Diabetes has become one of the most common chronic diseases today, with over 34 million Americans living with diabetes. However, nearly 7.3 million people are estimated to have undiagnosed diabetes, meaning they are unaware they have the disease. So it’s entirely possible for someone to have diabetes without realizing it.
What is diabetes?
Diabetes is a chronic condition in which the body cannot properly regulate blood sugar levels. Blood sugar (glucose) is the main source of energy for our bodies. A hormone called insulin, which is made by the pancreas, helps move glucose from the bloodstream into the cells to be used for energy.
In diabetes, either the pancreas cannot produce enough insulin or the body becomes resistant to insulin. This causes glucose to build up in the blood instead of being absorbed by the cells. Over time, high blood sugar levels can seriously damage organs and tissues throughout the body.
The main types of diabetes are:
- Type 1 diabetes – the pancreas cannot make insulin due to an autoimmune reaction.
- Type 2 diabetes – the body becomes resistant to insulin’s effects. This is the most common type, accounting for 90-95% of cases.
- Gestational diabetes – high blood sugar that develops during pregnancy.
- Other specific types – caused by genetic syndromes, surgery, medications, and other factors.
Risk factors
Several factors can raise your risk of developing diabetes, including:
- Weight – Being overweight or obese is a primary risk factor, especially if weight is concentrated around the belly.
- Inactivity – Lack of physical activity can make you more prone to type 2 diabetes.
- Family history – Having a close relative with diabetes increases your risk.
- Race – Certain racial and ethnic groups are at higher risk, such as African Americans, Hispanic/Latino Americans, American Indians, and some Asian Americans.
- Age – Risk rises as you get older, especially after age 45.
- High blood pressure – Hypertension is common with diabetes.
- Abnormal cholesterol – High LDL cholesterol and low HDL cholesterol can signal increased risk.
- Polycystic ovary syndrome (PCOS) – This hormonal condition can disrupt blood sugar control.
- Gestational diabetes – Women who developed diabetes during pregnancy have a greater chance of developing type 2 diabetes later.
- Smoking – Smokers are 30–40% more likely to develop diabetes.
Having one or more of these risk factors does not mean you will definitely develop diabetes. But it’s important to be aware of your risks and get screened if you have any signs or symptoms.
Signs and symptoms
Diabetes symptoms can develop slowly over time, which is why many people don’t realize they have the disease. Here are some common signs of diabetes:
- Increased thirst and frequent urination
- Greater hunger and unintended weight loss
- Fatigue
- Blurred vision
- Slow healing of cuts and bruises
- Tingling, pain, or numbness in hands and feet
- Frequent infections of the skin, gums, vagina, or bladder
Some people with type 2 diabetes have no symptoms at all, while others only have mild symptoms that are easy to overlook. Symptoms can also come on gradually over the years, making them less noticeable.
Who should be tested?
Screening for diabetes is recommended for:
- Adults aged 45 years and older, especially if overweight or obese.
- Adults under 45 who are overweight or obese and have additional risk factors like family history, high blood pressure, etc.
- Women who had gestational diabetes during pregnancy.
- Anyone with symptoms of diabetes.
Doctors may also recommend diabetes screening for children and teenagers who are overweight and have other risk factors.
If you are at high risk, getting tested regularly can help detect prediabetes or diabetes early. This allows treatment to start sooner, which can prevent or delay complications from the disease.
Diagnosis
Diabetes is diagnosed through simple blood tests that measure your blood sugar levels. The main diagnostic tests are:
- A1C test – This lab test shows your average blood sugar over the past 2-3 months. An A1C of 6.5% or higher indicates diabetes.
- Fasting blood sugar – You fast overnight, then get your blood drawn in the morning. 126 mg/dL or higher means diabetes.
- Oral glucose tolerance test – You fast overnight, then drink a sugary solution. Blood samples are taken over 2 hours. Diabetes is diagnosed if blood sugar is too high.
- Random blood sugar test – A blood sample is taken at a random time. 200 mg/dL or higher indicates diabetes if you have symptoms.
Your doctor may have you do a second test on a different day to confirm the diagnosis. Getting tested is a quick and simple way to know for sure whether or not you have diabetes.
Treatment
Although diabetes has no cure, treatment options are available to manage it effectively. The main goals for diabetes treatment are:
- Keep blood sugar levels in a healthy range as much as possible – generally between 70-130 mg/dL before meals.
- Prevent or delay complications from high blood sugar damaging organs and tissues.
Treatment typically includes:
- Healthy eating – Following a nutrient-rich diet, paying attention to portion sizes, and limiting foods that spike blood sugar.
- Physical activity – Getting regular exercise helps control body weight, reduce blood sugar, and improve insulin sensitivity.
- Medication – Such as metformin, insulin, and other drugs to lower blood sugar and manage diabetes.
- Regular monitoring – Checking blood sugar levels often and getting routine A1C tests to ensure treatment is working.
- Education – Learning about meal planning, medication use, getting active, and managing diabetes effectively.
Following the treatment plan outlined by your doctor is key to successfully managing diabetes and preventing serious complications.
Complications
Consistently high blood sugar levels can eventually cause damage throughout the body, leading to various complications:
- Cardiovascular disease – Damage to blood vessels and nerves increasing heart disease risk.
- Nerve damage (neuropathy) – Pain, numbness, and tingling in hands and feet due to nerve injury.
- Kidney disease (nephropathy) – Damage to small blood vessels in kidneys leading to renal failure.
- Eye damage (retinopathy) – Harm to small vessels in the retina causing vision loss or blindness.
- Foot damage – Poor circulation and nerve damage increasing risk of ulcers, infections, and bone/joint problems.
- Skin conditions – Bacterial and fungal infections due to high blood sugar.
Good diabetes management and control of blood sugar levels can prevent or slow the progression of complications.
Undiagnosed diabetes complications
Many complications associated with diabetes can develop even if blood sugar levels appear normal. Having undiagnosed diabetes for a long time raises the likelihood of complications. Potential problems from untreated diabetes include:
- Cardiovascular disease – Increased risk of heart attack, stroke, and blockages in leg arteries.
- Eye damage – More prone to cataracts, glaucoma, and retinopathy leading to blindness.
- Kidney disease – Unnoticed damage to the small vessels and internal structures in the kidneys.
- Nerve damage – Gradual harm to nerves in the hands, arms, feet, and legs.
- Foot injuries – Increased susceptibility to foot ulcers, deformities, infection, and amputation.
- Hearing impairment – Higher likelihood of hearing loss.
- Skin problems – Bacterial and fungal infections more likely to occur.
That’s why getting tested, diagnosed, and treated early is so important – it can prevent or delay major complications from diabetes.
Prevention
Making healthy lifestyle choices can help prevent or delay the onset of type 2 diabetes if you’re at high risk. Recommended prevention tips include:
- Achieving and maintaining a healthy body weight.
- Exercising regularly – aim for at least 30 minutes daily.
- Eating a balanced, nutritious diet focused on whole foods.
- Quitting smoking to reduce your risk.
- Limiting alcohol intake to moderate levels.
- Getting enough sleep and managing stress.
- Taking steps to lower blood pressure and cholesterol if elevated.
- Seeing your doctor for screening if you have risk factors.
Modest weight loss and moderate physical activity can make a big difference in reducing your chances of developing diabetes.
Living with undiagnosed diabetes
Here is what life might be like if you have undiagnosed diabetes and the subtle ways it could affect your health:
- You feel thirstier than normal and need to urinate frequently, especially at night. You assume it’s just part of aging.
- You experience fatigue and muscle weakness, so exercise is more difficult.
- Blurred vision comes and goes. You buy over-the-counter reading glasses.
- Tingling and numbness in your hands and feet is mildly annoying but doesn’t severely impact activity.
- You take longer to heal from cuts and bruises. You rarely connect it to blood sugar problems.
- You catch colds and urinary tract infections more often.
- You have occasional bouts of skin itchiness and vaginal yeast infections.
- You feel hungrier than normal and gain weight despite eating the same diet.
- Your eyesight gradually worsens over a few years.
- You sometimes feel short of breath going up stairs and walking short distances.
Left undiagnosed and untreated over many years, diabetes can start causing irreversible damage throughout the body. Getting tested and treated early is vital.
When to see a doctor
See your doctor promptly if you experience any persistent signs or symptoms of diabetes, such as:
- Increased thirst and frequent urination
- Fatigue
- Blurred vision
- Tingling, pain, or numbness in hands or feet
- Slow-healing cuts and sores
- Unexplained weight loss
Bring up any concerns about diabetes risk with your doctor. Be sure to get screened if you have any risk factors. Don’t ignore subtle symptoms as they can be signs of serious health problems.
Conclusion
Yes, it’s certainly possible to have diabetes without realizing it, especially in the early stages when symptoms may be mild. As many as 7 million Americans are estimated to have undiagnosed diabetes.
Knowing your risk factors like being overweight and inactive, getting screened as recommended, and not ignoring diabetes symptoms can help with early diagnosis. This allows treatment to start right away to manage diabetes, prevent complications, and safeguard your long-term health.