Type 2 Diabetes: The Symptoms Women Miss
Thirst, tiredness, thrush that keeps coming back: the early signs of type 2 diabetes are easy to explain away, and many women have none at all. For World Diabetes Day, here is what to look for, who is most at risk and how to get tested.
TL;DR: Type 2 diabetes often starts quietly. Common signs are thirst, peeing more, tiredness, thrush or genital itching, slow-healing cuts and blurred vision, but many people have no symptoms. In Africa, nearly three in four adults with diabetes do not know they have it. If you are over 25 and of Black African or Caribbean heritage, or have other risk factors, ask for a simple blood test.
You are thirsty, but it has been hot. You are up at night to pee, but you drank water late. You are exhausted, but you have work, children, a commute in Lagos or Nairobi traffic, and a period on the way. You have thrush again, and you assume you used the wrong soap. Each of these has an easy explanation on its own. Put together, they can be the early outline of type 2 diabetes, and this is exactly how so many women live with it for years before anyone checks. On World Diabetes Day, 14 November, here is how to read the signs, and how to find out for sure.
What are the symptoms of type 2 diabetes?
The NHS lists the main symptoms of type 2 diabetes as feeling very tired, peeing more than usual, feeling thirsty all the time, and losing weight without trying. Other signs include blurred vision, cuts or wounds taking longer to heal, itching around the vagina, and getting thrush again and again.
These happen because there is too much sugar in your blood. Your kidneys try to flush out the extra through your urine, which pulls water with it, so you pee more and feel thirsty. Your cells cannot use sugar properly for fuel, so you feel drained. High sugar also feeds yeast, which is why thrush can be one of the first clues. We go into that link, and what diabetes does to periods, sex and fertility, in diabetes and your body.
Can you have type 2 diabetes with no symptoms?
Yes. The NHS is clear that not everyone with type 2 diabetes has symptoms, which is why getting checked matters. Blood sugar usually rises slowly, over years, and the body adapts. Many people are only diagnosed when a complication appears, such as eye changes, kidney problems, a heart attack or a stroke.
Why women miss the signs
Women are often the last to put themselves first. Tiredness gets blamed on a heavy period, a new baby, perimenopause or simply being busy. Thrush gets treated at the pharmacy, again, without anyone asking why it keeps returning. Weight gain, irregular cycles and dark, velvety patches of skin, which can be linked to type 2 diabetes and hormone conditions, are often dismissed as cosmetic. The NHS notes that PCOS can increase the risk of type 2 diabetes, which we cover in PCOS and insulin resistance.
There is also a stage before diabetes. Prediabetes means your blood sugar is higher than it should be but not yet in the diabetes range, and it usually has no symptoms at all. It is the best moment to act, and our guide to prediabetes in women explains what you can do.
Diabetes is rising fast in Africa
The 11th edition of the IDF Diabetes Atlas, published in 2025, estimates that 589 million adults worldwide live with diabetes, and 252 million of them do not know it. Africa stands out. According to the IDF Africa factsheet, about 1 in 20 adults in the region, roughly 25 million people, had diabetes in 2024. That number is projected to rise by 142 percent to 60 million by 2050, the steepest increase of any region. And 73 percent of adults with diabetes in Africa are undiagnosed, the highest share in the world.
Many people only find out they have diabetes after years of high sugar have already done damage. We look at the wider pattern in African women's health risks and prevention.
Who is most at risk?
The NHS says you are more likely to get type 2 diabetes if you are over 25 and from a Black African, Black Caribbean, South Asian or Chinese background, or white and over 40. For women in the diaspora, that means risk starts 15 years earlier than for white British women. Other risk factors include:
- A parent, brother or sister with diabetes
- Carrying extra weight, especially around the waist, and being less active
- High blood pressure
- Having had gestational diabetes. The CDC notes that about half of women with gestational diabetes go on to develop type 2 diabetes, so yearly checks after pregnancy matter. Our guide to gestational diabetes explains more.
- PCOS
Why diabetes hits women's hearts harder
Diabetes raises everyone's risk of heart disease, but it raises women's more. A large meta-analysis of 64 studies and over 850,000 people found that women with diabetes had a 44 percent greater relative risk of coronary heart disease than men with diabetes. The CDC adds that women with diabetes face a higher risk of complications such as heart disease, vision loss, kidney disease and depression. Heart attacks and strokes in women can also look different, so it is worth knowing the signs in stroke in women.
How do you get tested for type 2 diabetes?
Type 2 diabetes is diagnosed with a blood test. The most common is HbA1c, which reflects your average blood sugar over the past two to three months and does not need fasting. Under UK guidance, an HbA1c of 48 mmol/mol (6.5 percent) or above suggests diabetes, and 42 to 47 mmol/mol (6.0 to 6.4 percent) suggests prediabetes. A fasting blood glucose of 7.0 mmol/L or above can also point to diabetes. If you have no symptoms, a second test is usually done to confirm.
In the UK, adults aged 40 to 74 without existing conditions should be invited to a free NHS Health Check every five years, which includes a diabetes risk assessment. If you are younger but in a higher-risk group, ask your GP for a test rather than waiting. In Nigeria, Kenya, Ghana or South Africa, a fasting glucose or HbA1c test is available at hospital labs and private diagnostic centres, and your clinic can tell you which one to ask for. Whatever the result, ask what it means and when to test again. Our women's health screening checklist shows where a blood sugar test fits alongside other checks.
When to seek urgent care
High blood sugar can become an emergency. The NHS advises calling an ambulance or going to A&E if you feel confused or very drowsy, are breathing faster than usual, or your breath smells fruity, especially if you are also vomiting or very thirsty. Do not drive yourself.
What happens after a diagnosis
A diagnosis is the start of a plan, not a verdict. For many women, changes to food, movement and weight, alongside medicine such as metformin when needed, bring blood sugar down and protect the heart, eyes, kidneys and nerves. Regular checks of your HbA1c, blood pressure, cholesterol, eyes and feet are part of good care. Ask your clinician about local diabetes education programmes, and bring a family member if it helps. Diabetes often runs in families, and your diagnosis can be the reason your sister or mother finally gets tested too.
This post is education, not medical advice. Only a blood test can tell you whether you have diabetes, and a clinician should guide your care.
If you have noticed a pattern, write it down. With Asele, symptom logging lets you record tiredness, thirst, thrush and cycle changes over time, and Amara can talk it through with you in Yoruba, Hausa, Igbo, Swahili, French or English. The Health Brief turns those notes into a short summary to take to your appointment, which makes it easier to ask for a test. You can find us at Asele.
References
- NHS. Type 2 diabetes: symptoms and diagnosis. nhs.uk
- International Diabetes Federation. IDF Diabetes Atlas, 11th edition (2025): global news release. idf.org
- International Diabetes Federation. Diabetes in Africa, 2024 factsheet, IDF Diabetes Atlas 11th edition. idf.org
- CDC. Gestational diabetes. cdc.gov
- CDC. Diabetes and women. cdc.gov
- Peters SA, Huxley RR, Woodward M. Diabetes as risk factor for incident coronary heart disease in women compared with men. Diabetologia, 2014. pubmed.ncbi.nlm.nih.gov
- NHS Scotland Right Decisions. Testing for prediabetes. rightdecisions.scot.nhs.uk
- NHS. NHS Health Check. nhs.uk
- NHS. High blood sugar (hyperglycaemia). nhs.uk
- NHS. Acanthosis nigricans. nhs.uk
- NHS. Polycystic ovary syndrome (PCOS). nhs.uk
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