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Symptoms of the onset of diabetes
The most common symptom my patients have when they develop diabetes is: none! Most of my patients are adults that I see regularly, many of whom receive regular blood tests. Patients at risk of diabetes - being overweight or having a family history of diabetes - are often diagnosed based on routine blood tests done for other reasons. Usually these patients do not show any specific symptoms. In the past, excessive thirst, frequent urination, weight loss, and increased hunger have been cited as classic diagnostic signs. Sweet-tasting urine is another, but modern doctors rarely use this diagnostic test. (Most doctors don't know what normal urine tastes like anyway.) ...
Symptoms of the onset of diabetes
The most common symptom my patients have when they develop diabetes is: none!
Most of my patients are adults that I see regularly, many of whom receive regular blood tests. Patients at risk of diabetes - being overweight or having a family history of diabetes - are often diagnosed based on routine blood tests done for other reasons. Usually these patients do not show any specific symptoms.
In the past, excessive thirst, frequent urination, weight loss, and increased hunger have been cited as classic diagnostic signs. Sweet-tasting urine is another, but modern doctors rarely use this diagnostic test. (Most doctors don't know what normal urine tastes like anyway.) The Latin words diabetes mellitus mean "runaway honey."
However, when a patient's blood sugar is high enough to cause these symptoms, diabetes is usually advanced.
What causes thirst and frequent urination in diabetics? The kidney is normally able to absorb all the glucose that flows through it. However, beyond a certain threshold, usually blood sugar of 200 to 300 mg/dL, the kidney can no longer absorb all of the blood sugar, causing the sugar to “spill” into the urine. Glucose in the urine acts as a diuretic, causing increased urine volume and therefore increased urinary frequency.
Because some of the calories from the diet flow directly through a patient with diabetes, weight loss can occur, especially in children with type I diabetes. Type I diabetics tend to be thin and eat more to make up for what they lose. Most type II diabetics (which account for most diabetes in adults) start out overweight and may not experience weight loss. Some are happy when weight loss occurs and therefore delay seeking medical help. Type II diabetes is no longer a disease limited to adults. Overweight teenagers and teenagers are also at risk.
The current definition of diabetes is a fasting blood glucose level of only 126 mg/dL, which is much lower than the level at which patients experience the above symptoms. However, recognizing more subtle symptoms of diabetes can lead to diagnosis at blood sugar levels below those that cause thirst and frequent urination. Sometimes a patient complains of fatigue (mental or physical). In women, recurrent vaginal yeast infections or a rash under the breast may be associated with diabetes. Occasionally, men complain of a yeast rash in the groin area. Some patients describe mild discomfort when urinating or a change in vision.
The laboratory definition of diabetes has changed over the past few decades, with the diagnostic threshold continuing to decline. At the same time, blood sugar treatment goals target normal or near-normal blood sugar levels. With our improved understanding of how obesity leads to diabetes, insulin resistance is now recognized as a pre-diabetic condition.
If you are at risk of diabetes, contact your doctor, who may want to do simple blood tests instead of waiting for symptoms to appear. Or take advantage of your local health fair or chain pharmacies, which often offer free diabetes testing.
Copyright 2010 Cynthia J. Koelker, MD
Inspired by Cynthia Koelker