Symptoms of Diabetes: Early Signs & When to Test

Symptoms of Diabetes:10 Early Warning Signs You Should Not Ignore

By Naeem Mustafa, Registered Pharmacist | PharmaServePk. Updated October 2026.

Diabetes is one of the most common long-term conditions in Pakistan, and one of the most often missed. Many people live with high blood sugar for years before a diagnosis, because the early symptoms are mild and easy to blame on stress, age or a busy life. This guide explains the early warning signs of diabetes, how type 1 and type 2 differ, who should get tested, and when you need urgent medical care. As a pharmacist with 25 years in the pharmaceutical field, my advice is simple: do not guess, get a blood test.

What Is Diabetes?

Diabetes mellitus is a condition in which the level of glucose (sugar) in the blood stays too high. Insulin, a hormone made by the pancreas, moves glucose from the blood into your cells to be used for energy.

• Type 1 diabetes: The body makes little or no insulin.
• Type 2 diabetes: The body does not respond properly to insulin (insulin resistance) and, over time, may not make enough.
• Gestational diabetes: high blood sugar that first appears during pregnancy.

When glucose stays high, it slowly damages blood vessels and nerves. That damage is what causes symptoms, and it is also why untreated diabetes leads to serious complications.

10 Common Symptoms of Diabetes

1. Frequent urination. When blood sugar is high, the kidneys try to remove the extra glucose through urine. You pass more urine than usual, often waking at night to go.
2. Excessive thirst. Losing so much fluid leaves you dehydrated, so you feel thirsty even after drinking.
3. Increased hunger. Your cells cannot get enough glucose, so the body keeps sending hunger signals, even soon after a meal.
4. Unexplained weight loss. When the body cannot use glucose, it starts burning fat and muscle. This is most common in type 1 diabetes but can also happen in type 2.
5. Constant tiredness. Cells that cannot use glucose properly leave you feeling weak and exhausted.
6. Blurred vision. High sugar levels cause fluid shifts in the lens of the eye, so your sight may go in and out of focus.
7. Slow-healing cuts and wounds. High glucose affects circulation and the immune response, so even small wounds take longer to heal.
8. Frequent infections. Repeated skin infections, gum disease, urinary tract infections, and fungal infections with genital itching can all be signs.
9. Tingling, numbness or burning in the hands and feet. This points to nerve damage (neuropathy) caused by long-standing high sugar.
10. Dark, velvety patches of skin on the neck, armpits or groin. This is called acanthosis nigricans and is a common sign of insulin resistance.

Having one of these symptoms does not mean you have diabetes, because other conditions can cause them too. But if you notice two or more, especially together, ask your doctor for a blood sugar test.

Type 1 vs Type 2 Diabetes: How the Symptoms Difference

Feature	Type 1 diabetes	Type 2 diabetes
Onset	Sudden, over days or weeks	Gradual, often over years
Usual age	Children, teenagers and young adults, but it can occur at any age	Mostly adults, but increasingly seen in younger people
Weight loss	Common and marked	Less common
Main cause	Immune system destroys insulin-producing cells	Insulin resistance linked to weight, inactivity and genetics
Treatment	Insulin is always required	Lifestyle changes, tablets, sometimes insulin
Symptoms missed?	Rarely	Often

Why Many People Have No Symptoms

Type 2 diabetes can be completely silent for years. Many people discover it only during a routine test, or when a complication appears, such as a foot ulcer that will not heal or a change in vision. This is why screening matters. Waiting for obvious symptoms means the damage may already have started.

Who Is at Higher Risk?

You should be especially alert if any of the following apply to you:

• You are overweight, especially with extra fat around the waist
• A parent, brother or sister has diabetes
• You are over 35 years of age
• You are physically inactive
• You have high blood pressure or high cholesterol
• You have polycystic ovary syndrome (PCOS)
• You had gestational diabetes, or gave birth to a baby weighing more than 4 kg

South Asians, including Pakistanis, tend to develop type 2 diabetes at a lower body weight and younger age than many other populations. The International Diabetes Federation estimated that Pakistan had more than 30 million adults with diabetes in 2021, one of the highest numbers in the world. Check the latest IDF Diabetes Atlas for the most recent figures.

Emergency Warning Signs: 

Very high blood sugar with a lack of insulin can cause diabetic ketoacidosis (DKA), A life-threatening emergency that is often seen in people with undiagnosed or poorly controlled type 1 diabetes. Seek emergency care if someone has:

• Nausea, vomiting or stomach pain
• Fruity-smelling breath
• Fast, deep breathing
• Extreme drowsiness or confusion
• Severe dehydration with very high blood sugar

Do not wait to see if it passes.

How Is Diabetes Diagnosed?

Diabetes is diagnosed with simple blood tests. Your doctor will usually repeat an abnormal result to confirm it. The commonly used cut-off values are:

Test	Normal	Prediabetes	Diabetes
Fasting blood glucose	Below 100 mg/dL	100 to 125 mg/dL	126 mg/dL or higher
HbA1c (3-month average)	Below 5.7%	5.7% to 6.4%	6.5% or higher
2-hour glucose tolerance test	Below 140 mg/dL	140 to 199 mg/dL	200 mg/dL or higher

Pre diabetes is an important warning stage. Blood sugar is higher than normal but not yet in the diabetes range, and this is the best time to act, because lifestyle changes can often prevent or delay type 2 diabetes. Only a doctor can diagnose diabetes. A home glucometer reading is a useful check, but it is not a diagnosis.

Complications of Untreated Diabetes

Over the years, uncontrolled blood sugar can damage almost every system in the body:

• Eyes: diabetic retinopathy, a leading cause of vision loss
• Kidneys: diabetic kidney disease, which can progress to kidney failure
• Nerves: numbness, pain and foot problems
• Heart and blood vessels: higher risk of heart attack and stroke
• Feet: ulcers and infections that heal poorly and may lead to amputation

The encouraging fact is that good blood sugar control, blood pressure control and regular check-ups greatly reduce these risks.

What to Do If You Notice These Symptoms

1. See a doctor and get tested. A fasting glucose or HbA1c test is quick and inexpensive.
2. Do not start or stop medicines on your own. Metformin, sulfonylureas and insulin must be prescribed and monitored. Never copy another person's diabetes medicine.
3. Write down your symptoms. Note when they started, any weight change, and your family history, so your doctor can assess you faster.
4. Start healthy habits now. You do not need to wait for a diagnosis to eat better and move more.

Prevention and Daily Habits That Help

Research from the Diabetes Prevention Program found that moderate weight loss and regular activity reduced the risk of developing type 2  diabetes by more than half in high-risk adults. Practical steps include:

• Aim for at least 150 minutes of brisk walking or similar activity every week
• Reduce sugary drinks, sweetened tea and sweets, and watch portions of white rice and roti
• Add vegetables, lentils, beans and whole grains to your meals
• Lose 5% to 7% of body weight if you are overweight
• Sleep 7 to 8 hours and manage stress
• Do not smoke

For food ideas, see our diabetes meal plan.

Common Myths About Diabetes

• "Eating sugar causes diabetes." Sugar alone does not cause it, but excess calories, weight gain and inactivity raise the risk of type 2 diabetes.
• "Only older or overweight people get it." Type 1 can start in childhood, and slim people can have type 2 as well.
• "Diabetes is contagious." It is not.
• "If I feel fine, my sugar is fine." Many people with high blood sugar feel normal for years.

Frequently Asked Questions

What are the first signs of diabetes? The earliest signs are usually frequent urination, increased thirst, tiredness and blurred vision. In type 2 diabetes they can be so mild that they go unnoticed.

Can diabetes be reversed? Type 2 diabetes can go into remission in some people through significant weight loss and lifestyle change, but it needs ongoing monitoring. Type 1 diabetes cannot be reversed and always needs insulin.

At what age should I get tested for diabetes? Many guidelines recommend testing from age 35, and earlier if you are overweight or have other risk factors such as a family history.

Can diabetes symptoms come and go? Yes. Symptoms may be more noticeable when your blood sugar is very high and may ease when it falls, so a symptom-free day does not rule out diabetes.

Should I fast for Ramadan if I have diabetes? This depends on your treatment and control. Speak to your doctor before Ramadan so your medicines and monitoring can be adjusted safely.

The symptoms of diabetes can be easy to dismiss, but early testing makes a big difference. If you notice constant thirst, frequent urination, unexplained weight loss, blurred vision or slow-healing wounds, or if you have risk factors, arrange a blood test this week. Early diagnosis, the right treatment and healthy daily habits can help you live a long, active life with diabetes.

Medical disclaimer: This article is for general education only and is not a substitute for professional medical advice, diagnosis or treatment. Always consult a qualified doctor about your health.

References

• American Diabetes Association: Standards of Care in Diabetes
• International Diabetes Federation: IDF Diabetes Atlas
• World Health Organization: Diabetes fact sheet
• National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK)
• Diabetes Prevention Program Research Group, New England Journal of Medicine, 2002