Most people are aware of the classic signs and symptoms of diabetes — increased thirst, increased hunger and increased urination. But by some estimates, over 7 million people in the United States have Type 2 diabetes and don’t even know it. For many of them, the first symptoms of diabetes may be due diabetic complications, and they’re symptoms that most people don’t typically associate with diabetes.
In some cases, vision problems may be the first sign that someone has diabetes. High blood glucose levels from diabetes can damage the capillaries (tiny blood vessels) of the eye, a condition known as diabetic retinopathy. Diabetic retinopathy is a leading cause of vision loss and blindness. Diabetes can cause the capillaries to leak, distorting vision and causing “floaters,” dark blobs that move around in a person’s field of vision. A related condition is macular edema, which is swelling (edema) of the macula, an area in the center of the retina. The macula is associated with the sharp, straight-ahead vision people need for reading, driving and recognizing faces, and macular edema can make vision blurry. The earlier diabetic retinopathy is diagnosed, the more vision can be saved, by controlling blood glucose and cholesterol levels and, in some cases, laser treatments and injections into the eyes.
Burning, tingling or numbness in the feet, legs, hands and/or arms may also be a symptom of undiagnosed diabetes. Over time, high blood glucose and triglyceride levels from diabetes can damage the nerves and the small blood vessels that supply them, leading to peripheral neuropathy (nerve disease). Other symptoms of peripheral neuropathy include extreme pain in the feet, legs, hands and arms when touched lightly, weakness and loss of balance. If diagnosed early, diabetic neuropathy can be halted or slowed down through blood glucose management, and there are several types of medications to treat the pain.
People with diabetes, especially undiagnosed diabetes, may become tired or fatigued for a couple of reasons. First of all, uncontrolled blood glucose levels can directly lead to fatigue. Second, high blood glucose levels can damage the blood vessels of the kidneys so that they don’t work as well. When the kidneys don’t filter the blood as well as they should, waste products can build up in the bloodstream. Typically, kidney disease causes no symptoms, but fatigue can be a symptom of kidney disease. The earlier diabetic kidney disease is diagnosed, the better it can be treated by controlling blood glucose levels and blood pressure. Specific blood pressure medications called ACE inhibitors and ARBs have been shown to be especially effective at slowing down the progression of diabetic kidney disease.
Chest pain can be another sign of underlying diabetes. People with diabetes have a higher risk of heart disease than those without diabetes. One symptom of heart disease is angina, which is chest pain or discomfort because the heart muscle isn’t getting enough oxygen-rich blood. Angina may also feel like tightness or pressure in the chest, and can also occur in the shoulder, arms, neck, jaw or back. It may also be mistaken for heartburn. Medications called nitrates, which relax and widen blood vessels to the heart, may be used to treat angina. The underlying heart disease may be treated with lifestyle changes, such as stopping smoking, eating a healthier diet and controlling blood glucose levels, as well as medications that lower blood pressure and cholesterol levels.
Erectile dysfunction, the inability to achieve an erection firm enough for sexual intercourse, is not only vexing but can also be a sign of diabetes. Chronically high blood glucose levels from diabetes can damage the nerves and blood vessels that make an erection possible. Once the problem is diagnosed, it can be treated with better diabetes control, medications and various devices.
When diabetes is not well controlled, the resulting high blood glucose levels promote the growth of harmful bacteria. These bacteria help to form a sticky film called plaque, which can cause tooth decay, cavities, gum disease and bad breath. Gum disease (gingivitis) can progress to periodontitis, in which the gums pull away from the teeth and form pockets that can become infected. Periodontitis can eventually break down the bone and tissue that hold teeth in place, which can lead to tooth loss. Gum disease can be treated by controlling diabetes, practicing good oral hygiene (regular brushing and flossing), and regular visits to the dentist for deep cleaning.
If you experience any of these signs or symptoms, whether or not you’ve been diagnosed with diabetes, be sure to seek medical attention.
Want to learn more about diabetes symptoms? Read “Symptoms of Diabetes” and “High Blood Sugar Symptoms.”
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