Diabetes affects every part of the body, causing symptoms like fatigue, weight gain, mood changes, and neuropathic pain, among others. These symptoms are not unique to diabetes: They are also common in other conditions, such as hypothyroidism, metabolic syndrome, and Cushing’s syndrome.
If you experience any of these symptoms, it’s important to speak with a healthcare provider. It could be a sign that you need to change your diabetes treatment plan or address an unrelated condition.
Hypothyroidism occurs when the thyroid gland, a butterfly-shaped organ that helps regulate your metabolism, doesn’t produce enough thyroid hormone. It can lead to symptoms like extreme fatigue, weight gain, and mood changes — all of which are also symptoms of diabetes.
Type 2 diabetes and thyroid disorders can involve similar types of hormone dysfunction, and each can increase the risk of the other.
“While these two conditions carry overlapping symptoms, many people with type 1 or type 2 diabetes also develop hypothyroidism,” says Egils Bogdanovics, MD, a diabetes and metabolism endocrinologist at Charlotte Hungerford Hospital in Torrington, Connecticut. “For this reason, annual thyroid screenings are recommended.”
Metabolic syndrome is not one health condition; it is a group of risk factors that can contribute to a higher risk of type 2 diabetes and cardiovascular diseases like heart attack, heart failure, and stroke.
To receive a diagnosis of metabolic syndrome, you need to have three of the following features:
- Excess fat around the abdomen
- High blood sugar levels
- High blood pressure
- Low levels of HDL ("good") cholesterol
- High triglyceride levels
“Metabolic syndrome shares the same causes as type 2 diabetes,” says Dr. Bogdanovics. “Type 2 diabetes and cardiovascular disease can develop due to the same underlying issues, including high triglycerides, high blood pressure, low HDL cholesterol, and obesity.”
Type 2 diabetes and metabolic syndrome require similar treatment strategies, including lifestyle changes and medication.
Though they have very different causes, type 2 and
type 1 diabetes can have extremely similar symptoms because they are both defined by
high blood sugar levels (hyperglycemia). Both conditions provoke warning signs such as extreme thirst, excessive urination, and blurry vision, especially before they have been diagnosed and treated.
As a result, it’s common for one condition to be mistaken for the other, and as many as 40 percent of adults who develop type 1 diabetes are initially misdiagnosed with type 2 diabetes.
“What looks like insulin resistance can be misdiagnosed as type 2 diabetes when you actually have type 1,” says Aimée José, RN, CDCES, a diabetes educator in private practice in the San Diego area. “If you don’t present with typical risk factors of type 2 diabetes, like challenges with your weight and a sedentary lifestyle, push for testing to rule out type 1 diabetes.”
José says that some of these misdiagnoses stem from the outdated belief that type 1 diabetes is a childhood disease. In fact, more than half of new cases of type 1 diabetes develop in adults.
If you are following all of your doctor’s diabetes treatment recommendations but still can’t keep your blood sugar on target and continue to experience the symptoms of hyperglycemia, it may be worth asking your doctor to confirm your diagnosis.
Polycystic ovary syndrome (PCOS) is a common hormonal condition that develops when the ovaries produce higher than normal levels of male hormones known as androgens.
Symptoms and signs of PCOS that are shared with diabetes are weight gain and
acanthosis nigricans, a condition in which skin folds become dark and velvetlike.
Many people with PCOS also have
insulin resistance, which interferes with the body’s ability to use insulin, leading to higher blood sugar levels. Contributing factors include obesity, a lack of regular physical activity, a diet high in processed food, and genetics.
“Due to the insulin resistance, PCOS can actually increase a woman’s risk of developing type 2 diabetes,” says Bogdanovics. “Some women also develop hyperpigmentation on the nape of their neck, also known as acanthosis nigricans.”
Health experts estimate that more than half of women with PCOS develop type 2 diabetes by age 40.
To prevent the development of diabetes, Bogdanovics prescribes
metformin or a
GLP-1 medication early on to combat insulin resistance. “Many people with type 1 can also develop PCOS,” José says. “This makes type 1 diabetes management significantly more challenging.”
Cushing’s syndrome is a hormonal condition defined by high
cortisol levels, which can lead to insulin resistance that resembles type 2 diabetes.
Weight gain, particularly around the midsection, is a common symptom of Cushing’s syndrome.
“We also consider possible Cushing’s syndrome in any person with type 2 diabetes who requires abnormally high doses of insulin,” says Bogdanovics. “Most cases of Cushing’s syndrome go unrecognized.”
Healthcare providers check for Cushing’s syndrome using saliva, urine, and blood tests that can detect if there is excess cortisol in the body. A variety of treatments are available, depending on the cause and severity of the overproduction of cortisol, including medication and surgery.
Pancreatitis can resemble diabetes because both conditions involve the death or dysfunction of the cells in the pancreas that produce insulin, leading to overlapping symptoms.
“Broadly speaking, pancreatitis is about inflammation of the pancreas, but there are multiple potential causes,” Bogdanovics says. These can include gallstones, heavy alcohol use, high triglyceride levels, certain medications, and injury.
Treatment varies depending on the cause. Taking pain medication and receiving intravenous fluids can ease symptoms, whereas other strategies, such as gallbladder surgery and limiting or quitting alcohol use, address the underlying cause.
Diabetes can develop as a result of chronic pancreatitis when inflammation of the pancreas damages the cells that make insulin.
Hemochromatosis is a hereditary condition involving the gradual buildup of iron in the body. When iron levels rise high enough, iron overload can result in uncomfortable symptoms, such as joint pain and fatigue.
This condition is also sometimes referred to as “bronze diabetes,” since it can cause the skin to appear tan and bronzelike.
“The excess iron can affect the pancreas and mimic type 1 diabetes,” says Bogdanovics. “I screen using ferritin [a protein in the bloodstream that stores iron] in any patients who test negative for the autoantibodies of type 1 diabetes, especially if their skin looks abnormally tan.”
Diabetes insipidus, which is being renamed arginine vasopressin deficiency and arginine vasopressin resistance, is a rare condition in which the body is unable to concentrate the urine.
It can cause frequent urination and thirst, which are common symptoms of diabetes mellitus, the family of conditions that includes both type 1 and type 2 diabetes. The conditions, however, are unrelated.
“In the 1700s, physicians would actually taste a patient’s urine if they presented with frequent urination and constant thirst,” says Bogdanovics. “They tasted the urine because it would taste sweet if it’s diabetes mellitus or tasteless if it’s diabetes insipidus because it’s essentially pure water.”
If you experience these symptoms, healthcare providers can use blood glucose and urine testing to determine if you have either of these conditions. With diabetes insipidus,
blood glucose levels are usually normal, and urine will test negative for glucose. The opposite is true for diabetes mellitus.
- Conditions like hypothyroidism, metabolic syndrome, and Cushing’s syndrome can provoke signs and symptoms that are similar to those of diabetes. These overlapping features include fatigue, weight gain, and insulin resistance.
- Many conditions that mimic diabetes, such as PCOS, hypothyroidism, and Cushing’s syndrome, share insulin resistance as a defining feature. The most common cause of insulin resistance is obesity.
- Conditions like pancreatitis and hemochromatosis have symptoms that mimic common diabetes symptoms, but the underlying causes are significantly different.
- Because the complications of diabetes overlap with those of so many other conditions, it’s important to get any new symptoms checked out by your doctor.
