Meet the experts: Pouya Shafipour, MD., a family and obesity physician at Providence Saint John Health Center in Santa Monica, CA; Carrie Burns, MD., an endocrinologist with Penn Medicine; Christoph Buettner, MD, Ph.D.chief of the division of endocrinology at Rutgers Robert Wood Johnson Medical School

While many people have heard of more common symptoms such as frequent urination and increased hunger or thirst, there are other equally important signs that can signal that you have one of the diseases under the umbrella of diabetes.

With that in mind, these are some of the less common symptoms of diabetes that you should keep on the backburner.

Diabetes can manifest itself in many ways. However, these are some unusual signs that may occur.

Recurrent infections

Uncontrolled diabetes causes a condition known as hyperglycaemia (high blood sugar), which is when there is too much sugar in the blood. When you have high blood sugar, your white blood cells, which are a vital part of your immune system, have operating problems.

As a result, your body has difficulty fighting infections, making you more likely to experience them. “Diabetes in general weakens the immune system and that exposes the risk of recurrent infections,” he says Pouya Shafipour, MD., family physician and obesity at Providence Saint John’s Health Center in Santa Monica, CA. The types of infections vary, but may include respiratory infections, skin infections, gastrointestinal infections and yeast infections.

Dizziness

Diabetes can also cause a condition called hypoglycaemia, which is low blood sugar. This can happen when you miss a meal, are physically active close to bedtime or drink alcohol at night, according to CDC. One of the symptoms of hypoglycemia is dizziness.

Hyperglycemia (again, high blood sugar) can, too indirect causes dizziness through dehydration. If you pee a lot and don’t replace those fluids, you might feel lightheaded.

Vision problems

Vision changes can occur independently of diabetes, but can also be a sign of high blood sugar. Hyperglycemia increases the risk of vision changes, including causing blurred vision, says Dr. Shafipour.

Sexual dysfunction

Research shows that the risk of developing erectile dysfunction is about 3.5 times higher in men with diabetes compared to those without the disease. While some lifestyle changes can help, specific treatments for erectile dysfunction may be necessary.

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Having untreated diabetes can lead to fluctuations in blood sugar. And unfortunately, those highs and lows can leave you feeling down, which leads to irritability, says Dr. Shafipour.

Unexplained weight loss

If you’re losing weight without trying, diabetes could be to blame. “This is usually one of the first signs of diabetes,” says Dr. Shafipour. With diabetes, the body doesn’t produce enough or any insulin, which is a hormone that helps escort glucose (sugar) into your body’s cells, where it can be used for energy, explains Dr. Shafipour. But when glucose can’t get to your cells, your body will burn fat and even muscle for energy. As a result, you can lose weight, he says.

Itching in hands and feet

Undiagnosed and unmanaged diabetes can increase the risk of nerve fiber damage throughout the body, including in the hands and feet. It can feel like itching, sensitivity to temperature, numbness, and a tingling sensation, says Dr. Shafipour.

Fruity breath

Breath that smells fruity can be a sign that your body uses fat for energy. This creates an acid called ketones, which leads to that fruity smell.

But it can also signal that you’re dealing with a severe complication of diabetes known as diabetic ketoacidosis (DKA), according to the study. American Diabetes Association (ADA), which can lead to death if left untreated. Tell your doctor as soon as possible if you experience this.

Nausea

Diabetes can cause gastropathy or stomach problems, says Dr. Shafipour. Among other things, it can slow the transit of food through the stomach and increase the risk of acid reflux—both of which can cause nausea, he says.

Dry mouth

This is another indirect symptom. Having diabetes can cause high blood sugar – and this can decreases the flow of saliva in your mouth, explains dr. Shafipour. As a result, you may experience problems with dry mouth.

Dry mouth can also be the result of dehydration from peeing too much, he says.

Unfortunately, no. “Not everyone has symptoms — and that continues to surprise me,” he says Carrie Burns, MD., an endocrinologist at Penn Medicine. “Some people explain things like: “I thought it was because I drank more water.”

But dr. Burns says he also sees patients with very high blood sugar who have no detectable symptoms. “We don’t know why this happens, but I see a lot,” she says.

Diabetes is a condition that does not go away on its own and will only get worse with time, especially if left untreated, says Christoph Buettner, MD, Ph.D.chief of the division of endocrinology at Rutgers Robert Wood Johnson Medical School.

“Diabetes, if left undiagnosed or untreated, can lead to diabetic complications over time, including heart disease, kidney damage, nerve damage and retinal problems,” he says. “Diagnosis and treatment to manage blood sugar levels reduce the risk of these complications.”

So if you suspect you have type 1 diabetes, it’s important to see a doctor for a thorough evaluation.

During this evaluation, your doctor will likely do a blood test, including an A1C test that measures your average blood sugar over the past two to three months, and a glucose tolerance test that measures your blood sugar before and after drink glucose, according to the CDC.

From there, your doctor can make a diagnosis and help create a treatment plan that works for you.