The classic symptoms of diabetes—“three polys and one less” (polydipsia, polyphagia, polyuria, and weight loss)—are widely known. However, it is important to note that some patients may not have obvious symptoms in the early stage of the disease, or only show mild, non‑specific manifestations. These symptoms are often overlooked, allowing the disease to progress silently.
For people with diabetes, especially in the early stage, the typical “three polys and one less” may not appear at all. Some patients may only experience mild fatigue, blurred vision, or frequent infections.When blood glucose is mildly elevated—for example, fasting blood glucose around 9 mmol/L—glycosuria may be negative due to normal renal reabsorption, so polyuria will not occur. If energy intake is sufficient, body weight may also remain stable temporarily.
Besides diabetes itself, other factors can also raise blood glucose.Excessive eating or intense exercise may cause transient blood glucose fluctuations.Thyroid dysfunction, kidney disease, and other conditions can also affect blood glucose levels.Therefore, these possibilities must be excluded when diagnosing diabetes.
Diagnosing suspected diabetes is not straightforward.In addition to common blood glucose tests, glycated hemoglobin (HbA1c) reflects blood glucose levels over a period of time and is an important tool for auxiliary diagnosis.Other tests—such as urine protein measurement and thyroid function tests—are also needed to rule out complications or other underlying diseases.
Notably, diabetes is still possible even in patients without weight loss or obvious polyuria, especially those with risk factors such as family history and obesity.Regular blood glucose screening is recommended for high‑risk groups to detect and treat diabetes early.
Diabetes is a complex disease with diverse symptoms that can easily be confused with other conditions.Anyone suspected of having diabetes should seek professional medical advice early for systematic examination and treatment, to avoid delaying optimal care by ignoring atypical symptoms.