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, so many people are unsure about the actual diabetes symptoms in women.
The full picture of diabetes in South Africa is complicated and grim. First of all, non-communicable diseases have surpassed HIV/Aids and TB to become the leading cause of death since 2010. Leading the charge firmly? Diabetes. According to Statistics South Africa’s latest Mortality and Causes of Death report, which evaluates data from 2001 to 2022, diabetes is listed as the number one cause of death for 2022, taking second place from 2020 to 2021 only because of Covid-19.
Diabetes also disproportionately affects women more than men. The Stats SA report also lists how the sugar-linked disease killed more women than men over three years, indicating that women are worse off in terms of health outcomes. The worst part? Despite these scary statistics, South Africa lacks an integrated system to properly track diabetes cases. This means that the numbers listed could be far higher, which many experts suspect. According to one estimate, over half of diabetes patients aged 20-79 are undiagnosed. And, unless you’re aware of the diabetes symptoms, you may not take action until it’s too late.
Back up – remind me what diabetes is again
Diabetes isn’t just one disease. There are actually three types of diabetes: type 1, type 2, and gestational diabetes. They’re all intrinsically linked to insulin, a hormone that shuttles sugar from the blood and into cells, where it can be turned into fuel.
Type 1 is the less common form. It occurs when the body doesn’t create enough insulin, making it an autoimmune condition in which the body can’t regulate its sugar supply.
Gestational diabetes occurs in pregnant women; it usually goes away after you give birth, but it can increase your likelihood of developing type 2 diabetes later on, according to the US National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK).
Type 2 diabetes is the most common and is largely self-inflicted. It happens when the body is unable to adequately use the sugar supply because insulin isn’t working well. In the long term, untreated diabetes can erode organs and could become life-threatening. It could lead to heart attack, stroke, kidney failure and nerve damage.
All three types of diabetes can easily be detected through a blood test. The test, essentially, checks to see if your blood glucose (a.k.a. blood sugar) is too high. But be warned: You can’t diagnose yourself—not even with an OTC blood glucose meter, per the NIDDK.
Unfortunately, many people are walking around undiagnosed because the diabetes or pre-diabetes symptoms are super-subtle, says Dr Poorani Goundan, an endocrinologist at Boston Medical Center. These sneaky diabetes symptoms in women might indicate that it’s time to head into your doctor’s office for a test.
READ MORE: 10 Scarily Common Diabetes Myths That Can Put Your Health At Risk
1. You have to pee all the time.
When you have excess sugar coursing 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 having high-volume urine loss,” she explains.
If you notice you’re suddenly peeing a lot, and more often, for no real reason – especially if you’re waking up a few 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, dehydration is a very real possibility. The thirst happens because kidneys are working overtime to remove all that unprocessed sugar, which means you’re thirsty for water (to flush it out) and need to pee a lot (i.e., your body wants that 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 adds to their blood sugars,” Dr Goundan says. Signs of dehydration include dark-coloured urine, a drop in (water) weight and extreme thirst.
Sound familiar? Talk to your doc about this potential symptom of diabetes, especially if it occurs in tandem with lots of bathroom breaks.
3. Your breath smells awful.
Diabetes-related dehydration contributes to dry mouth and the bad breath that can accompany it. (After all, with dry mouth, there’s not enough spit to wash away bacteria and balance the pH in your mouth, says Dr Kellis.) That could feel like a sticky mouthfeel, and could even lead to issues like gum disease and infections.
What’s more, undiagnosed or uncontrolled diabetes can trigger ketosis, a process in which the body uses fat, rather than glucose, for energy. Ketosis releases a chemical byproduct called ketones, which can make your breath smell unpleasantly sweet or fruity, she says – sometimes it might even smell like acetone, since that’s a type of ketone. Unless you’re on a keto diet (which is designed to put you into ketosis), it’s worth talking to your doctor.
And, FYI: this diabetes symptom in women is more common than among men. If you’re not sure of your breath, look out for cracked lips, loose teeth, mouth sores and/or wider spaces in between teeth.
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4. Your vision’s getting increasingly blurry.
Blurry vision is a common – and often ignored – diabetes symptom in women. What does diabetes have to do with your vision? Dr Kellis explains that fluid can form in your eye’s lens as sugar levels increase (remember: fluid follows sugar).
A build-up of fluid in the eye blurs vision, causes nearsightedness, and sends many people to the optometrist for a new prescription for glasses or contacts. FYI: optometrists can actually detect symptoms of diabetes during eye tests.
Fortunately, getting your blood sugar levels under control can clear up blurred vision, she adds.
5. Your hands and feet fall asleep a lot.
Neuropathy – a condition characterised by numbness or weird sensations like pins and needles in your arms, legs, hands and feet – occurs in more than half of people with type 2 diabetes, according to a 2017 Diabetes Care review.
Why so common? Diabetes reduces blood flow to your extremities and, over time, damages your blood vessels and nerves, Dr Kellis says.
6. Your cuts and bruises take forever to heal.
Reduced sensation in your extremities makes you more prone to injuries. “You’re less likely to notice a cut because you can’t feel it, which means you’re less likely to take care of it and it’s more likely to get infected,” says Dr Goundan.
Then, once you do have an injury, uncontrolled diabetes can make it harder for your body to heal. “High blood sugars provide a good environment for bacteria to grow,” she says. That’s 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 defence against infection. “When you have high blood sugar, it’s like delaying your body’s army to go to the wound to heal it,” says Dr Kellis.
7. You’re losing weight… but aren’t trying to.
Unexplained weight loss can happen for lots of reasons, and diabetes is one of them. Dr Goundan explains that insulin helps your body move sugar from your blood to your cells, so when you have insulin resistance, you don’t get enough energy into your cells despite all that 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. “Weight loss can be pretty significant, sometimes 4.5 to 9 kilos.”
Generally, doctors recommend visiting the doc if you unintentionally lose between 5 to 10 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 effectively use that source of energy when you have diabetes, explains Goundan. (And diabetes-related dehydration can also bring on fatigue.)
Of course, there are tons of other reasons you could be feeling exhausted, including your diet, stress levels, and how much you’ve been sleeping.
Still, 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 sugars create an environment in your vagina that’s ripe for yeast infections. “Glucose is fuel for yeast. The more that’s around, the more they can multiply,” says Kellis.
If you’re having two to three yeast infections every few months or if the standard treatments just aren’t working, it’s time to see a doctor. “Once blood sugar is controlled, the frequency goes down,” says Goundan.
10. You’ve got weird dark spots on your skin.
Darkening skin around the nape of your neck, under your armpits, or even in your groin area 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 often in women with polycystic ovary syndrome (PCOS),” says Kellis, who notes that women with PCOS are at an increased risk of insulin issues. If you notice new dark spots on your skin, they’re worth checking out with your doctor.
READ MORE: Exactly How Much Do You Know About Prediabetes?
11. You feel really itchy all the time.
Those with diabetes often experience itching due to yeast infections (which can occur on the skin, too), dry skin, or poor circulation, according to the American Diabetes Association. If poor circulation is to blame, your legs will be the itchiest area.
Per the ADA, you can try to treat the itching yourself by limiting how much you bathe (especially in less humid climates), using soap with a built-in moisturiser, and remembering to apply lotion immediately after washing up.
This article was originally published on www.womenshealthmag.com and has been updated with new information.
