How to know if you have diabetes: guide to symptoms

How to know if you have diabetes

Complete guide of symptoms for how to know if you have diabetes, the differences between Type 1 and Type 2, and how the doctor diagnoses diabetes for you.

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Diabetes is one of the most common diseases in the world. According to the World Health Organization WHO, around 350 million people worldwide suffer from the metabolic disease. It is estimated that there are around 31 million people affected in USA (the countries with most diabetes sufferers are China with 117 million and India with 77 million. Many do not recognize the disease at first. Diabetes usually develops slowly and often does not initially cause any acute symptoms, therefore it is wise to check the indicators below for how to know if you have diabetes.

Various diseases are hidden behind the term “diabetes mellitus”. What they have in common is that there is a metabolic disorder that results in increased blood sugar levels.

How to tell if you have diabetes: the two main types

What is Type 2 Diabetes?

In type 2 diabetes, the most common form of diabetes, the body’s cells are becoming increasingly insensitive to the hormone insulin. This is supposed to promote the absorption of grape sugar (glucose) from the bloodstream into the cells, where the sugar is used to generate energy. As a result of the increasing insensitivity of the cells, the blood sugar level rises. The main risk factors for this form of diabetes are genetic predisposition, obesity and lack of exercise. Mostly older people are affected, but increasingly also young people. 

What is Type 1 Diabetes?

The second most common form is type 1 diabetes . It is an autoimmune disease. Your own immune system destroys the islet cells in the pancreas that make the hormone insulin. There is therefore an insulin deficiency. In order to treat the increased blood sugar level, those affected usually have to inject insulin for the rest of their lives . Type 1 diabetes often occurs in adolescence or young adulthood. 

How to know if you have diabetes: Possible symptoms that indicate diabetes

The pathologically increased blood sugar levels trigger a wide variety of symptoms in diabetes mellitus . This applies to the two main forms of diabetes ( type 1 and type 2 diabetes) as well as to the less common forms.

Acute symptoms of diabetes primarily occur when the metabolism derails and the blood sugar level is extremely high. Then there are strong changes in the water and mineral balance. At the same time, there is a severe lack of energy in the body cells and in the central nervous system. The main diabetes symptoms are:

Frequent urination

In diabetes, the body tries to excrete the excess sugar in the blood through the urine. Those affected may therefore have an increased urge to urinate (polyuria). This is often the first sign of diabetes.

If the blood sugar level is permanently elevated, more sugar (glucose) is excreted via the kidneys with the urine (glucosuria). Since sugar physically binds water, those affected also excrete large amounts of urine (polyuria) – they have to go to the toilet very often. Many diabetics are plagued by an annoying need to urinate, especially at night. The urine released is usually clear and only slightly yellow in color.

Polyuria is a typical sign of diabetes mellitus, but it can also have other causes. An increased urge to urinate also occurs with various kidney diseases and during pregnancy.

By the way: the sugar in the urine of diabetics gives it a slightly sweet taste. This is where the technical term diabetes mellitus comes from: It means “honey-sweet flow”. However, the days when doctors tasted their patients’ urine for diagnosis are long gone. Today the sugar content can be detected with a rapid diabetes test with indicator strips.

Strong feelings of thirst

The strong urge to urinate triggers an excruciating feeling of thirst in diabetes patients: the body wants to compensate for the loss of fluid by drinking more. But this often does not succeed sufficiently. Even if those affected drink a lot, the thirst cannot really be quenched.

Dry or itchy skin

Dry skin can be the first sign of diabetes. It also occurs when the body excretes more sugar in the urine and loses fluid in the process. One reason for this is the high loss of fluid as a result of the increased urine excretion (glucosuria). However, other mechanisms are also suspected that may be responsible for increased itching in diabetics. 

These could be, for example, stress hormones such as adrenaline and cortisol, which the adrenal gland releases into the blood in increased amounts when the blood sugar is too high or too low. Changes in the blood vessel walls may also contribute to the development of itching in diabetics.


Diabetes can make people feel weak.  There is a lot of energy-rich glucose in the blood of people with diabetes. However, this cannot get into the cells to be used. This creates a lack of energy within the cells. As a result, patients often feel powerless and are less physically efficient.

Most of the glucose the body needs during the day is for the brain. A glucose deficiency therefore affects normal brain function. It can cause poor concentration and tiredness to severe impaired consciousness and even a coma in extreme cases.

Weight loss

In some cases, there is weight loss in diabetes. On the one hand, this is due to the loss of fluid as a result of the increased urge to urinate. Another possible cause, which occurs primarily in type 1 diabetes: If the cells can no longer adequately cover their energy requirements due to the deterioration in blood sugar utilization, the body falls back on fat deposits – and those affected lose weight.

Wounds do not heal well

With diabetes, the immune system is often weakened. This and poorer blood circulation in the skin help wounds to heal more slowly.

Increased susceptibility to infections

Diabetics are more susceptible to various infectious diseases, such as urinary tract infections, athlete’s foot or other skin infections. Periodontitis is also more common in diabetes.

The increased blood sugar weakens the immune system against infections in a way that is not yet fully understood. That is why many diabetics suffer more often and for longer than non-diabetic patients from bronchitis, pneumonia , skin infections or various fungal diseases, for example. The flu vaccination and the pneumococcal vaccine are recommended for protection against diabetes patients (pneumococci cause lung and meningitis, for example).

Breath smells of acetone

Only in type 1 diabetes can an acetone odor become noticeable in the breath, reminiscent of overripe fruit. If the cells do not get enough sugar, the body breaks down fat cells. Among other things, acetone is produced in the process. It is a sign of a severe insulin deficiency, which can lead to ketoacidosis and in the worst case to a diabetic coma.

Visual disturbances

In the case of untreated or insufficiently treated diabetes mellitus, the blood sugar level is not only very high, it also fluctuates greatly. These strong fluctuations can cause the lens in the eye to swell. This changes their optical power and thus their visual acuity – the patients get visual disturbances. These usually last for a few hours and then subside again.

How to know if you have diabetes: Long term symptoms and damage

Late symptoms of diabetes mellitus mainly arise when the blood sugar levels are not well controlled and are often or latently too high. Then blood vessels and nerves are irreversibly damaged – with serious consequences for various organ systems and body functions.

Nerve damage (polyneuropathy)

Over time, high blood sugar levels damage the peripheral nervous system. Both motor (controlling the muscles) as well as sensitive (feeling) and vegetative (controlling the organs) nerve tracts are affected. Diabetics therefore often have a disturbed sense of pain. For example, they do not perceive injuries to the skin or a heart attack as pain. Muscle coordination during movement can also suffer.

The function of internal organs (such as the digestive tract) can also be impaired in diabetes: diarrhea and other digestive problems can result. If the high blood sugar values ​​damage the autonomic nervous system that supplies the digestive tract, this can lead to nerve paralysis of the stomach (gastroparesis) or the intestines. Possible consequences are bloating and vomiting, gas , diarrhea, or constipation .

Damage to the blood vessels (angiopathies)

High blood sugar levels usually trigger changes in the inner wall layer in the small and smallest blood vessels ( capillaries ) (microangiopathy). Over time, the medium and large blood vessels can also be damaged (macroangiopathy). The vascular damage results in circulatory disorders up to complete occlusion. Various organs can be affected. Here are the most important examples:

  • Heart : Narrowing or occluding small blood vessels means that the heart muscle is poorly supplied with oxygen. Possible consequences are heart failure ( heart failure ), coronary heart disease (CHD) and heart attack .
  • Brain: Circulatory disorders in the brain impair brain performance and can trigger chronic neurological deficits . In the worst case scenario, a stroke occurs .
  • Eyes: Damage to the blood vessels in the retina of the eye ( diabetic retinopathy ) causes symptoms such as ” flashes of light “, blurred vision , impaired color vision and ultimately loss of vision up to blindness .
  • Kidneys: Here, circulatory disorders cause changes and damage to the tissue. This diabetic nephropathy can ultimately lead to impaired kidney function ( renal insufficiency ). If the kidneys fail completely, patients are dependent on blood washing ( dialysis ) in the long term .
  • Skin: Damage to the small skin vessels makes the skin more susceptible to being colonized by germs ( skin infections ). In addition, poor wound healing is observed . Poor healing chronic wounds and ulcers in the lower legs / feet are called diabetic foot .

Diabetes and depression

About a quarter of all diabetes patients suffer from a depressive mood or depression. The trigger is usually the diabetes itself as well as possible long-term effects that can put those affected psychologically stressful.

Conversely, people with depression are also at an increased risk of developing type 2 diabetes. One reason for this could be that depressed people pay less attention to a healthy lifestyle, e.g. eat unhealthily and do little exercise. Such factors contribute to the development of type 2 diabetes. In addition, depression could change the hormonal system and metabolism of the patient via various signaling pathways in such a way that diabetes is favored.

How to know if you have diabetes: Type 2 often causes no symptoms

Apart from the acetone odor in the air, these symptoms can in principle occur in both type 1 and type 2 diabetes. However, they are often more subtle in type 2 diabetes, as this develops over a longer period of time and the metabolism therefore only slowly goes off course.

Because it often does not cause any symptoms, type 2 diabetes is only discovered incidentally in many cases. For example, when a person is hospitalized for another illness. It is estimated that only about 30 to 50 percent of untreated type 2 diabetics develop the typical signs. Often there is already a diabetic consequential damage before when the disease is detected.

How to know if you have diabetes: Type 1 signs appear earlier

Type 1 diabetes, on the other hand, develops much faster than type 2 diabetes, often within a few weeks. For this reason, it almost always shows up with the typical symptoms. Above all, increased thirst, the urge to urinate, tiredness and an increased infection rate are often present. Symptoms occur when most of the islet cells in the pancreas are destroyed.

Often it is thirst and increased urination that drive those affected to the doctor. On this occasion, the doctor then diagnoses the diabetes.

Multiple ways to diagnose diabetes

How to know if you have diabetes by medical testing: the doctor diagnoses “diabetes” when one of the following limit values ​​is exceeded and a repeated measurement confirms the result:

  • The blood sugar level reaches 200 mg / dL (11.1 mmol / L) or higher at any point in time
  • A fasting blood sugar of 126 mg / dL (7.0 mmol / L) or higher
  • A blood sugar level of 200 mg / dL (11.1 mmol / L) or higher two hours after an oral glucose tolerance test (OGTT)

Further tests provide information about the type of diabetes. Type 1 diabetes can be diagnosed with the help of typical autoantibodies.

View a diabetes diagnosis as an opportunity

A diagnosis of diabetes always means a change in the life of those affected, so it is wise to know how to know if you have diabetes as early as possible. Type 1 diabetics will have to inject insulin from then on, Type 2 diabetics will at least have to adapt to a new lifestyle with more exercise and a healthy diet. In any case, the diagnosis also represents an opportunity. With the appropriate approach, many patients can improve their metabolism, often significantly alleviate symptoms and thus gain a better quality of life.