Here’s a
scary stat: more than three and a half million South Africans suffer from
. But it gets worse: It’s estimated that five million South
Africans have pre-diabetes (a.k.a. almost diabetes, when your blood sugar
levels are high, but not high enough for full-blown diabetes) – and 90% of
those people don’t know they have it either.

Remind me what diabetes is again

Diabetes isn’t just one disease. There are actually three
types of diabetes: type 1, type 2, and gestational diabetes. Most people with
diabetes have type 2 – it happens when your body doesn’t use insulin well and is
unable to keep your blood sugar stable, per the Centers for Disease Control and
Prevention (CDC)

Type 1 diabetes is much less common – only about 5% of those
with diabetes have type 1 – and it’s essentially an autoimmune disease where your
body stops making insulin at all (and as such, can’t regulate blood sugar).

And gestational diabetes occurs in pregnant women – it usually goes
away after you give birth, but it can increase your likelihood of developing
type 2 diabetes later on, according to the US National Institute of Diabetes
and Digestive and Kidney Diseases (NIDDK).

All three types of diabetes can easily be detected through a blood
test. The test, essentially, checks to see if your blood glucose (a.k.a. blood
sugar) is too high. But be warned: You can’t diagnose yourself – not even with an
OTC blood glucose meter, per the NIDDK.

Unfortunately, many people are walking around with undiagnosed
diabetes or pre-diabetes because the symptoms are super-subtle, says Dr Poorani
Goundan, an endocrinologist at Boston Medical Center.

These sneaky diabetes symptoms might indicate that it’s time to
head into your doctor’s office for a test.

Read more: This new research suggests that diabetes is actually 5 separate diseases

1. You have to pee all the time

When you have excess sugar coursing through your bloodstream, your
body instinctively tries to get rid of it, says endocrinologist Dr Mary
Vouyiouklis Kellis. “Water follows sugar, so you end up having high-volume
urine loss,” she explains.

If you notice you’re suddenly peeing a lot, and more often, for no
real reason – especially if you’re waking up a few times during the night to
go – it’s time to talk to your doctor, she says.

2. You never stop drinking water

With all that peeing, dehydration is a very real
possibility. And, to make matters worse, “some patients who don’t know they
have diabetes quench their thirst with sugary drinks like soda or juice, which
adds to their blood sugars,” Goundan says. Signs of dehydration include
dark-coloured urine, a drop in (water) weight and extreme thirst.

Sound familiar? Talk to your doc about this potential symptom of
diabetes, especially if it occurs in tandem with lots of bathroom breaks.

3. Your breath smells awful

Diabetes-related dehydration contributes to dry mouth and the bad
breath that can accompany it. (After all, with dry mouth, there’s not enough
spit to wash away bacteria and balance the pH in your mouth, Kellis says.)

What’s more, undiagnosed or uncontrolled diabetes can trigger
ketosis, a process in which the body uses fat, rather than glucose, for energy.
Ketosis releases a chemical byproduct called ketones, which can make your
breath smell unpleasantly sweet or fruity, she says – sometimes it might even smell
like acetone, since that’s a type of ketone.

Unless you’re on a keto diet (which is designed to put
you into ketosis), it’s worth talking to your doctor.

Read more: 6 ways to make diabetes MUCH easier to manage

4. Your vision’s getting increasingly blurry

Blurry vision is a common – and often ignored – diabetes symptom in
women. What does diabetes have to do with your vision? Kellis explains that
fluid can form in your eye’s lens as sugar levels increase (remember: fluid
follows sugar).

A build-up of fluid in the eye blurs vision, causes
nearsightedness, and sends many people to the optometrist for new glasses or
contacts prescription.

Fortunately, getting your blood sugar levels under control can
clear up blurred vision, she adds.

5. Your hands and feet fall asleep a lot

Neuropathy – a condition characterised by numbness or weird
sensations like pins and needles in your arms, legs, hands and feet – occurs in
more than half of people with type 2 diabetes, according to a 2017 Diabetes Care review.

Why so common? Diabetes reduces blood flow to your extremities
and, over time, damages your blood vessels and nerves, Kellis says.

6. Your cuts and bruises take forever to heal

Reduced sensation in your extremities makes you more prone to
injuries. “You’re less likely to notice a cut because you can’t feel it, which
means you’re less likely to take care of it and it’s more likely to get
infected,” says Goundan.

Then, once you do have an injury, uncontrolled diabetes can make
it harder for your body to heal. “High blood sugars provide a good environment
for bacteria to grow,” she says. That’s because diabetes is also often
accompanied by high blood pressure and high cholesterol, and the resulting
plaque buildup can narrow blood vessels, reducing blood supply and leading to
slow healing.

Diabetes can also weaken the T-cells that make up your immune
system – your body’s defence against infection. “When you have high blood sugar,
it’s like delaying your body’s army to go to the wound to heal it,” says

7. You’re losing weight… but aren’t trying to.

Unexplained weight loss can happen for lots of reasons, and
diabetes is one of them. Goundan explains that insulin helps your body move
sugar from your blood to your cells, so when you have an insulin resistance,
you don’t get enough energy into your cells despite all that sugar flowing
through your body. “Because you’re unable to get enough energy from sugar, your
body burns your own fat and muscle for energy,” Kellis says. “Weight loss can
be pretty significant, sometimes 4.5 to 9 kilos.”

Generally, doctors recommend visiting the doc if you
unintentionally lose between five to 10 percent of your body weight over the
course of six months.

Read more: Everything you really need to know about diabetes

8. You get enough sleep, but you’re still so

Carbohydrates, which your body breaks down into glucose, are your
body’s main source of energy. But your body can’t effectively use that source
of energy when you have diabetes, explains Goundan. (And diabetes-related
dehydration can also bring on fatigue.)

Of course, there are tons of other reasons you could be feeling
exhausted, including your diet, stress levels, and how much you’ve been

Still, if you can’t think of any other good reason for your
extreme fatigue, and your low energy levels are accompanied by some of these
other diabetes symptoms, it’s worth getting checked out.

9. You get a surprising number of yeast

High blood sugars create an environment in your vagina that’s ripe
for yeast
. “Glucose is fuel for yeast. The more that’s around, the
more they can multiply,” says Kellis.

If you’re having two to three yeast infections every few months or
if the standard treatments just aren’t working, it’s time to see a doctor.
“Once blood sugar is controlled, the frequency goes down,” says Goundan.


10. You’ve got weird dark spots on your skin

Darkening skin around the nape of your neck, under your
armpits, or even in your groin area is a surprising and common early sign of
insulin resistance, the precursor to diabetes – the medical name for the
condition is acanthosis nigricans (AN).

“We see this often in women with polycystic ovary syndrome
(PCOS),” says Kellis, who notes that women with PCOS are at an increased risk
of insulin issues. If you notice new dark spots on your skin, they’re worth
checking out with your doctor.

Read more: 7 diabetes food swaps anyone who wants to lose weight should know

11. You feel really itchy all the time

Those with diabetes often experience itching due to yeast
infections (which can occur on the skin, too), dry skin, or poor circulation,
according to the American Diabetes Association.
If poor circulation is to blame, your legs will be the itchiest area.

Per the ADA, you can try to treat the itching yourself by limiting
how much you bathe (especially in less humid climates), using soap with a
built-in moisturiser, and remembering to apply lotion immediately after washing

This article was originally
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