat — all symptoms of low blood sugar — about two to three hours after eating a carb-heavy meal, you could be experiencing reactive hypoglycemia, also known as postprandial hypoglycemia.

When someone with prediabetes or early type 2 diabetes eats foods that are absorbed rapidly (like refined carbs or simple sugars), their body produces more insulin than it needs. “To oversimplify, the insulin lasts longer than the sugars that are consumed, so once the sugar is used up, the insulin is still around and active,” says Warriner. “This ultimately leads to low blood sugar.”

To prevent this from happening, avoid high-carb meals and make sure you balance your carbs with adequate protein and fat. To relieve symptoms, try eating or drinking something naturally sweet (like an orange or half a cup of orange juice), says Warriner: “You feel better after eating again because you are providing your system with more sugar.” Reactive hypoglycemia is also less common after meals that include lean proteins and healthy fats, so including those on your plate can be helpful.

Recurrent infections

People with poorly managed high blood sugar can be at risk of getting an infection in the same area over and over again or having infections that take longer to heal. This can include recurring urinary tract infections, skin and soft-tissue infections, respiratory infections, and yeast infections. There are two reasons why:

1. High blood sugar impacts the immune system. Infection-fighting white blood cells don’t function as well when blood sugar is high, making it harder for you to fend off infections, as well as increasing the risk of those infections spreading, says Geliebter.
   
   
2. High blood sugar fosters the growth of bacteria and fungus in certain areas. When blood sugar levels are high, excess sugar shows up in your urine, creating a great environment for bacteria and fungus to grow. “Fungus loves sugar,” says Warriner. This can lead to issues like urinary tract infections or yeast infections.

Erectile dysfunction

While it likely won’t be one of the first signs of diabetes, erectile dysfunction (ED) can be a long-term side effect of uncontrolled high blood sugar. The reason: High blood sugar can negatively impact the nervous system, and when nerves are damaged, it can be tougher for a man to have an erection, according to Geliebter. Both vascular disease (a complication of diabetes that affects arteries and veins) and the impact high glucose has on blood vessels also play roles in ED.

As surprising as it may be to hear that ED is a sign of diabetes, it’s incredibly common: Researchers looked at 145 studies and found that ED impacted about 52% of men with diabetes — a number that’s more than three times higher than those without the disease.

While medications such as Viagra can help, they won’t solve the problem. “The nerve issues causing the ED are hard to reverse completely,” says Geliebter, who says that, in this instance, prevention is key.

Blurry vision

High blood sugar levels — especially when it fluctuates up and down — can make the lenses of your eyes swell, which, in turn, can change the shape of the lens, distorting your vision. This can be very scary, but it usually improves quickly with diabetes treatment, often within days or weeks of getting your blood sugar under better control, notes Geliebter.

Because people are quick to notice vision issues, this symptom can be the reason people go see their doctor. “We get patients referred to us by their eye doctors who we ultimately diagnosed with diabetes,” says Geliebter.

Mood swings

It’s something anyone who’s ever been hangry knows: “Some of us are really sensitive to fluctuations in blood sugar,” says Warriner. And those fluctuations can impact how we feel. Sudden increases in blood sugars can bring on negative mood changes, like sadness, anxiety, and fatigue. And if your blood sugar stays high, which is known as hyperglycemia, you may feel lethargic and tired. “It zaps your energy because it’s very stressful on the body,” says Warriner. Low blood sugar, called hypoglycemia, can result in feelings of irritability, confusion, anxiety, or nervousness. This is often coupled with physical symptoms, like sweating, headaches, or dizziness. One reason: When blood sugar levels drop, your body releases the hormone epinephrine, which can bring on feelings like anxiety.

Diabetic retinopathy

Several different eye conditions can develop over years of uncontrolled blood sugar — including diabetic retinopathy, which is when the blood vessels in your retinas are damaged by high blood sugar. You may notice symptoms like:

• Spots or flashes
• Colors that seem off
• Vision loss

These symptoms take a long time to come on: “Diabetic retinopathy can slowly cause vision loss but is usually not what a patient would first notice,” says Geliebter. An eye exam can catch diabetic retinopathy, and your eye doctor will work with your healthcare team on a treatment plan, which can include medication, laser treatment, or surgery.

Dry mouth

One of the most common symptoms of diabetes is having to pee a lot. (Your body is trying to flush out the excess blood sugar through your urine, which makes you thirsty, so you drink a lot of water, and pee even more.) If you’re not replacing the lost fluids with ample water, you can get dehydrated and develop a dry mouth, tongue, or throat. You may notice that it’s harder to swallow or chew your food or that your lips are cracked. As with many of the other unusual diabetes symptoms, getting your blood sugar levels under control can help.

Itching and skin tags

High blood sugar can lead to poor circulation, which causes blood to pool in certain areas and ultimately cause your skin to feel itchy and sometimes look discolored. Diabetes can also cause skin tags, which are little growths that you might find in places like your eyelids, underarms, or thighs. Skin tags are typically caused by an overgrowth of cells on the top layers of your skin and are more frequently found in patients with obesity, insulin resistance, and diabetes, explains Geliebter.

What should you do if you notice these symptoms?

Experiencing any of the above symptoms isn’t a guarantee that you have diabetes — it’s just a sign that you should get checked out. “Most UTIs and blurry vision are not from diabetes, but uncontrolled sugars can definitely cause them,” says Geliebter. “Seeing a doctor about these symptoms would allow them to assess all possible causes of the symptoms.” And remember that diabetes might have no symptoms at all, so make sure that you get your glucose levels tested at your annual physical, especially if you’re at a higher risk of developing diabetes.

If it turns out you do have diabetes, it’s natural to feel overwhelmed by the diagnosis. That’s where the WeightWatchers Diabetes Program comes in. It’s proven to help you lose weight, lower your blood sugar, and feel less stressed about managing your condition.*

The bottom line

Diabetes can be hard to spot because of how unusual some of the symptoms are (if there are any symptoms at all). The signs include marks on your skin, infections that keep coming back, erectile dysfunction, blurry vision, dry mouth, and itchy skin. A good rule of thumb is to always talk to your doctor about any changes in your health to figure out what’s going on and to get your glucose tested at your annual physical.