Experts are sounding the alarm about type 2 diabetes in South Africa as the complex disease has reached crisis levels in the country – and women are disproportionately affected. And yet many people are unsure about the actual symptoms of diabetes in women.
The overall picture of diabetes in South Africa is complicated and bleak. First, noncommunicable diseases have overtaken HIV/AIDS and tuberculosis to become the leading cause of death since 2010. Are you firmly at the top? Diabetes. According to Statistics South Africa’s latest mortality and cause of death report, which evaluates data from 2001 to 2022, diabetes is listed as the number one cause of death for 2022, second only to Covid-19 in 2020 to 2021.
Women are also disproportionately more likely to be affected by diabetes than men. The Stats SA report also lists that the sugar-related disease killed more women than men over a three-year period, suggesting that women fare worse in terms of health outcomes. The worst? Despite these frightening statistics, South Africa lacks an integrated system to properly track diabetes cases. This means the numbers listed could be far higher than what many experts suspect. One estimate suggests that more than half of diabetes patients ages 20 to 79 are undiagnosed. And if you’re unaware of diabetes symptoms, you may not be able to take action until it’s too late.
Back – remind me again what diabetes is
Diabetes is not just a disease. There are actually three types of diabetes: type 1, type 2 and gestational diabetes. They are all inextricably linked to insulin, a hormone that transports sugar from the blood into cells where it can be converted into fuel.
Type 1 is the rarer form. It occurs when the body does not produce enough insulin, leading to an autoimmune disease in which the body cannot regulate its sugar supply.
Gestational diabetes occurs in pregnant women; According to the U.S. National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK), it usually goes away after birth, but may increase your chances of developing type 2 diabetes later.
Type 2 diabetes is the most common and mostly self-inflicted disease. This happens when the body cannot adequately use the sugar reserves because insulin is not working properly. In the long term, untreated diabetes can lead to organ damage and become life-threatening. It could lead to heart attack, stroke, kidney failure and nerve damage.
All three types of diabetes can be easily detected through a blood test. The test essentially checks whether your blood sugar (also known as blood sugar) is too high. But be warned: According to the NIDDK, you cannot self-diagnose – even with an OTC blood glucose meter.
Unfortunately, many people go around unrecognized because the symptoms of diabetes or prediabetes are very subtle, says Dr. Poorani Goundan, an endocrinologist at Boston Medical Center. These secret diabetes symptoms in women could be a clue that it’s time to go to the doctor’s office for a test.
READ MORE: 10 shockingly common diabetes myths that can put your health at risk
1. You have to pee all the time.
When excess sugar flows through your bloodstream, your body instinctively tries to get rid of it, says endocrinologist Dr. Mary Vouyiouklis Kellis. “Water follows sugar, so you end up with a lot of urine loss,” she explains.
If you notice that you’re suddenly peeing a lot and more frequently for no real reason — especially if you’re waking up multiple times during the night to go — it’s time to talk to your doctor, she says.
2. You never stop drinking water.
With all that peeing, there is a very real possibility of dehydration. The thirst occurs because the kidneys are working overtime to remove all the unprocessed sugar, meaning you’re thirsty for water (to flush it out) and have to pee a lot (i.e. your body wants the sugar to leave the party).
And to make matters worse, “Some patients who don’t know they have diabetes quench their thirst with sugary drinks like soda or juice, which increases their blood sugar levels,” says Dr. Goundan. Signs of dehydration include dark-colored urine, a drop in (water) weight and intense thirst.
Does this sound familiar? Talk to your doctor about this potential diabetes symptom, especially if it occurs along with lots of bathroom breaks.
3. Your breath smells terrible.
Diabetes-related dehydration contributes to dry mouth and the associated bad breath. (After all, with dry mouth, there isn’t enough spit to wash away bacteria and balance the pH in the mouth, says Dr. Kellis.) This could feel like a sticky mouth feeling and could even lead to problems like gum disease and infections.
Additionally, undiagnosed or uncontrolled diabetes can trigger ketosis, a process in which the body uses fat instead of glucose for energy. Ketosis releases a chemical byproduct called ketones, which can cause your breath to smell unpleasantly sweet or fruity, she says—sometimes it even smells like acetone, since it’s a type of ketone. Unless you’re on a keto diet (which is designed to put you into ketosis), it’s worth speaking to your doctor.
And FYI: This diabetes symptom is more common in women than in men. If you are unsure about your breathing, look for cracked lips, loose teeth, mouth sores, and/or larger gaps between your teeth.
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4. Your vision becomes increasingly blurry.
Blurred vision is a common – and often ignored – diabetes symptom in women. What does diabetes have to do with your vision? Dr. Kellis explains that as sugar levels rise, fluid can form in the lens of the eye (remember: fluid follows sugar).
A buildup of fluid in the eye impairs vision, causes nearsightedness, and leads many people to go to the optician to get a new prescription for glasses or contact lenses. FYI: Optometrists can actually detect symptoms of diabetes during eye tests.
Fortunately, controlling blood sugar levels can eliminate blurry vision, she adds.
5. Your hands and feet often fall asleep.
Neuropathy — a condition characterized by numbness or strange sensations such as tingling in the arms, legs, hands and feet — occurs in more than half of people with type 2 diabetes, according to a 2017 study by Diabetes Care.
Why so often? Diabetes reduces blood flow to your extremities and damages your blood vessels and nerves over time, says Dr. Kellis.
6. Your cuts and bruises take forever to heal.
Decreased sensation in your extremities makes you more susceptible to injury. “You’re less likely to notice a cut because you can’t feel it. This means you have less to worry about and a higher chance of infection,” says Dr. Goundan.
If you do have an injury, uncontrolled diabetes can make it difficult for your body to heal. “High blood sugar levels provide a good environment for bacteria to grow,” she says. This is because diabetes is also often accompanied by high blood pressure and high cholesterol, and the resulting plaque buildup can narrow blood vessels, reducing blood supply and leading to slow healing.
Diabetes can also weaken the T cells that make up your immune system – your body’s defense against infections. “When you have high blood sugar, it’s like delaying your body’s army from going to the wound to heal it,” says Dr. Kellis.
7. You’re losing weight, but you’re not trying.
Unexplained weight loss can have many reasons, and diabetes is one of them. Dr. Goundan explains that insulin helps your body move sugar from your blood into your cells. So if you have insulin resistance, you don’t get enough energy into your cells even though there’s a lot of sugar flowing through your body. “Because you’re unable to get enough energy from sugar, your body burns your own fat and muscle for energy,” says Dr. Kellis. “The weight loss can be quite significant, sometimes 10 to 20 pounds.”
In general, doctors recommend seeing a doctor if you unintentionally lose between five and ten percent of your body weight over the course of six months.
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8. You get enough sleep, but you’re still so tired.
Carbohydrates, which your body breaks down into glucose, are your body’s main source of energy. But your body can’t use this energy source effectively if you have diabetes, explains Goundan. (Dehydration caused by diabetes can also cause fatigue.)
Of course, there are many other reasons why you may feel exhausted, including your diet, your stress levels, and how much sleep you’ve slept.
However, if you can’t think of any other good reason for your extreme fatigue and your low energy levels are accompanied by some of these other diabetes symptoms, it’s worth getting checked out.
9. You get a surprising number of yeast infections.
High blood sugar levels create an environment in your vagina that is susceptible to yeast infections. “Glucose is the fuel for yeast. The more there is, the more they can multiply,” says Kellis.
If you’re having two to three yeast infections every few months or standard treatments just aren’t working, it’s time to see a doctor. “Once blood sugar levels are under control, the frequency goes down,” says Goundan.
10. You have strange dark spots on your skin.
Darkening skin on the neck, armpits, or even groin is a surprising and common early sign of insulin resistance, the precursor to diabetes – the medical name for the condition is acanthosis nigricans (AN).
“We see this frequently in women with polycystic ovary syndrome (PCOS),” says Kellis, who notes that women with PCOS are at increased risk for insulin problems. If you notice new dark spots on your skin, you should check with your doctor.
READ MORE: How much exactly do you know about prediabetes?
11. You constantly feel intense itching.
According to the American Diabetes Association, diabetics often experience itching due to yeast infections (which can also appear on the skin), dry skin, or poor circulation. If poor circulation is the cause, your legs are the most itchy area.
According to the ADA, you can try to treat the itching yourself by limiting the amount of bathing you do (especially in less humid climates), using soap with built-in moisturizer, and remembering to apply lotion immediately after washing off.
This article was originally published on Women’s Health US. Additional reporting added from the Women’s Health SA team.
