Type 2 Diabetes: 4 Signs of Trouble

If your glucose levels get out of control, it can lead to serious diabetes problems. Knowing the signs of these diabetes conditions can help you take quick action to resolve them.

By Barbara Sadick

Medically reviewed by Niya Jones, MD, MPH

Diabetes complications can occur if you don't regulate your blood sugar (glucose) levels properly. Blood sugar is produced in your liver and muscles, and most of the food you eat is converted into blood sugar. This is your body's source of energy, but when your blood sugar gets too high, diabetes is the result.

Your pancreas produces the hormone insulin, which then carries blood sugar into your cells, where it’s stored and used for energy. When you develop insulin resistance, high levels of sugar build up in your blood instead of your cells and you start to experience signs and symptoms of diabetes. You may notice fatigue, hunger, increased thirst, blurred vision, infections that are slow to heal, pain and numbness in your feet or hands, and increased urination. For awhile, your pancreas will work to keep up with your body’s sugar demand by producing more insulin, but eventually it loses the ability to compensate and serious diabetes complications — including blindness, kidney failure, loss of circulation in your lower extremities, and heart disease — can develop.

For most people with diabetes, the target blood sugar level is 70 to 130 mg/dL, but your doctor will work with you to pinpoint your individual target range. Your doctor can also help you learn what to eat and how to keep your blood sugar within a healthy range.

Joel Zonszein, MD, director of clinical diabetes at Montefiore Medical Center in New York City, says it’s very important to work with and see your doctor regularly and to consult a diabetes educator. If your diabetes is well-controlled and you're monitoring your blood sugar level at least once or twice a day, seeing your doctor four times a year should be sufficient to maintain good diabetes control.

Four Signs of Diabetes Complications

One of the main reasons monitoring your blood sugar level is so important is that it can change quickly and unpredictably. The sooner you detect any changes, the sooner you can catch early signs of diabetes complications. Be aware of these four specific diabetes problems:

Hyperglycemia. The most common cause of diabetes complications is hyperglycemia, or when your blood sugar level rises above 180. This kind of spike indicates that either there isn’t enough insulin in your body or that insulin isn’t being properly used. You can experience high blood sugar from overeating, medication deficiency, or as a reaction to new medication. Signs of hyperglycemia include being very thirsty, experiencing extreme fatigue, having blurry vision, needing to urinate a lot, and feeling sick to your stomach. Although regular exercise may help stabilize your blood sugar level, it’s important to contact your doctor because your meal plan, your medication, or both may need to be adjusted. If left untreated, hyperglycemia can become a life-threatening condition.

Hypoglycemia. A quick drop in your blood sugar level is called hypoglycemia. Blood sugar levels below 70 are dangerously low and can be caused by missing or delaying a meal, exercising too much, or taking too much medication. Hypoglycemia may cause feelings of weakness, confusion, irritability, shakiness, hunger, and fatigue. You can prevent passing out or having a seizure from hypoglycemia by eating regular meals, taking your diabetes medication, and checking your blood sugar level often. When your blood sugar begin to drop, you should drink fruit juice or regular soda, take glucose tablets, eat a spoonful of sugar or honey, or eat five or six pieces of hard candy to stabilize your blood sugar. If you experience hypoglycemia, contact your doctor as soon as possible. Until your blood sugar level has stabilized, repeat the sugary drink or food every 15 minutes. Always carry food with you for this reason.

Diabetic ketoacidosis. When there isn’t enough insulin or sugar for fuel, your body starts breaking down fats for energy instead. As a result, your body produces ketones, which are waste products found in the blood. Because your body can’t tolerate high levels of ketones, your system will try to eliminate them through your urine. If ketones build up in the blood, a life-threatening condition called diabetic ketoacidosis can poison your body and lead to a coma or death. Early symptoms include thirst, dry mouth, shortness of breath, fruity smelling breath, frequent urination, fatigue, dry skin, nausea, vomiting, abdominal pain, confusion, high blood sugar, and high levels of ketones in your urine. You can check your ketone levels with a simple drugstore urine test. Diabetic ketoacidosis, which is relatively rare with type 2 diabetes, can be prevented by regularly checking for ketones, particularly when you're sick. Symptoms of diabetic ketoacidosis develop slowly, increase quickly, and can create an urgent medical situation. If you suspect you have diabetic ketoacidosis, call your doctor immediately and go directly to the emergency room.

Hyperosmolar hyperglycemic nonketonic syndrome (HHNS). HHNS occurs you’re your blood sugar level is extremely high — greater than 600 mg/dL. It’s most common in older people with type 2 diabetes and develops over days or weeks, especially after an illness or infection. The high level of sugar in your blood makes it thick and syrupy, and your body will work to rid itself of excess sugar by passing it through your urine. If you don’t drink enough liquid, you run the risk of dehydration, and HHNS can also lead to a seizure, a coma, or death. Warning signs of HHNS include a dry mouth, extreme thirst, a fever greater than 101° F, drowsiness, confusion, vision loss, hallucinations, weakness on one side of your body, and dark urine. The best way to prevent HHNS is to check your blood sugar level regularly, and more often when you’re sick. If warning signs begin to appear, drink liquids at least every hour and call your doctor or 911.

Follow your doctor's recommendations about how often to check your blood sugar level. In general, Melissa Li-Ng, MD, an endocrinologist at the Cleveland Clinic in Ohio, advises people who take diabetes medication to check their blood sugar once a day, and if you're on insulin, check it three times a day before each meal. Monitoring your blood sugar closely can help you prevent serious diabetes complications from developing.