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Warning Signs of Diabetes

In 2021, the Center for Disease Control and Prevention reported there were 37.3 million adults and children in the United States, or 11.3% of the population, who had diabetes. About one in five do not know they have diabetes.Further, 96 million American adults, greater than one in three, have pre-diabetes. a condition that if not treated often leads to type 2 diabetes within five to 10 years. This makes up 38% of the US population. How can a person determine if they are likely to develop or even have this disease? Diabetes is a serious disease that can result in disabling complications. Early diagnosis is critical for the prevention of complications and for living a long healthy life.3

Are you or a family member at risk for diabetes?

If you think you may be at risk for diabetes, answer the short seven questions below to find out. Write in the points next to each statement that is true for you. If the statement is not true for you, write in a 0. At the end, add up your points to learn your total score and compare it to the scoring section further down the page.

  1. My weight is equal to or above what is listed in the chart below. [Add 5] _____
  2. I am under 65 years of age and I get only a little or no exercise each day. [Add 5] _____
  3. I am between 45 and 64 years of age. [Add 5] _____
  4. I am 65 years of age or older. [Add 9] _____
  5. I am a woman who has had a baby weighing more than nine lbs. at birth. [Add 1] _____
  6. I have a sister or brother with diabetes. [Add 1] _____
  7. I have a parent with diabetes. [Add 1] _____


Height in feet and inches, and weight (without shoes or clothes).

4′ 10″ – 129 lbs

4′ 11″ – 133 lbs

5′ 0″ – 138 lbs

5′ 1″ – 143 lbs

5′ 2″ – 147 lbs

5′ 3″ – 152 lbs

5′ 4″ – 157 lbs

5′ 5″ – 162 lbs

5′ 6″ – 167 lbs

5′ 7″ – 172 lbs

5′ 8″ – 177 lbs

5′ 9″ – 182 lbs

5′ 10″ – 188 lbs

5′ 11″ – 193 lbs

6′ 0″ – 199 lbs

6′ 1″ – 204 lbs

6′ 2″ – 210 lbs

6′ 3″ – 216 lbs

6′ 4″ – 224 lbs

If you scored 3-9 points:

You are most likely at low risk for having diabetes at this time. Answer the questions again in 1-5 years, especially if you are Hispanic/Latino, African American, Native American, Asian American, or Pacific Islander. These groups of people have a high risk of developing diabetes.

If you scored 10 or more points:

You have a greater risk of having diabetes. Ask your doctor about getting tested at your next visit.

Why should you be concerned about diabetes if you are likely to develop it?

Diabetes is a silent yet serious, chronic disease that can lead to blindness, heart attacks, devastating strokes, amputations, and kidney failure.4 It is possible to delay or prevent these complications by managing your daily activities of eating, activity, and medications if needed. If you are at risk for diabetes or if you are over 45 years of age, have your doctor test you for it every year. Usually, there are no symptoms of diabetes until a person’s blood sugar is over 250 or even 500. This is the main reason why approximately one-third of the people in the United States who have this disease don’t even know they have it.

If you are at risk for developing diabetes, what symptoms should you watch for?

Some of the common symptoms of diabetes are extreme thirst and dry mouth, frequent urination, especially during the night, unexplained fatigue, numbness and tingling in toes or feet, frequent infections, blurry vision, and unexplained weight loss.These symptoms are the classic symptoms of diabetes because they are the most frequent symptoms that people experience. Type 2 diabetes takes many years to develop, possibly up to 20 years. There are no early warning signs of type 2 diabetes. By the time symptoms are present, the person has already had type 2 diabetes for several years.

Other symptoms include headaches, gum disease, dizziness, forgetfulness, and shakiness. Again, many people do not experience symptoms but find out they have diabetes when they have routine blood work done.

A closer look at the risk factors:

Are all people with excess body weight likely to develop Type 2 diabetes?

Excess body weight is frequently a risk factor for Type 2 diabetes. However, even more important is the body shape and how the fat is distributed on the body. Excess fat around the waist increases the risk of insulin resistance, which occurs more often in abdominal fat. This mid-body fat is not just located under the skin but is also distributed deep inside the abdominal cavity around the organs.

Insulin resistance is defined as body cells, especially fat cells, not responding effectively to insulin. The role of insulin is to carry blood sugar from the blood into body cells. When body cells ignore insulin, the pancreas works harder to make more insulin to keep the blood sugar as close to normal as possible. After years of the pancreas producing higher and higher levels of insulin, the pancreas becomes unable to make as much insulin and blood glucose rises to abnormally high levels.6

Family history of diabetes

Having a parent, brother, or sister with diabetes increases the risk for Type 2 diabetes. Many people say they don’t know anyone in their family with diabetes. However, diabetes can skip generations before showing up again. It is always possible that a family member with diabetes has not been diagnosed yet or a deceased family member was never diagnosed.

What makes women who have given birth to a nine-pound baby more at risk?

Pregnancy has been found to be associated with insulin resistance. The hormones produced during pregnancy cause insulin to be sluggish leading to slightly elevated or even high blood sugar during pregnancy. The mother’s blood sugar crosses the placental barrier making the developing baby’s blood sugar the same or close to the same level as the mother’s blood sugar. The mother’s insulin does not cross the placental barrier.

At 13 weeks of pregnancy, the baby’s pancreas begins making insulin. If the baby’s blood sugar is abnormally high, the baby’s body produces excess insulin to keep the blood sugar as close to normal as possible. This excess insulin leads to a large baby with excess body fat. Women who have given birth to a large baby should be tested for diabetes every year. The high blood sugar usually improves or normalizes after the baby is born but the insulin resistance continues. It is likely for Type 2 diabetes to result in five to 15 years.7

What is the connection between a sedentary lifestyle and Type 2 diabetes?

A sedentary lifestyle is described as not being active enough to burn the calories that have been eaten. The amount of food eaten should be balanced with activity to use the calories. Eating more calories than are burned causes weight gain, which leads to insulin resistance and diabetes.

How is diabetes diagnosed?

Diabetes is diagnosed by laboratory blood tests ordered by a physician. Three types of blood tests can be used to diagnose diabetes. The first type is a fasting blood sugar. Fasting means that you do not eat or drink any food or drinks except water for eight to 12 hours before the test is performed. Usually, this test is done in the early morning before the first meal of the day. A fasting blood sugar result of 126 mg/dL or higher means that diabetes is present. The second type of blood test is called a random blood test. A person can take this test any time of day after they have eaten. A random blood sugar result of 200 mg/dL or higher indicates that the person has diabetes.

The third and final type of blood test is a two-hour glucose tolerance test. Three blood tests are drawn for this diagnostic test. The first is a fasting blood sugar. Then the person is asked to drink a very sweet drink that usually contains 50, 75, or 100 grams of fast-acting carbohydrates. Their blood is drawn again in one hour and at two hours after drinking the sweet drink. All three blood tests are reviewed to determine if the person has diabetes or not.  Diabetes is present if the fasting blood sugar is 126 mg/dL or higher or either the one-hour or the two-hour blood sugar test is 200 mg/dL or higher.8


Diabetes is a preventable but serious disease that is increasing at an alarming rate. Currently, there is more research being done regarding diabetes than ever before. Since 1995, the treatment for diabetes has been rapidly improving in the United States. A healthy lifestyle is the number one treatment for diabetes. Medications are also available when needed. The diagnosis of diabetes is not a death sentence. The serious complications that frequently happen with diabetes are not due to chance or fate. Rather, diabetes can be controlled instead of diabetes controlling people.

Debbie Clausen writes from Southern California.

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About Debbie Clausen RN, MSN, FNP, CDE, BC-ADM

Debbie Clausen RN, MSN, FNP, CDE, BC-ADM

writes from Southern California.

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