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The Early Warning Signs of Diabetes

Diabetes is a condition that affects how your body metabolizes sugar, and it can lead to serious health complications if left untreated. The good news is that type 2 diabetes is often preventable, and there are a few key warning signs to watch out for.

The condition is often associated with genetics, obesity and a sedentary lifestyle. If you have any of the risk factors of diabetes, it’s important to be proactive about your health. In this guide, we provide advice for maintaining a healthy weight, eating a balanced diet, and exercising regularly — all of which can help to prevent the development of type 2 diabetes.

At its most basic, what is diabetes?

Diabetes is a health condition which affects your blood sugar levels. In order to understand its impact, we first need to look at how the body breaks down the food we eat — and how this is different for people with diabetes.

  • When someone doesn’t have diabetes, their body breaks most food down into glucose and releases it into the bloodstream. An increase in blood sugar acts as a signal to the pancreas, a gland behind the stomach. The pancreas releases a hormone called insulin. Insulin lets the blood sugar into the body’s cells, which use it to produce energy.

  • When someone has diabetes, their body doesn’t make enough insulin, can’t use it the way it should, or can’t make insulin at all. The blood sugar stays in the bloodstream instead of being broken down into energy. Too much blood sugar in the bloodstream can lead to serious health conditions, including angina (chest pain), heart disease, kidney disease, loss of vision, and stroke.

There’s no cure for diabetes at this point in time. However, the condition can be managed using lifestyle practices, such as eating a balanced diet and exercising regularly.

There are three main types of diabetes: type 1, type 2 and gestational (which occurs in pregnancy). There’s nothing you can do to lower your risk of developing type 1, but type 2 can be prevented with the lifestyle choices mentioned above.

What’s the difference between type 1, type 2 and gestational diabetes?

Type 1 diabetes

Type 1 diabetes stops your body from making insulin. The immune system attacks and destroys the cells that make insulin by mistake, so if you have this type of diabetes you must take insulin every day in order to stay alive. Type 1 diabetes develops quickly and there’s no known way of preventing it. Between 5 and 10% of Americans who’ve been diagnosed with diabetes have type 1.

What causes type 1 diabetes?

Scientists believe type 1 diabetes is caused by the body attacking itself by mistake, known as an autoimmune reaction. In the case of type 1 diabetes, this reaction destroys the cells which create insulin.

Some people have genes which make them more likely to develop type 1 diabetes, but this doesn’t mean they will. This condition isn’t caused by lifestyle choices.

Type 2 diabetes

Type 2 diabetes affects the way your body uses insulin. You may not produce enough of it, or react the way you’re supposed to, which in turn affects your blood sugar levels. It can be prevented and managed using healthy lifestyle practices. Type 2 diabetes is more commonly diagnosed in adults, although the number of children and teenagers being diagnosed is increasing. Between 90 and 95 percent of Americans who’ve been diagnosed with diabetes have type 2.

What causes type 2 diabetes?

Type 2 diabetes is caused by insulin resistance (i.e. cells not responding normally to insulin). When this happens, the pancreas makes more insulin in an attempt to get the cells to respond. But this is unsustainable and when the pancreas can’t keep up, your blood sugar levels rise.

Gestational diabetes

Gestational diabetes occurs during pregnancy, when someone hasn’t been diagnosed with diabetes before. Blood glucose levels are so high that the body is unable to produce enough insulin to absorb it. Between 2 and 10 percent of pregnancies in the US are affected by the condition. It can be managed by eating a balanced diet and exercising. Your doctor may also prescribe medication.

Gestational diabetes normally goes away after the baby is born, but it does increase the risk of type 2 diabetes in both parent and child. You may need to undergo regular tests to measure your blood sugar levels.

What causes gestational diabetes?

Pregnancy comes with a vast number of changes, including the addition of new hormones and weight gain. These changes can lead to the body not being able to make enough insulin, which causes gestational diabetes. Prenatal care includes checks for gestational diabetes, as it doesn’t always have symptoms, although you may be more thirsty and need to urinate more often.

Diabetes statistics

  • 11.3% of the US population have diabetes. This is approximately 37.3 million people.

  • Of these:

    • 28.7 million have been diagnosed (8.7% of the US population).

    • 28.5 million of those who’ve been diagnosed are adults.

    • 200,000 of those who’ve been diagnosed are children.

    • 8.5 million people have yet to be diagnosed, although a new study by researchers at John Hopkins Bloomberg School of Public Health suggests this number is lower.

  • The CDC’s most recent Diabetes Report Card, published every other year, shows:

    • The number of newly diagnosed cases of diabetes fell over a decade, from 9.3 per 1,000 adults in 2009 to 5.9 per 1,000 adults in 2019.

    • Diagnosis of prediabetes has increased, however, from 6.5 to 17.4 percent.

    • 40% of adults who died from COVID-19 in the US also had diabetes.

  • More than 25 percent of adults who are over the age of 65 have diabetes.

The early warning signs of diabetes

It’s not always easy to know that you might have developed diabetes or prediabetes. However, certain demographics are at a higher risk than others, and there are some symptoms which you may or may not experience. Keep these in mind, and speak to your primary care provider if you’re at risk or notice any symptoms.

What is prediabetes?

A person is said to have prediabetes when their blood sugar levels are above the normal range, but not high enough to be diagnosed with diabetes. A person with prediabetes is at a greater risk of developing diabetes later in life, but there’s good news too — it’s also possible to reverse it.

1 in 3 adults in the US have prediabetes, but most don’t know they have it as there aren’t always noticeable symptoms. The CDC has a prediabetes risk test that you can take online.

What are the risk factors for diabetes and prediabetes?

  • Being overweight (defined by the World Health Organisation, WHO, as having a BMI over 25)

  • Being 45 years and above

  • Being physically active less than three times per week

  • Being an African American; Latino American; Hispanic; American Indian, Asian American, or a Pacific Islander

  • Having gestational diabetes

  • Giving birth to a baby who weighed over nine pounds

  • Having family with type 2 diabetes

  • Having polycystic ovary syndrome

What are the symptoms of diabetes?

  • Blurry vision

  • Cuts, wounds or sores that take a long time to heal

  • Feeling very hungry a lot of the time

  • Feeling very thirsty a lot of the time

  • Feeling very tired a lot of the time

  • Having more infections than usual

  • Losing weight and muscle mass without trying to

  • Needing to urinate a lot, especially at night

  • Numb or tingling hands or feet

  • Very dry skin

Someone with type 1 diabetes may also experience nausea, stomach pains or vomiting.

Seeing a doctor

It’s important to see a doctor if you notice any symptoms of diabetes. You may also want to see them if you fit into multiple risk factor categories.

There are several tests you can take to diagnose diabetes and they must be done in a medical setting, as self-diagnosis kits don’t have the level of accuracy needed.

  • A1C. This blood test measures your average blood glucose levels for the past three months. It can be used to diagnose diabetes and prediabetes, as well as manage the condition, as having a high A1C result can indicate diabetes complications.

  • Fasting Plasma Glucose (FPG). This test measures your fasting blood glucose levels. You avoid eating or drinking anything (except water) for a minimum of eight hours beforehand, so for this reason the test is normally done early in the morning.

Fasting triggers the production of glucagon by the pancreas and the release of glucose into the bloodstream. If you don’t have diabetes, your body produces insulin to prevent high blood sugar; if you do, your body can’t produce insulin or respond to it properly, blood sugar levels remain high.

  • Oral Glucose Tolerance Test (OGTT). This test is used to screen for type 2 diabetes. It measures your blood glucose levels before you drink a solution which contains 2.6 ounces of sugar, and two hours after, in order to see how your body processes glucose after a meal.

If you’ve been diagnosed with diabetes, you’ll also become familiar with the Random Plasma Glucose Test. This test measures your blood glucose levels when you have severe diabetes symptoms and can be done at any time of day (hence the name ‘random’). You prick your finger to draw blood, then wipe it on a test strip to give a glucose reading. This type of testing can help you and your primary care provider to see how well diabetes is being managed, as someone whose diabetes is not well managed will have results that vary significantly.

Ways to help prevent the development of type 2 diabetes

The good news is that even if you’re at risk, type 2 diabetes can be prevented. Let’s explore what you can do and what support is available.

Maintain a healthy weight

Being overweight can increase the chances of you developing type 2 diabetes. This is because the increase in fatty acids and inflammation can lead to insulin resistance, which in turn leads to type 2 diabetes. Between 80 and 90 percent of people who have type 2 diabetes are overweight.

A healthy weight is defined as having a body mass index (BMI) between 18.5 and 24.9. BMI is based on your height and weight and can be calculated using the CDC’s tool.

It’s important to manage your weight safely. There are plenty of restrictive diets out there, and although they might offer short-term results, they aren’t sustainable long-term and can even be harmful to your health. Research shows that dieting is ineffective and can have psychological effects, such as irritability, depression and emotional distress. It can also have unwanted physical effects, including lack of energy, nutrient deficiencies, muscle cramps, dehydration and, ironically, weight gain.

The safest way to manage your weight is by making lifestyle changes like eating a balanced, varied diet, moving your body and exercising regularly.

Eat a balanced diet

The usual guidelines for eating a balanced diet apply, as recommended by the government’s Dietary Guidelines for Americans:

  • Vegetables, including dark greens, red and yellow vegetables, beans, peas and lentils

  • Fruits of all types

  • Grains, especially wholegrains

  • Dairy products, including low-fat milk, yogurt and cheese, or fortified dairy alternatives

  • Sources of protein, including lean meat, poultry, eggs, beans, peas, lentils, nuts and seeds

  • Oils, including vegetable oils

There are also some additional guidelines which, if followed, can help to reduce the risk of type 2 diabetes:

  • Choose whole grain versions of products where possible

  • Avoid processed meat and limit your consumption of red meat

  • Choose healthy fats, like those found in vegetable oils, nuts, seeds and fish

  • Minimize the amount of salt, saturated fat and sugar that you eat

  • Avoid sugary drinks like soda and smoothies, and opt for water, tea or coffee

  • Eat three meals a day

It’s more sustainable to make gradual changes to your diet, instead of changing everything at once. Take it slow and you’re more likely to stick with it.

Stay hydrated

Your body needs water in order to function properly. Water helps to:

  • Bring nutrients to your cells

  • Get rid of waste

  • Improve your mood

  • Improve your sleep

  • Improve the way your brain functions

  • Keep your organs working correctly

  • Lubricate your joints

  • Prevent infections

  • Protect your tissues

  • Regulate your temperature

If you’re dehydrated, you might get a dry mouth and a headache, as well as feel tired and dizzy.

The best option for hydration is water. However, milk, herbal teas, and water flavoured with fresh fruit like lemon or lime will also help you to hydrate. The U.S. National Academies of Sciences, Engineering, and Medicine recommend 3.7 liters of water per day for men, and 2.7 liters per day for women. However, this is only a guideline, as you may need more or less depending on your health and activity levels.

Limit alcohol consumption

Studies have shown that consuming alcohol excessively can increase the risk of developing type 2 diabetes, as it reduces the body’s sensitivity to insulin.

If you do drink, a light-to-moderate amount of alcohol is considered to be up to one drink per day for women, and up to two drinks per day for men, as per the Dietary Guidelines for Americans.

If you need advice or support around alcohol consumption, don’t hesitate to reach out to an organisation or support group such as the ones listed here.

Keep moving and exercise regularly

It’s easy to end up leading a sedentary lifestyle, especially if you have a job which requires you to work at a desk. Unfortunately, being inactive can:

  • Weaken muscles and bones

  • Reduce the efficacy of your metabolism, immune system, and blood circulation

  • Cause hormonal imbalance and weight gain

  • Increase the risk of health problems, including:

    • Cancer

    • Heart diseases

    • High blood pressure

    • High cholesterol

    • Stroke

    • Type 2 diabetes

However, if you’re used to being fairly inactive throughout the day, it can be counterproductive and even dangerous to suddenly start intensely exercising. Instead, think about how you could gradually incorporate movement into your routine. You might take the stairs instead of the elevator, go for a walk on your lunch break, or make time for household activities like cleaning or gardening — it all adds up. Once you’re used to it, you can start thinking about the kind of exercise that might suit you.

What kind of exercise is right for you?

The best exercise is the one that you enjoy, because you’re more likely to be motivated to do it and therefore stick with it. Sociable types might enjoy team sports or working out with a friend, while introverts might enjoy at-home workouts or solo gym time. It can take time to figure out which activities you enjoy, but luckily most places offer free trial sessions before you commit.

Examples of exercise you could try include:

  • Bodyweight exercises, like squats, push-ups, lunges, and planks

  • Cycling or spinning

  • Dance classes

  • Fitness classes

  • Pilates`

  • Running

  • Strength training

  • Swimming

  • Tai chi

  • Team sports like soccer, basketball, or baseball

  • Two-person sports like tennis

  • Walking

  • Water aerobics

  • Yoga

Don’t smoke

There are many reasons not to smoke, including the increased risk of developing cancer, lung diseases, and problems with the immune system. Amongst them is the fact that smoking increases your risk of developing diabetes (as found in the 2014 Surgeon General’s Report). This is because smoking causes inflammation and oxidative stress, which affects how cells function.

How to quit smoking

The American Lung Association offers a Freedom From Smoking program, as well as advice and information on what to expect when you quit. Joining a program like this, using the online resources, and speaking to your primary health care provider ensures you have support available when you need it.

It may take some time to fully integrate healthy lifestyle practices into your routine. But it’s worth making the effort. You’ll be helping to prevent the development of type 2 diabetes and keep yourself in good health, ensuring you can enjoy and take on everything life throws your way.


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