Diabetes symptoms: early signs, who should get tested, and what FBS and HbA1c results mean

Diabetes means there is too much sugar (glucose) in your blood. Many Filipinos call it "may sugar" or "mataas ang asukal sa dugo". The most common diabetes symptoms are:

• Peeing more than usual, especially at night
• Feeling very thirsty and drinking much more than usual
• Feeling very tired or weak
• Losing weight without trying

An easy way to remember them is the 4 Ts: toilet, thirsty, tired and thinner.

Other symptoms can include feeling very hungry even after eating, blurred vision, cuts or sores that heal slowly, infections that keep coming back (urinary tract, skin or yeast infections), itching around the genitals, and numbness or tingling in the feet or hands.

Thirst and tiredness have many causes, especially in hot weather. But if you notice several of these signs, or they don't go away, ask for a blood sugar test. Only a blood test can tell.

Type 2 diabetes, the most common kind, often starts slowly, and many people feel well for years. Some only find out after it has harmed their eyes, kidneys, nerves or heart.

Signs people often ignore:

• Waking up at night to pee more than before
• A wound on the foot that takes weeks to heal, or a pigsa (boil) that keeps coming back (see our boils guide)
• Dark, thick, velvety skin on the back of the neck, armpits or groin, called acanthosis nigricans. Philippine guidelines list it as a risk factor for type 2 diabetes and a reason to get tested.
• "Pins and needles" in the feet

So don't wait for symptoms. If you have the risk factors in Who should get tested, get tested even if you feel fine.

In women, diabetes can show up as vaginal itching or yeast infections that keep coming back, and frequent UTIs (see our UTI guide). Polycystic ovary syndrome (PCOS), a hormone condition that often causes irregular periods, raises the risk of diabetes.

In pregnancy, gestational diabetes usually causes no symptoms, so pregnant women are offered a blood sugar test, usually at 24 to 28 weeks, or earlier if they have risk factors. If you had gestational diabetes, get a blood sugar test 6 to 13 weeks after the birth, then every year, because your risk of type 2 diabetes stays higher.

In men, diabetes can also cause problems with erections, and itching around the penis or yeast infections (thrush) that keep coming back.

In children and young adults, diabetes (often type 1) can come on fast, over days or weeks. Watch for a child who starts wetting the bed again, eats more but loses weight, is very thirsty and tired, or has breath that smells fruity, like nail polish remover. This child should see a doctor the same day, because type 1 diabetes can quickly lead to a dangerous condition called diabetic ketoacidosis (DKA).

A hormone called insulin, made by the pancreas, moves sugar from your blood into your cells for energy. In diabetes, the body doesn't make enough insulin, can't use it well, or both, so sugar builds up in the blood.

• The kidneys flush out the extra sugar, so you pee more and feel thirsty.
• Your cells lack energy, so you feel tired and hungry.
• The body burns fat and muscle instead, so you lose weight.
• Over time, high sugar damages small blood vessels and nerves, causing slow healing and tingling feet.

Type 2 diabetes causes more than 95 in every 100 cases. It is linked to being overweight, not moving enough, smoking and family history. Type 1 diabetes happens when the immune system destroys the cells that make insulin. It is not caused by diet. Gestational diabetes starts in pregnancy and usually goes away after birth.

Some medicines, such as steroids, can also raise blood sugar, so tell the doctor everything you take.

Prediabetes means blood sugar is higher than normal but not yet diabetes. It is common: Philippine guidelines report it in about 28 in every 100 Filipino adults. Healthy changes can delay or prevent type 2 diabetes.

Philippine guidelines for periodic health check-ups, made with the Department of Health, recommend a fasting blood sugar (FBS) test for all adults aged 40 and above, even without symptoms. Get tested younger if you have at least one of these:

• Prediabetes, or a high sugar result on an earlier test
• A parent, brother or sister with type 2 diabetes
• Overweight: for Asians, a body mass index (BMI) of 23 or more
• A big waist: 80 cm or more for women, 90 cm or more for men
• Little physical activity, such as sitting all day at work
• High blood pressure of 130/80 or higher, or taking medicine for it (see our high blood pressure guide), high triglycerides or low "good" cholesterol
• Heart disease, a past stroke or blocked blood vessels in the legs
• Gestational diabetes before, or a baby who weighed 8 pounds (about 3.6 kg) or more at birth
• PCOS, dark velvety skin on the neck or armpits, or schizophrenia

If your result is normal, your doctor will say when to test again; many experts advise every 3 years. With prediabetes, test every year.

To lower your risk, WHO advises keeping a healthy weight, staying active, eating less sugar and fatty food, and not smoking. Our annual check-up guide lists the other tests adults need.

Diabetes is diagnosed with a laboratory blood test, usually confirmed with a second test. Results below are in mg/dL, the unit most Philippine labs print.

Fasting blood sugar (FBS). The most common test. You eat and drink nothing but water for at least 8 hours, then blood is taken, usually in the morning.

• Normal: 99 or below
• Prediabetes: 100 to 125
• Diabetes: 126 or higher

If your lab uses mmol/L, a fasting result of about 7 or higher is in the diabetes range.

HbA1c (A1C). Shows your average blood sugar over the past 2 to 3 months. No fasting needed.

• Normal: below 5.7%
• Prediabetes: 5.7% to 6.4%
• Diabetes: 6.5% or higher

HbA1c can be wrong if you have anemia or another blood problem, kidney or liver disease, or are pregnant. Philippine guidelines prefer FBS for screening because it is easy to get everywhere; HbA1c is also accepted when the lab's test is standardized. Your doctor will choose.

Oral glucose tolerance test (OGTT). Blood is taken after fasting, then again 2 hours after a very sweet drink. At 2 hours: normal is 139 or below, prediabetes 140 to 199, diabetes 200 or higher. It is also used in pregnancy, with different cut-offs.

Random blood sugar. Taken any time. A result of 200 or higher with symptoms points to diabetes.

PhilHealth YAKAP (the expanded Konsulta package) gives free primary care at accredited YAKAP clinics, including many rural health units (RHUs) and city health centers. As of May 2026 there were 4,287 YAKAP clinics. Every Filipino can register.

When your YAKAP doctor finds you need them, you can get:

• A free check-up
• Lab tests: PhilHealth's Konsulta benefit table (2024), which YAKAP builds on, lists FBS, OGTT and HbA1c, plus creatinine, lipid profile and urinalysis
• Medicines your YAKAP doctor prescribes. As of January 2026, the 21 medicines given at YAKAP clinics include the diabetes medicines metformin and gliclazide. Under PhilHealth GAMOT, more medicines are free at accredited GAMOT pharmacies, up to ₱20,000 a year for each member and each dependent.

Public YAKAP clinics are free. A private YAKAP clinic may charge up to ₱900 a year (PhilHealth FAQ, July 2025).

How to start: register with a YAKAP clinic through the eGovPH app, the PhilHealth Member Portal, a PhilHealth office or the clinic itself, then go to the clinic for your first visit. You need your PhilHealth Identification Number (PIN) to register. See our PhilHealth YAKAP guide, or find a health center near you. Your barangay health station can also point you to the nearest clinic.

If you have symptoms, the most important step is getting tested soon. Until then:

• Drink plain water when thirsty. Skip softdrinks, sweet juices, milk tea and "3-in-1" coffee.
• Don't diagnose yourself with a glucometer. Home meters help people who already have diabetes, but they cannot diagnose it. A high reading is still a reason to see a doctor.
• Don't take someone else's diabetes medicine, even a relative's. It can make your sugar drop dangerously low.
• Check your feet every day for cuts, blisters or sores, and wear footwear if your feet feel numb.
• Start small habits now: more vegetables, less rice, and at least 150 minutes of moderate activity, such as brisk walking, each week.

If your test shows diabetes, only a doctor can prescribe medicines such as metformin or insulin and set the dose. Want to talk it through? Our AI diabetes coach can explain your results in plain words, or you can ask a nurse or book a call.

"Ants on the urine means diabetes." Very high sugar can spill into urine, but ants are not a test, and many people with diabetes never see this. Get a blood test.

"Only people who eat lots of sweets get it." Type 2 diabetes is mainly linked to weight, waist size, inactivity, smoking, age and family history. Thin people can get it too. Type 1 has nothing to do with diet.

"Ampalaya, banaba or a special milk can cure it." Ampalaya is a fine vegetable, but no tea, capsule or milk can tell you whether you have diabetes or replace a doctor's care. The FDA Philippines has warned against unregistered products sold as "for diabetes" with false claims. Before buying any product, check that it is registered on the FDA Verification Portal.

"The dark skin on my neck is just libag (dirt)." Dark, velvety skin that won't scrub off can be acanthosis nigricans. Scrubbing won't help; a blood sugar test will.

"Insulin causes kidney failure or blindness." These come from high blood sugar left untreated for years, not from insulin. People with type 1 diabetes need insulin to live.