When to seek urgent help
Go to the emergency department if someone with high blood sugar has vomiting, deep rapid breathing, breath smelling sweet or of nail polish, or increasing drowsiness and confusion. Those suggest a diabetic emergency. Equally, sweating, shakiness and confusion in someone on diabetes medication may be low blood sugar — give something sugary immediately and get help.
When to seek urgent help
The situations above. Also come in the same day for a foot ulcer, or a foot that has become red, swollen, hot or is discharging — diabetic foot infections escalate fast.
The classic symptoms
- Passing urine more often, particularly getting up at night
- Unusual thirst that is not satisfied
- Tiredness out of proportion to what you have been doing
- Unexplained weight loss, despite eating normally or more
- Blurred vision, which can fluctuate
- Slow-healing cuts and wounds
- Recurrent infections — skin, gum, urinary or fungal
Symptoms people dismiss
These are the ones that get attributed to age, work or the weather:
- Tingling or numbness in the feet, often described as pins and needles or burning at night. This is nerve involvement and is not an early symptom — it suggests sugar has been raised for a while
- Itching, particularly in the groin, and recurrent fungal infection
- Slow recovery from ordinary illness
- Erectile difficulty, which is a common and under-reported early presentation in men
- Recurrent urinary infection in women
- Dark, velvety skin in the neck folds or armpits, which suggests insulin resistance
Why type 2 is often silent
Blood sugar rises gradually. The body adapts, and the symptoms above are individually unremarkable — so they get explained away for years while the raised sugar quietly affects blood vessels, kidneys, eyes and nerves.
That is the entire argument for testing rather than waiting: by the time symptoms are obvious, damage has often begun. It is also why nerve tingling at diagnosis is a common finding rather than an early warning.
Who should be tested
Get tested if you have any of the symptoms above, or if any of these apply even with no symptoms at all:
- Aged 30 or over, particularly with a family history of diabetes
- Overweight, especially carrying weight around the abdomen
- A parent or sibling with diabetes
- Previous gestational diabetes, or a baby over about 4 kg
- Polycystic ovary syndrome
- High blood pressure or abnormal cholesterol
- A previous borderline or "pre-diabetic" result
People of South Asian origin develop type 2 diabetes at a lower body weight and a younger age than many other populations. Weight thresholds borrowed from Western guidance understate the risk here, which is a reason to test earlier rather than a reason for fatalism.
What the tests are
Simple, quick and inexpensive:
- Fasting blood glucose — after eight hours without food
- HbA1c — reflects average blood sugar over roughly three months, and needs no fasting
- Glucose tolerance test — occasionally, where the picture is unclear
A single borderline result usually gets repeated rather than acted on immediately.
What happens if it is diabetes
It is a manageable condition, and that is not a platitude. What causes harm is years of uncontrolled sugar, not the diagnosis itself.
Treatment starts with diet and activity — which in early type 2 diabetes can be genuinely powerful, sometimes returning blood sugar to a normal range — alongside medication where needed, and regular screening of kidneys, eyes and feet.
Full detail on our diabetes page. If you have never been tested and several of the risk factors above apply, a preventive health checkup covers blood sugar along with blood pressure and cholesterol.
This page is general health information, not medical advice. It cannot account for your history, medication or test results. Please speak to a qualified doctor about your own symptoms and treatment. If you think you are having a medical emergency, seek immediate help.