It can appear at any age, but it is more likely to occur after the age of 45 years. In 2019, 37.3 million Americans had diabetes, mostly type 2.
This article examines the early signs and symptoms of type 2 diabetes, the risk factors, and potential complications.
What is type 2 diabetes?
Type 2 diabetes occurs when a person’s body no longer responds to insulin correctly. This is called insulin resistance. After some time, the pancreas makes less and less insulin.
Insulin is a hormone that regulates the movement of blood glucose, or sugar, into cells, which use it as energy.
When sugar cannot enter cells, too much glucose collects in the blood, and the body cannot use it for energy.
A doctor may diagnose diabetes if a person’s blood sugar levels are 126 milligrams per deciliter (mg/dl) or above after fasting for 8 hours.
What are the risk factors for diabetes?
Symptoms
The symptoms of high blood sugar in type 2 diabetes tend to appear gradually. Not everyone will notice symptoms in the early stages, but they may appear over time.
If symptoms do occur, they may include the following:
Frequent urination and increased thirst
When too much glucose builds up in the bloodstream, the kidneys cannot reabsorb it. The body removes the excess glucose in the urine, taking water from the body with it. This can lead to excessive thirst and the need to drink and urinate more.
Weight loss
When there is too little insulin, the body may start burning fat and muscle for energy. This causes weight loss.
Fatigue
When cells lack glucose, the body becomes tired. Fatigue can interfere with daily life when a person has type 2 diabetes.
Blurred vision
High blood glucose can cause fluid to be pulled from the lenses of the eyes, resulting in swelling, and leading to temporarily blurred vision.
Infections and sores
A person may notice itching around the penis or vagina or frequent Candida infections. Infections and sores may take longer to resolve because diabetes impacts blood circulation.
If people notice these symptoms, they should consult a doctor. Diabetes can lead to several serious complications. The sooner a person starts managing glucose levels, the better the chance of preventing complications.
Symptoms in children and teens
Type 2 diabetes is more likely to appear after the age of 45 years, but it can affect children and teens who:
have a high body mass index (BMI) for their age
do not do much physical activity
have high blood pressure
have a family history of type 2 diabetes
are Black American, Asian American, Hispanic American, or Native American
Symptoms will be the same as for adults, as mentioned above.
If a child or teen has these symptoms, they should talk with a doctor. They may be signs of type 2 diabetes but can also indicate type 1 diabetes.
Type 1 is less common but more likely to affect children and teenagers than adults.
Learn more about how diabetes affects children and teens and how to spot the symptoms early.
Symptoms in older adults
Around 29.2% of people aged 65 and above have type 2 diabetes in the United States. They may have some or all the classic symptoms of type 2 diabetes.
They may also experience one or more of the following:
flu-like fatigue, which includes feeling lethargic and chronically weak
urinary tract infections
numbness and tingling in the hands, arms, legs, and feet due to circulation and nerve damage
dental problems, including infections of the mouth and red, inflamed gums
Early skin symptoms
Diabetes can lead to a range of skin changes, some of which may be early warning signs.
Examples include:
acanthosis nigricans, areas of darker, velvety skin, especially on the neck, elbows, knees, and knuckles
necrobiosis lipoidica, raised patches that may be yellow, red, brown, or darker than the surrounding skin and that may become swollen and hard
digital sclerosis, when hard, thickening, or swollen skin appears on the hands, possibly spreading to the arms and elsewhere
painless blisters that suddenly appear
wounds that take longer to heal
frequent skin infections
Learn more about the early signs of type 2 diabetes.
Prediabetes
A person with prediabetes will not have any symptoms, but they will have blood sugar levels of 100–125 mg/dl.
Their blood sugar levels are high, but they do not have diabetes. Taking action at this stage can prevent diabetes from developing.
The Centers for Disease Control Prevention (CDC) estimate that around 96 million American adults have prediabetes, but 80% do not know they have it.
Complications
Diabetes may cause a number of health complications if people are unable to manage it. Many are long term, but some need immediate medical attention.
Emergency complications
Complications can arise quickly if blood sugar rises or falls too far.
Hypoglycemia
Hypoglycemia, or low blood sugar, is when blood glucose dips below 70 mg/dl.
This can happen if a person who uses insulin takes more than they need for a particular time. It can also occur with other medications that treat diabetes, such as sulfonylureas.
A home blood glucose test can check for hypoglycemia.
It is vital to know the early signs of hypoglycemia, as it can progress quickly, resulting in seizures and a coma. In the early stages, however, it is easy to treat.
Symptoms of hypoglycemia include:
confusion
dizziness
feeling faint
heart palpitations
rapid heartbeat
mood changes
loss of consciousness
sweating
clamminess
If symptoms are mild, a person can often resolve low blood sugar levels by consuming 15 grams (g) of carbohydrates, for example, by consuming:
4 ounces of orange juice
4 glucose tablets
a tablespoon of honey or sugar
The person should then wait 15 minutes, test their blood sugar, and if it is still low, repeat the process with another 15 g of carbohydrates.
When levels return to above 70 mg/dl, the person should eat a meal, to stabilize their glucose levels.
If glucose levels remain low or symptoms worsen, someone should take the person to the emergency room.
Anyone who has frequent or severe hypoglycemic episodes should speak with a doctor, as they may need to adjust their treatment plan.
Hyperglycemia and diabetic ketoacidosis (DKA)
If blood sugar levels rise too far, hyperglycemia can result. If a person notices increased thirst and urination they should check their blood sugar levels.
If the level is above the target level agreed with a doctor, the person should do some exercise to reduce the level.
However, a person should not exercise if their blood glucose levels are 240 ml/dl or above, as this could be a sign of diabetic ketoacidosis (DKA).
DKA can develop if a person has hyperglycemia and does not take action to reduce it. DKA happens when high levels of ketones collect in the blood, making it too acidic. For this reason, the person should also test their ketone levels.
Ketoacidosis can lead to:
difficulty breathing
a fruity smell on the breath
a dry mouth
nausea and vomiting
coma
A person with these signs and symptoms should seek immediate medical attention, as DKA can be life threatening.
People who regularly experience high blood sugar should discuss adjusting their treatment plan with their doctor.
What types of diabetic emergencies are there?
Long-term complications
Keeping blood glucose within target levels can prevent long-term complications.
Here are some complications that can arise:
cardiovascular disease
high blood pressure
nerve damage (neuropathy)
eye damage and vision loss
kidney disease
foot problems
Effective management of blood glucose levels can reduce the risk of complications.
Diagnosis
A doctor can diagnose type 2 diabetes with a range of blood tests that measure blood glucose levels. Many people discover they have high blood sugar during a routine screening test, but anyone who experiences symptoms should see a doctor.
Which tests do doctors use to diagnose diabetes?
Treatment
Treatment aims to keep blood glucose levels stable at a healthy level and prevent complications. The main ways to do this are through lifestyle measures.
These include:
following a diabetes meal plan agreed with the healthcare team
eating plenty of fresh fruits and vegetables
reaching and maintaining a suitable BMI
doing physical activity
getting enough sleep
avoiding or quitting smoking
taking medications or insulin as the doctor recommends
attending routine medical visits and blood tests
Some herbs and supplements may also help.
Find out more about the different types of diabetes and their treatment options.
Outlook
There is currently no cure for diabetes, but lifestyle measures can help most people manage their blood sugar levels and reduce the risk of complications. If these do not help, a doctor may prescribe medication.
People who receive a diagnosis of prediabetes may be able to slow, stop, or reverse the progress of diabetes.
If a person is unable to manage their blood glucose levels, complications can arise. Some of these can be life threatening.
Frequently asked questions
Here are some questions people often ask about type 2 diabetes.
What is type 2 diabetes caused by?
Type 2 diabetes is caused by problems with a chemical in the body (hormone) called insulin.
It’s often linked to being overweight or inactive, or having a family history of type 2 diabetes.
What is the difference between type 1 and 2 diabetes?
Type 1 diabetes is a lifelong condition where the body’s immune system attacks and destroys the cells that produce insulin.
Meanwhile, type 2 diabetes is when the body does not produce enough insulin, or the body’s cells do not react to insulin properly.
There is no cure for type 1 diabetes but type 2 can be prevented and it can potentially be put into remission.
Is type 2 diabetes curable?
There is no cure for diabetes, but lifestyle measures, such as exercise and dietary choices, can help manage it. In some cases, a person may need medication.
What are the warning signs of type 2 diabetes?
Often, the first time a person knows they have type 2 diabetes is after a routine blood test, possibly for another condition. If symptoms occur, they include an increased need to urinate, thirst, fatigue, blurry vision, and feeling hungrier than usual.
How does type 2 diabetes start?
Type 2 diabetes starts when the body becomes unable to use insulin effectively. The body produces more insulin to help itself process glucose in the blood. Over time, the body can no longer make enough insulin, and blood glucose levels rise. This can lead to complications.
Summary
Type 2 diabetes often has no symptoms in the early stages, and people often find out they have it during a routine blood test.
If symptoms appear, they include feeling thirsty and needing to urinate more often, having frequent infections, fatigue, and unexplained weight loss.
Current guidelines recommend regular screening from the age of 45 years or younger if an individual has other risk factors, such as obesity. A doctor can advise on individual needs.
Anyone who has concerns about diabetes should seek medical advice. An early diagnosis can help slow the progression of type 2 diabetes and prevent complications.