Diabetes
mellitus is a common disease which affects many people worldwide. Chronic
uncontrolled diabetes is a major source of death and disability because of the
damage it causes to many different tissues and organ systems throughout the
body. Over time it causes blood vessel disease which can lead to heart disease
and heart attack, stroke and peripheral vascular disease. It also has negative
effects on the kidneys, eyes and the immune system, to name just a few other
long-term damaging effects of diabetes.
Because
it is so common and so damaging, many people begin to wonder how to know if
they have diabetes. What are the early symptoms of diabetes to look out for?
This is actually a very important question because the earlier diabetes is
caught, the better the chance of treating it effectively and preventing or
minimizing the long-term complications that can occur.
The
hallmark of diabetes is poorly controlled blood sugar (glucose).
Normally, the blood glucose level hovers throughout the day in a fairly tightly
controlled range. Insulin, a hormone secreted by the pancreas, helps to
lower levels of glucose while other hormones (and eating carbohydrates) raise
them. The balance between them helps keep glucose levels normal. In diabetes
there is an imbalance because insulin is not working as it should to lower
blood sugar levels. The glucose goes up and stays high at most times. This high
level of glucose in the blood is termed hyperglycemia.
Diabetes
Symptoms
When
blood sugar levels are very high there are a number of acute symptoms which can
occur. The most common are the three 'P's', polyphagia (increased
hunger), polydipsia (increased thirst) and polyuria (frequent
urination). The high blood sugar causes the blood to become thickened, more
concentrated, because of the sugar dissolved in it. Sugar also gets dumped in
the urine by the kidney which pulls water with it, dehydrating the body and
further concentrating body fluids. The net effect is that the body gets
dehydrated and urination increases. The brain senses the dehydration and causes
an increased sense of thirst and hunger. Other symptoms that can occur with
hyperglycemia include blurred vision, fatigue, dry mouth, dry or itchy skin and
recurrent infections (such as vaginal yeast infections, groin rashes and
others), among others.
Early
Diabetes Symptoms
However,
these symptoms generally only occur with quite high levels of blood sugar when
diabetes is quite severe. In early diabetes, symptoms can be less common. In
fact, in very early diabetes patients may be completely asymptomatic,
meaning they have no symptoms. Also, the early symptoms may be mild and may not
be noticed or passed off as something less important. At this early stage,
sometimes referred to as prediabetes, the blood glucose levels are
elevated above normal, but not yet in the high range which could be diagnosed
as diabetes. While it is not yet severe, it is still important because the
increased sugar may already be doing damage to your organs and most people with
prediabetes will go on to develop diabetes in time if they do not make changes
in their life to prevent it.
So
if early symptoms are absent or mild how do you know if you should be worried
about diabetes? For one, simply educating yourself (as you are doing now) about
the signs and symptoms of diabetes help to make you more aware so that if you
do experience early symptoms you recognize them. Another thing to keep in mind
is that if you have any concern or suspicion, seek the advice of your own
doctor. They can counsel you about your risks for diabetes and perform simple
tests which can help identify early diabetes.
Diabetes
Risk Factors
One
final suggestion is to learn more about your own risk for diabetes. Even if you
do not yet have symptoms, knowing whether you are at high risk for developing
diabetes can help you to be aware and get screened early. The most common form
of diabetes is called Type II Diabetes, adult-onset diabetes or
non-insulin dependent diabetes. While it generally occurs in adults it can
affect younger individuals too, particularly if they are considerably
overweight. Many of the risk factors for this type of diabetes are well
understood. First and foremost, obesity and a sedentary lifestyle (lack
of physical activity) both increase your risk for type II diabetes
considerably. There is also a strong genetic link to diabetes which means that family
history and ethnicity are important predictors. If you have close
family members (parents and/or siblings especially) with Type II diabetes then
your risk is greater. Also, individuals of African American, Native American,
some Asian and Latino decent are at highest risk for diabetes. Age is
also an important factor. As mentioned above, while diabetes can occur at
almost any age, its risk increases as one gets older. Finally, in women, a history
of gestational diabetes, high blood sugar during pregnancy, is another risk
factor.
If
you have one or more of these risk factors, your chances of developing diabetes
are greater than the general public and you should be on the look out for it.
Talk to your doctor about it and ask if getting screened for prediabetes or
diabetes is advisable. Also, if you think you are at risk for diabetes or know
you have early diabetes, there are changes you can make to help prevent it
progressing and causing long-term complications. While some of the risk factors
cannot be changed (age, family history, ethnicity, etc.), some are called modifiable
risk factors which can be changed. If you improve them, your risk for
diabetes will decrease. The best examples are obesity and sedentary lifestyle.
Increasing physical activity and exercise both help to control blood glucose
and help to control weight. Improving diet and losing weight can significantly
improve your body's ability to keep glucose in a normal range. Other factors,
such as quitting smoking, and lowering blood pressure and cholesterol can be
useful as well. While they do not directly impact diabetes, they are also risk
factors for heart disease, stroke and other blood vessel diseases. Controlling
diabetes as well as these other risk factors will greatly decrease your chances
of developing these diseases as well.
A
Note on Type I Diabetes
Type
I Diabetes, also known as juvenile-onset diabetes and insulin
dependent diabetes, is a less common form of diabetes. It most commonly
presents in childhood although it can affect anyone. In a sense it is a more
severe form of the disorder because the pancreas which secretes insulin is
completely dysfunctional and there is little or no insulin secreted. Therefore,
this form generally presents earlier with more severe symptoms. Patients can
quickly develop severe hyperglycemia and the symptoms associated with it
(increased thirst, hunger, frequent urination, etc.). In addition, if untreated
by insulin injections, patients can develop diabetic ketoacidosis and diabetic
coma, potentially life-threatening conditions which require emergent treatment.
The risk factors for Type I diabetes are less well understood.
In
Conclusion
In
conclusion, stay aware of the early signs of diabetes as well as the risk
factors which are associated with the disease. By being educated you can better
judge your personal risk for the disease and better catch early signs of the
disease. Again, if in doubt, ask your doctor. Making an early diagnosis of
prediabetes or diabetes can help prevent the long-term damage that diabetes can
do. It allows you to make changes in your life (improved diet, weight loss,
exercise, etc.) which can help control diabetes and prevent the death and
disability associated with poorly controlled diabetes.
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