What Are the Signs of Diabetes? 22 Red Flags for Older Adults

Diabetes is a serious condition that affects people from childhood on up. I have personal knowledge about this because my husband was diagnosed, and I also had a diabetic cat. 

I noticed that my former cat was drinking excessively, and his litter box looked like a river ran through it. I took him to the vet, and the vet performed some tests and found out he had diabetes. From there, we learned how to give him insulin and what to watch for in his behavior that would show if his blood glucose was too low or too high. We had some scares with him being hypoglycemic, but most of the time we had it under control.

My husband was a big surprise. He never complained of any issues, and I didn’t notice any changes in him or his habits before he received the diagnosis. That was almost a year ago, and he has made great strides since. Unlike our cat, he does not need insulin and is only on medication. 

I will not lie. At the beginning of both these scenarios, it was stressful. I was obsessed with both of them and felt overwhelmed all at the same time. However, with time and education, things have become easier.

I know this disease well. We see lots of information about what to look for in children and young adults, but what about older adults? Well, here are some signs to watch out for.

1. Increased Thirst/Urination

Excessive thirst and urination are some of the earliest and most noticeable signs of diabetes. When there is an excess of glucose buildup in your body, it causes your kidneys to overwork. As your kidneys work to flush out this excess glucose, they pass it into your urine, which also draws fluids from your body. In doing this, you become more thirsty and urinate more from drinking so much.

Why This Happens:

• Glucose buildup in the blood – High levels of glucose send the kidneys into overdrive, trying to rid the body of excess sugar by flushing it out through urine.
• Fluid imbalance – As glucose escapes into urine, it pulls water with it, leaving your body needing more hydration.
• Chain reaction – The loss of fluids increases thirst, and excessive drinking leads to more urination, creating a cycle of dehydration.

When to See a Doctor:

If you’re experiencing unexplained, persistent thirst or needing to urinate more than usual, it’s important to speak with your healthcare provider. These could be signs of diabetes or other conditions that warrant medical attention.

2. Excessive Fatigue

One of the most challenging symptoms of diabetes is ongoing fatigue. If you find yourself feeling sluggish or unusually tired, it might be because your body is struggling to convert glucose into energy. When your blood sugar levels are high, your body’s cells can’t properly absorb glucose, leaving you low on energy. On top of that, diabetes-related dehydration can make the problem even worse.

Why This Happens:

• Glucose conversion issues – Instead of being used for energy, glucose stays in your bloodstream, leaving your cells “starved.”
• Dehydration – High blood sugar levels lead to frequent urination, which can deplete your body’s fluids and reduce energy levels.
• Inflammation and stress – Chronic high blood sugar can cause inflammation in the body, which also contributes to feelings of fatigue.

When to See a Doctor:

If your tiredness feels overwhelming or interferes with your daily activities, talk to your doctor.

3. Wounds That Heal More Slowly

If you’re an older adult with diabetes, you’ve likely noticed that cuts, scrapes, or other wounds take longer to heal. This happens because high blood sugar affects your body’s ability to repair itself. Elevated glucose levels can weaken your circulation, meaning less oxygen and nutrients reach the affected area. On top of that, diabetes compromises your immune function, making you more prone to infections like skin sores or foot ulcers. For females with diabetes, the risk is even higher for bladder infections and vaginal yeast infections.

Why This Happens:

• Poor circulation – High blood sugar can narrow blood vessels, reducing blood flow to wounds and slowing the healing process.
• Weakened immunity – Diabetes weakens the immune system, making it harder for your body to fight off bacteria and infections.
• Damaged nerves – Nerve damage, or neuropathy, often associated with diabetes, can mean you don’t notice a wound until it has worsened.

When to See a Doctor:

• If you notice a wound that isn’t healing, or one that seems to worsen over time.
• Seek medical attention for any sign of infection, such as redness, swelling, warmth, or discharge from a wound.
• For women, recurring yeast or bladder infections should be discussed with a doctor.

4. Dizziness and/or Fainting

For some older adults with diabetes, episodes of dizziness, fainting, or general weakness can be warning signs of hypoglycemia (low blood sugar). Hypoglycemia happens when blood glucose levels drop below 70 mg/dL, which can leave your body without enough energy to function properly. This drop in blood sugar often triggers symptoms such as confusion, shakiness, and, in severe cases, fainting.

Why This Happens:

• Insufficient glucose in the blood – When your blood sugar drops too low, your brain and muscles don’t get the energy they need to operate effectively.
• Medicine-related dips – Some diabetes medications, including insulin, can lower blood sugar too much.
• Delayed meals – Skipping meals or going too long without eating can cause a steep decline in blood sugar levels.

When to See a Doctor:

• Seek medical advice if dizziness, fainting, or hypoglycemia episodes occur frequently.
• If you experience severe episodes of confusion or fainting, contact your healthcare provider immediately.

5. Headaches

Headaches can often be an indication that something isn’t quite right, especially for older adults with diabetes. Our brains rely on a steady supply of glucose to function properly. However, diabetes can cause dips and spikes in blood sugar, which disrupt this balance. When blood sugar drops too low (hypoglycemia), it can trigger headaches, but high blood sugar (hyperglycemia) can cause them too.

Why This Happens:

• Low blood sugar (hypoglycemia) – When blood glucose dips, your brain may not get the energy it needs, resulting in pain or discomfort.
• High blood sugar (hyperglycemia) – Elevated glucose levels can lead to dehydration, which often causes headaches.
• Fluctuations – Sudden and frequent changes in blood sugar levels can stress the body, leading to vascular changes and headache pain.

When to See a Doctor:

If headaches are frequent, severe, or persistent.

6. Tingling Sensations in Hands and Feet

Tingling, numbness, or pain in your hands and feet can mean diabetic neuropathy, a type of nerve damage caused by long-term high blood sugar. This condition often starts subtly, with mild tingling or a “pins and needles” feeling, but it can progress to more noticeable pain, weakness, or even a loss of sensation.

Why This Happens:

• High blood sugar damages nerves – Prolonged exposure to elevated glucose can harm the tiny blood vessels that supply your nerves.
• Reduced circulation – Poor blood flow, common with diabetes, can worsen nerve damage and lead to further discomfort.
• Nerve sensitivity – Damaged nerves may send pain signals even in the absence of an actual injury, causing discomfort.

When to See a Doctor:

If you experience persistent tingling, pain, or burning in your extremities.

7. Gum Problems

Gum problems, often overlooked, can be a significant warning sign of diabetes. If you notice red, swollen, or painful gums, it might not just be a case of poor dental hygiene. These symptoms can point to gingivitis, a common gum condition that may signal uncontrolled blood sugar. Diabetes compromises your immune system, making it harder for your body to fend off infections, including those that affect your gums.

Why This Happens:

• Immune system weakness – High blood sugar impairs your body’s ability to fight off bacteria, which can lead to gum infections.
• Inflammation – Uncontrolled diabetes can increase inflammation throughout the body, including the gums, making them more prone to irritation and infection.
• Poor oral health connection: -Diabetes can decrease saliva production, leading to dry mouth, which can exacerbate gum issues.

When to See a Dentist or Doctor:

• If gum problems persist despite good oral hygiene.
• If severe pain, abscesses, or other symptoms like loose teeth appear.

8. Increased Appetite

Feeling unusually hungry, even after a large meal, might be more than just a strong appetite. This symptom, known as polyphagia, is a classic sign of diabetes. When your body doesn’t use insulin properly or produce enough of it, glucose can’t reach your cells where it’s needed for energy. Instead, it stays in your blood, leaving your body without the fuel it needs. Your brain responds by triggering hunger signals, causing you to eat more in an attempt to gain energy. Unfortunately, this can create a cycle where eating raises blood sugar, which may intensify cravings.

Why This Happens:

• Glucose starvation – Your cells are deprived of glucose, so your body requests more food to compensate for the energy shortage.
• Blood sugar highs and lows – Uncontrolled diabetes can cause spikes and crashes in glucose levels, which often trigger hunger pangs.
• Inefficient insulin response – Without proper insulin function, the food you eat doesn’t fully convert into the energy your body can use.

When to See a Doctor:

If increased appetite is frequent and accompanied by other symptoms like extreme thirst or weight loss.

9. Dry Mouth

Dry mouth is another potential warning sign of diabetes in older adults. This condition occurs when your body doesn’t produce enough saliva, leading to an ongoing feeling of dryness in the mouth. Saliva plays an important role in keeping your mouth comfortable, washing away bacteria, and aiding digestion. Without it, you may experience symptoms like dry, cracked lips or a rough sensation on your tongue.

Why This Happens:

• Elevated blood sugar – High glucose levels in the blood can reduce saliva production, leaving your mouth feeling dry.
• Dehydration – Diabetes can increase urination frequency, potentially leading to dehydration, which worsens dry mouth symptoms.
• Medications – Certain medications used to treat diabetes or other conditions may list dry mouth as a side effect.

When to Consult a Doctor or Dentist:

If your dry mouth becomes a persistent problem.

10. Blurry Vision

When your glucose is high, it can draw fluid out of the lenses of the eyes, which makes it difficult to focus. Because this symptom can cause new blood vessels to be created behind your retina, it can cause partial or complete vision loss. 

Why This Happens:

• Fluid imbalances – High glucose draws fluid from the eye lenses, disrupting their ability to focus.
• Retinal changes – Diabetes can damage tiny blood vessels in the retina. The body may respond by creating new blood vessels, which are fragile and prone to leaking. This can lead to vision loss or diabetic retinopathy.

Warning Signs to Watch For:

• Difficulty focusing or sudden changes in vision clarity.
• Spots, dark strings, or “floaters” in your field of vision.
• Dark or empty areas in your sight.
• Loss of central vision or complete vision in one or both eyes.

When to See a Doctor:

• If blurry vision persists or worsens.
• If you experience sudden vision changes or any vision loss.

11. Unexplained Weight Loss

Shedding pounds unexpectedly can be concerning, especially in older adults, and diabetes could be a key reason behind it. When your body doesn’t produce enough insulin or use it effectively, glucose can’t enter your cells to provide energy. Without this fuel, your body starts breaking down fat and muscle to generate energy, leading to weight loss even if you’re eating your usual amount of food. This type of sudden weight loss often happens in cases of undiagnosed or poorly controlled diabetes.

Why This Happens:

• Insulin dysfunction – Without enough insulin, glucose stays in your bloodstream rather than being used by your cells, leaving your body short on energy.
• Fat and muscle breakdown – To compensate for the energy shortage, your body breaks down stored fat and muscle, leading to weight loss.
• Dehydration – Increased urination can cause fluid loss, which may also register as weight loss.

Signs to Watch For:

• Noticeable, unintentional weight loss over a short period.
• Persistent fatigue or low energy despite eating normally.
• Increased thirst and frequent urination alongside weight changes.
• Weakness or muscle loss.

When to See a Doctor:

If you’ve lost more than 5% of your body weight in six months without trying.

12. Confusion

Feeling confused or having difficulty concentrating can be a significant, yet often underestimated, sign of diabetes in older adults. High blood sugar over time can damage blood vessels that supply oxygen to the brain. This lack of proper oxygen flow can impair cognitive function, leading to moments of mental fog or confusion.

Why This Happens:

• Blood vessel damage – Prolonged high glucose can harm the blood vessels that transport oxygen and nutrients to the brain.
• Hypoglycemia – When blood sugar drops too low, your brain doesn’t receive enough energy, which can lead to a foggy or disoriented feeling.
• Chronic inflammation – Diabetes can contribute to systemic inflammation in the body, increasing the risk of cognitive decline.

When to See a Doctor:

If confusion is frequent, prolonged, or paired with other symptoms like dizziness, excessive thirst, or blurry vision.

13. Depression

Depression is a common but often overlooked symptom of diabetes in older adults. Living with diabetes can be challenging, both physically and emotionally. The stress of managing the condition, combined with its impacts on overall health, can contribute to feelings of sadness, hopelessness, or withdrawal. Additionally, diabetes may directly influence brain function, making it harder to think clearly or regulate emotions, and this can worsen depression symptoms.

Why This Happens:

• Stress – Monitoring blood sugar, taking medications, and sticking to a treatment plan can feel overwhelming.
• Physical health impact – Complications from diabetes, such as fatigue or chronic pain, can lead to or exacerbate depression.
• Biological factors – Diabetes can alter hormone levels and brain function, which may affect mood regulation.

Common Signs of Depression in Older Adults:

• Persistent sadness or a low mood.
• Loss of interest in activities once enjoyed.
• Fatigue or low energy, even after resting.
• Difficulty concentrating or making decisions.
• Feelings of worthlessness or guilt.
• Changes in appetite, either eating more or less than usual.
• Trouble sleeping or sleeping too much.

14. Sexual Dysfunction

Sexual dysfunction, particularly in men, can be an early or ongoing sign of diabetes. High blood sugar can affect blood flow and nerve function throughout the body, including in the reproductive system. For men, this often manifests as erectile dysfunction (ED).

Why This Happens:

• Nerve damage – Over time, high glucose levels can damage the nerves that control sexual response.
• Poor blood circulation – Diabetes can affect blood vessel health, restricting blood flow.
• Hormonal changes – Men with diabetes might experience changes in testosterone levels, which can lower libido and energy.

When to See a Doctor:

If sexual dysfunction becomes frequent or significantly impacts your quality of life.

15. Nausea and Constipation

High blood glucose interferes with the normal functioning of the digestive system, sometimes slowing it down to the point of discomfort. These symptoms are usually a result of a condition called gastroparesis, which occurs when diabetes damages the nerves that control your stomach muscles.

Why This Happens:

• Nerve damage – High blood sugar over time can harm the nerves in the digestive tract, disrupting normal bowel movements and digestion.
• Dehydration – When elevated glucose causes frequent urination, you may become dehydrated, making constipation worse.
• Medication side effects – Some diabetes medications can contribute to nausea or bowel changes.

When to See a Doctor:

• If nausea or constipation becomes more frequent or severe.
• If you notice other symptoms like unexplained weight loss, vomiting, or abdominal pain.
• If your blood sugar levels are frequently out of range, as poor glucose control can worsen digestive symptoms.

16. Mood Swings

Changes in blood sugar levels, fatigue, and other diabetes-related factors can have a direct impact on emotional health. These swift shifts in mood can range from irritability and frustration to feelings of sadness or anxiety, often making day-to-day life more challenging.

Why This Happens:

• Blood sugar fluctuations – High or low glucose levels can directly affect brain function, causing sudden changes in mood.
• Fatigue – Persistent tiredness due to poorly controlled diabetes can make coping with emotions more difficult.
• Physical stress – Living with diabetes and managing its symptoms, like pain or frequent illness, can contribute to emotional distress.
• Hormonal imbalances – Diabetes can impact hormone levels, which play a role in regulating mood.

When to See a Doctor:

• If mood swings become severe or happen frequently.
• If you feel persistently anxious, sad, or overwhelmed.

17. Dark Patches of Skin

Dark patches of skin, often found in the creases of the neck, armpits, or groin, can be a lesser-known but significant sign of diabetes in older adults. These areas of discoloration, called acanthosis nigricans, may appear velvety or leathery, sometimes resembling soot that doesn’t wash off.

Why This Happens:

• Insulin resistance – When the body struggles to use insulin effectively, it can lead to changes in skin cells, resulting in darker pigmentation in certain areas.
• Excess insulin – High levels of insulin circulating in the bloodstream can stimulate skin cells to grow more rapidly, particularly in areas where folds and creases occur.
• Obesity and hormonal imbalances – Factors like being overweight or experiencing hormonal changes can also contribute to the development of these skin patches, which are strongly linked to type 2 diabetes.

When to See a Doctor:

• If you notice new or worsening dark patches on your skin.
• If these skin changes are accompanied by other symptoms of diabetes, such as fatigue, frequent urination, or excessive thirst.
• If the darkened patches start to itch or show other signs of irritation.

18. An Overabundance of Facial Hair or Acne

For some older adult women, diabetes can lead to noticeable and often frustrating physical changes, such as an overgrowth of facial hair or persistent acne. These symptoms are most likely caused by insulin resistance, a condition common in type 2 diabetes, which disrupts the balance of hormones in the body.

Why This Happens:

• Hormonal imbalance – Insulin resistance stimulates the production of male hormones like testosterone, which can lead to thick, coarse hair growth on the face, chest, or back and contribute to acne by increasing oil production in the skin.
• Chronic inflammation – Diabetes-related inflammation can exacerbate acne by making the skin more prone to redness, swelling, and irritation.

When to See a Doctor:

• If excessive facial hair growth or acne starts suddenly or worsens over time.
• If over-the-counter acne treatments or hair removal methods are ineffective.

19. Skin Tags

Skin tags are small, soft, benign growths that often appear in areas where the skin folds, such as the neck, eyelids, armpits, and groin. While they’re generally harmless and don’t cause pain, these tiny flaps of skin can sometimes be a sign of insulin resistance. Skin tags are more common among people with type 2 diabetes, obesity, or other conditions related to hormone imbalances.

Why This Happens:

• Insulin resistance – When the body becomes less effective at using insulin, it triggers growth factors that may encourage the formation of skin tags.
• Friction in skin folds – Skin-on-skin friction in areas like the armpits or groin can lead to the development of these soft, fleshy growths.
• Hormonal imbalances – Higher insulin or hormonal levels associated with diabetes can promote skin cell growth.

When to See a Doctor:

• If skin tags suddenly increase in quantity or size.
• If they become painful, bleed, or show signs of infection.

20. Hearing Problems

Hearing loss might seem like a typical part of aging, but when it occurs alongside diabetes, it can signal more than just getting older. Studies show that older adults with diabetes are twice as likely to experience hearing loss compared to those without diabetes. This connection stems from how high blood sugar levels impact the delicate structures of the ear, underscoring why hearing changes should never be overlooked.

Why This Happens:

• Damage to blood vessels and nerves – High blood sugar can harm small blood vessels and nerves in the inner ear, reducing the ability to pick up sound effectively.
• Chronic inflammation – Diabetes-related inflammation can further damage the auditory system, accelerating hearing loss.
• Reduced blood flow – Poor circulation caused by diabetes may deprive the inner ear of adequate oxygen and nutrients, compromising hearing over time.

When to See a Doctor:

• If you notice sudden or worsening hearing loss.
• If you experience ringing in your ears (tinnitus) alongside other diabetes symptoms.
• When hearing trouble disrupts your daily activities or social interactions.

21. Memory Problems

High blood sugar can lead to the buildup of plaques in the brain, disrupting the way nerve impulses are transmitted. Over time, this can contribute to difficulties with memory and cognitive function.

Why This Happens:

• Plaque buildup – Chronically high blood sugar can result in deposits in the brain, which interfere with communication between nerve cells.
• Reduced blood flow – Poor circulation caused by diabetes can deprive the brain of oxygen and nutrients, affecting memory and decision-making.

When to See a Doctor:

• If you or a loved one experiences persistent memory problems, confusion, or difficulty concentrating.
• If there are noticeable changes in problem-solving or decision-making abilities.
• When memory issues interfere with daily life and independence.

22. Joint Problems

Joint problems can be especially challenging for older adults with diabetes, as the condition can worsen arthritis and other joint-related issues. Diabetes not only increases inflammation throughout the body, but also contributes to nerve damage, which can make joint pain feel even more intense. Over time, these complications can reduce mobility, making it harder to stay active and manage the condition.

Why This Happens:

• Inflammation – Persistently high blood sugar can lead to chronic inflammation, which exacerbates joint pain and stiffness.
• Nerve damage – Neuropathy related to diabetes can make joint pain more severe and uncomfortable, especially in the feet, knees, and hips.
• Cartilage damage – Poor blood sugar control may also impact the health of cartilage, the tissue that cushions joints, leading to early wear and tear.

When to See a Doctor:

• If joint pain suddenly worsens or doesn’t improve with usual remedies.
• If you notice significant swelling, redness, or warmth around a joint.
• If joint stiffness limits your ability to perform daily activities.
• When neuropathy symptoms, like tingling or numbness, spread or intensify.

Diabetes in Older Adults

Our older loved ones are some of the most precious people in our lives. If you have an older relative or friend who is having any of these symptoms, offer to go with them to the doctor to be tested. It can be scary for older people when they think about developing a new health issue. They can get overwhelmed by just the thought and put it off. If they find out they have diabetes, offer to help them figure things out. Offer your help in attending their diabetes education classes, so you can understand the steps and be prepared for any potential emergencies. Check in with them daily to make sure they have checked their glucose and have taken their meds on time. If you need to, help them sort and organize their meds in a pill box so they know they have forgotten nothing. With a little help, love, and compassion, you can set up your loved one for success in navigating this new normal in their life.

This article is intended for informational purposes only and does not constitute medical advice. Always consult with a healthcare professional for personalized guidance and medical recommendations tailored to your individual needs.

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