In brief

• Doctor Irina Starkova points to less obvious signals that may precede the typical symptoms of diabetes, such as thirst and persistent fatigue.
• Among warning signs she lists a growing waist circumference, drowsiness after meals, and darker, velvety skin changes on the neck, under the armpits, on the elbows, and under the breasts.
• She also mentions menstrual cycle disorders and polycystic ovaries in women, waking up at night to urinate, snoring with breathing pauses, and fluctuations in visual sharpness.
• These symptoms are nonspecific, and if they recur, the doctor recommends testing glucose and HbA1c.

Early symptoms

Diabetes can develop for years before thirst, frequent urination, and persistent fatigue appear. Starkova notes that even with a normal body weight, fat tissue surrounding internal organs can build up, so it is better to monitor waist circumference, not just body weight (Врач Старкова назвала скрытые признаки диабета | 360.ru – 360.ru) (Врач объяснила, как распознать скрытые признаки диабета - Газета | Новости – gazeta.press). The doctor considers a waist over 80 cm in women and over 94 cm in men to be an alarming value (Врач Старкова: увеличение живота может говорить о риске диабета - Рамблер/здоровье – rambler.ru).

Drowsiness and glucose fluctuations

After a meal, a marked drop in energy and difficulty continuing work may appear, which can be a signal to examine carbohydrate metabolism. A single such episode means nothing, but a recurring one requires checking carbohydrate metabolism. The doctor also describes trembling, irritability, and a strong craving for sweets 2–4 hours after eating, which according to her may indicate glucose level fluctuations.

Skin, urinary tract, and sleep

According to the doctor, a higher risk may also be indicated by darker, velvety areas of skin located on the neck, under the armpits, on the elbows, and under the breasts. She also includes persistent fungal infections, itching without a cause, and wounds that heal slowly. In women, menstrual cycle disorders, polycystic ovary syndrome, and recurring vaginal thrush should draw attention. Getting up two or more times at night to urinate, cramps, restless sleep, and snoring with breathing pauses may also warrant a consultation. The doctor links sleep apnea with insulin resistance, which according to her intensify each other.

Vision, feet, and oral cavity

Fluctuations in visual sharpness may be related to glucose levels, and burning, tingling, and a feeling of "cotton-like" feet are sometimes observed already in the prediabetic stage. Starkova also lists dry mouth, an unusual taste, and gum bleeding as possible symptoms.

What next

All of these symptoms are nonspecific and may have other causes. If they recur, it is worth going to a doctor for glucose and HbA1c testing.