Diabetes Symptoms & Complications: Early Signs & Long-Term Risks

Jakarta – A specialist in internal medicine at the Faculty of Medicine, University of Indonesia, Dr. Wirawan Hambali, Sp. P.D, FINASIM, has outlined the common symptoms experienced by individuals with diabetes mellitus, along with its complications, ranging from short-term (acute) to long-term (chronic).

“The classic symptoms of diabetes are often described as the ‘4 Ps’: high blood sugar, unexplained weight loss, increased appetite, frequent urination, and excessive thirst,” Dr. Hambali explained during a media briefing in Jakarta on Wednesday, February 26, 2026.

He elaborated that a significant rise in blood glucose levels coupled with drastic weight loss can occur because glucose is unable to enter the body’s cells due to a lack of insulin. The body’s cells experience a state of starvation, prompting individuals with diabetes mellitus to feel constantly hungry.

“We often observe a situation where untreated, advanced diabetes patients, who were initially overweight, gradually lose weight. This is because glucose utilization by the cells is impaired,” he stated.

Another key symptom is polyphagia, or increased appetite. This manifests as an excessive feeling of hunger or an abnormally increased desire to eat.

Individuals with diabetes mellitus also tend to urinate frequently, or polyuria. Dr. Hambali noted that urine often attracts ants, indicating a high sugar content. This is because excess glucose is excreted through the urine when blood sugar levels are elevated.

“The urine of people with diabetes contains sugar, making it highly osmotic. This draws fluid from the body, explaining why they urinate so often,” he explained. Osmotic diuresis, he clarified, is an increased production of urine caused by a high concentration of solutes, such as glucose, in the kidneys.

The increased frequency of urination ultimately leads to excessive thirst, or polydipsia.

Dr. Hambali further categorized diabetes mellitus complications into short-term and long-term.

Short-term complications typically arise from rapid and drastic fluctuations in blood sugar levels, either too high or too low, potentially leading to medical emergencies like diabetic coma.

Long-term complications, however, develop as a result of prolonged, uncontrolled high blood sugar levels, which can damage small blood vessels, large blood vessels, and non-vascular structures.

Damage to small blood vessels can lead to blindness and kidney dysfunction. Damage to large blood vessels can increase the risk of coronary artery disease and stroke.

Long-term non-vascular complications include fatty liver disease and impaired intestinal peristalsis.

The Mayo Clinic notes that long-term complications of diabetes develop gradually, and the risk increases with the duration of the disease and the degree of blood sugar control.

Recognizing the early signs of diabetes is crucial. According to the American Diabetes Association, common symptoms include frequent urination, excessive thirst, unexplained fatigue, blurry vision, slow-healing sores, and tingling or numbness in the hands and feet. Weight loss, even with increased appetite, can also be a sign, particularly in type 1 diabetes.

Early detection and treatment of diabetes can significantly reduce the risk of developing these complications. The American Diabetes Association offers a Type 2 Diabetes Risk Test to help individuals assess their risk.

the organization highlights the importance of a Diabetes Prevention Program for those at risk or with prediabetes, which can cut the risk of developing the disease in half.

Prediabetes, characterized by higher-than-normal blood glucose levels but not high enough to be diagnosed as diabetes, doesn’t automatically lead to diabetes, but requires monitoring and lifestyle adjustments.