Some people will have no symptoms before they are diagnosed with diabetes.

Others may notice these symptoms as the first signs of type 1 diabetes, or when the blood sugar is high:

• Feeling tired or fatigued
• Feeling hungry
• Being very thirsty
• Urinating more often
• Losing weight without trying
• Having blurry eyesight
• Losing the feeling or feeling tingling in your feet

For others, warning symptoms that they are becoming very sick may be the first signs of type 1 diabetes, or may happen when the blood sugar is very high (see: diabetic ketoacidosis):

• Deep, rapid breathing
• Dry skin and mouth
• Flushed face
• Fruity breath odor
• Nausea or vomiting, unable to keep down fluids
• Stomach pain

Low blood sugar (hypoglycemia) can develop quickly in people with diabetes who are taking insulin. Symptoms typically appear when the blood sugar level falls below 70. Watch for:

• Headache
• Hunger
• Nervousness
• Rapid heartbeat (palpitations)
• Shaking
• Sweating
• Weakness

Diabetes is diagnosed with the following blood tests:

• Fasting blood glucose level -- diabetes is diagnosed if it is higher than 126 mg/dL on two occasions
• Random (nonfasting) blood glucose level -- diabetes is suspected if it is higher than 200 mg/dL, and the patient has symptoms such as increased thirst, urination, and fatigue (this must be confirmed with a fasting test)
• Oral glucose tolerance test -- diabetes is diagnosed if the glucose level is higher than 200 mg/dL after 2 hours.

Ketone testing is also used in type 1 diabetes. Ketones are produced by the breakdown of fat and muscle. They are harmful at high levels. The ketone test is done using a urine sample. Ketone testing is usually done at the following times:

• When the blood sugar is higher than 240 mg/dL
• During an illness such as pneumonia, heart attack, or stroke
• When nausea or vomiting occur
• During pregnancy

The following tests will help you and your doctor monitor your diabetes and prevent complications of diabetes:

• Check the skin and bones on your feet and legs.
• Check the sensation in your feet.
• Have your blood pressure checked at least every year (blood pressure goal should be 130/80 mm/Hg or lower).
• Have your glycosulated hemoglobin (HbA1c) checked every 6 months if your diabetes is well controlled; otherwise, every 3 months.
• Have your cholesterol and triglyceride levels checked yearly (aim for LDL cholesterol levels below 100 mg/dL).
• Get yearly tests to make sure your kidneys are working well (microalbuminuria and serum creatinine).
• Visit your ophthalmologist at least once a year, or more often if you have signs of diabetic retinopathy.
• See the dentist every 6 months for a thorough dental cleaning and exam. Make sure your dentist and hygienist know that you have diabetes.