Nice guy I used to work with died today because his health insurance wouldn't cover treatment for..

[Ms. Toad]

75. There are generally zero clear-cut symptoms of type 2 diabetes

prior to significant damage being done. It is generally silent (see the link below), and most doctors do not test for it at annual physicals.

Fuzzy vision, or slow-healing wounds are often the first signs - and that is typically around the same time (or later than) chronic kidney damage develops.

Every single person my age or older who descended from my grandfather has type 2 diabetes (and I grew up in a neighborhood with rampant Type 1 diabetes - in a school of fewer than a dozen children, 4 had type 1 diabetes), my spouse has type 2 diabetes (as do several of her siblings and ancestors. So I am intimately familiar with both types.

I have diabetes, as you might surmise from the description of who, in my family has diabetes. Mine was caught early because my doctor is among the few who test every year - so I was diagnosed within a year of first meeting the diagnostic criteria. My spouse, on the other hand, was not being tested regularly - and likely went a half dozen years before diagnosis.

My spouse had blurry vision. That was the only obvious symptom. I had no obvious symptoms. Neither of us experienced thirst or frequent urination, the only obvious symptom that type 2 diabetes patients notice - and even that is not common. Elevated blood sugar doesn't obviously feel different than normal blood sugar (unlike the low blood sugar associated with type 1 diabetes (or type 2 treated with insulin or a drug that increases insulin production))

In retrospect, my mental acuity was diminished. But it diminished gradually over time. My spouse's still is - she does not control her blood sugar. But the only reason I know this symptm now is that I immediately got my blood glucose under very tight control, so I went from mild diabetes back to normal blood glucose (unlike the gradual rise and gradual corresponding impact on blood glucose) so the change in mental acuity when I returned to normal was much more pronounced. In addition, after I got my blood glucose under control my boss (who is extraordinarily sensitive to mood) noticed a change in my affect, commented on it, and I tested my blood glucose (it was all of 140 - apparently around 130 is the level at which I begin to experience very subtle symptoms). Once that connection was made, I can tell when my blood glucose goes aboove 130. If I'm paying close attention. Had she not pointed it out, I might still not be aware of the subtle impact on mood.

Type 2 diabetes is largely a silent killer, destroying your internal organs significantly before you experience any overt symptoms.

Type 2 DM has previously been erroneously referred to as mild diabetes, because it is often asymptomatic in terms of the classical symptoms of diabetes such as thirst and polyuria.

http://onlinelibrary.wiley.com/doi/10.1002/pdi.230/pdf

If your brother had Type 2 diabetes, and truly had "clear and obvious" symptoms, before his diabetes was advanced enough to damage his kidneys he is among the lucky.