Signs and Symptoms of Diabetes! Endocrinologist explains!

 

Symptoms and Signs of Diabetes

Signs and symptoms of diabetes can include but not limited to:

  • Excessive thirst and urination
  • Weight loss
  • Hunger and fatigue
  • Blurry vision
  • Numbness or tingling on the feet
  • Dry mouth and itchy skin
  • Slow healing cuts or wounds
  • Frequent infections
  • Erectile dysfunction
  • Chest pain

 

 

Many patients come to me with a diabetes diagnosis. I am an Endocrinologist. Diabetes is more than half of what I do every day.  I get a frequent question which is how can you tell if you have diabetes?

Early warning symptoms or signs of diabetes can be so mild, you may not even notice them.  Sometimes diabetes can happen so quickly that you may be hit hard by the diabetes signs and symptoms.  Patients with type 1 diabetes typically present with symptoms of diabetes virus, type 2 diabetes, in particular, can have some very subtle signs.  Sometimes blood sugar can be very high before the diagnosis of diabetes. Frequently, blood sugar control can be lost sooner or later after the diagnosis.  My goal in my practice is of course to prevent any symptoms or signs of diabetes.  Symptoms and signs of diabetes are typically more noticeable with uncontrolled (high) blood sugars. On the other hand, many patients aren’t diagnosed until they develop problems from long-term damage caused by diabetes.  Whereas, symptoms of type 1 diabetes occur much more rapidly and tend to be more severe.

I want to clarify something about semantics before we dive deeper into the understanding of diabetes signs or symptoms.  We are going to use signs and symptoms interchangeably.  In reality, the signs and symptoms are different things.  Symptoms are what the patients perceive as a problem.  On the other hand, signs are what physicians find as a result of their work-up or examination.  For example, excessive urination is a symptom whereas polyuria is a sign.  Nevertheless, let us move onto the topic to better understand diabetic signs or symptoms.

So, what may be things noticeable early warning signs of diabetes?

Both Type 1 and Type 2 share some of the same warning signs in variable degrees.

Urinating more frequently and increased thirst.

This side effect typically happens if blood sugars are running more than 200 on average.

In a 24-hour period, the average individual urinates between 4 and 7 times but individuals with diabetes, go much more. So how does peeing more relate to diabetes? Well, your body reabsorbs glucose as it passes through your kidneys normally. Diabetes causes your blood sugar to increase above 180 mg/dL which is the renal threshold for maximum blood sugar to be able to reabsorb the glucose by the kidneys.  So, your kidneys may be unable to absorb it all.  Since the glucose is on osmotic substance meaning it tracks the weather with it, this creates more urine. With your body making more urine, it requires more fluids.  If the fluid loss is more than the fluid intake dehydration can happen.  Of course, the body’s need to make more urine leads to increased thirst due to the dehydration.

Hunger and Fatigue

  • The food you eat converts into glucose that the cells in your body use for energy. The body’s cells need insulin to utilize the glucose. If you’re not producing enough insulin you will feel tired and hungry. For example if you have millions of dollars in the bank but you do not have access to it.  He will still feel poor right?  Body feels the same way when the blood sugars are high in the blood but the tissues cannot access to that glucose.  Another reason for not being able to use glucose is if the cells repel the insulin your body does make. we call this insulin resistance.  Due to the insulin resistance the glucose will be unable to enter the cells. This leads to low energy. You may feel more hungry and tired than usual.

Blurry Vision

With diabetes, fluid levels change in the body. This change in the fluid can make the eye lenses swell up which causes an inability to focus leading to blurry vision. Rapid changes in blood sugars also will change in the thickness of the lens which can also lead to blurry vision.

Occasionally diabetic retinopathy can happen early or it can happen due to uncontrolled diabetes.  When that happens blurry vision will happen as well.  Discussing with an ophthalmologist early on will be very helpful to avoid further damage to the eyes due to diabetes.

Dry and itchy skin

Uncontrolled diabetes causes the body to use more fluid to keep up with the demand for urine. This can lead to dehydration contributing to dry mouth and dry skin. Dry skin can make you quite itchy.  In addition to improving blood sugars, you should pay attention to your hydration.  You can also avoid using too much soap during showers and use hydrating creams daily.  Dry skin tends to also crack and cause infection to happen especially at the bottom of the feet.  Pain attention to the skin especially at the bottom of the feet is crucial.

The symptoms listed below present if your blood sugar has been high for a long time.

Slow Healing sores or cuts.

This one is a well-known diabetic sign or symptom high blood sugars over time that can cause decreased blood flow and nerve damage. This makes it much harder for your body to heal any wounds.  So how does really high blood sugar affect wound healing?

Number 1 reason is that the immune system especially the white blood cells are not fully functional in the high blood sugar environment.  As a result hospital defenses are down.  Another reason for bacteria and fungus to be present and Flourish is the high sugar environment.  As you can imagine bacteria and fungus love the sugar to replicate and grow.  So in an environment where there is a lot of food and no defense by the immune system infection settles in.  When there is an infection in cut or wound it makes it almost impossible to heal unless the infection is treated.

In patients with diabetes vascular system is also weak.  As a result to necessary nutrients will not be available to the healing tissues.

Pain or numbness in your feet or legs.

This symptom or sign of diabetes is a direct result of nerve damage from prolonged high blood sugars.

Nerve damage due to diabetes type 1 or type II happens as a result of small vessel damage.  Affected blood vessels are narrower and cannot supply enough nutrients to the nerves.  This causes initially numbness and tingling at the nerves.  If the lack of blood supply persists nerve damage (neuropathy) will become a permanent problem.

Yeast Infections

Women, as well as men, can get yeast infections with diabetes. It is more common in women due to anatomical differences.  As we discussed yeast lives and thrives on glucose. Patients with diabetes have plenty of glucose for the yeast to feast on.  Again immune system being down invites yeast infections.  Yeast (mycotic) infections occur in moist, warm skin fold such as between fingers, around sex organs, or under breasts.  Although treatment is not difficult or complicated, recurrent yeast infections can be quite annoying and disturbing for patients with diabetes.

Some diabetic signs or symptoms can be more often with patients with Type 1 diabetes.  Type II diabetic patients may have similar symptoms as well but that is less common.  They may notice the following:

Unexpected weight loss

Although most patients initially like the fact that they are losing weight, not too long after they realized that excessive weight loss is not to do to their efforts.  Patients with type 1 diabetes more frequently than patients with type 2 diabetes may notice weight loss.  Of course, the glucose loss in the urine is the main reason for weight loss.  This leads to weight loss regardless of what you’re eating. As mentioned earlier, if your body is unable to get the energy it needs from the food you eat, it will start to burn fat and muscle.  Burning muscle will also make you tired and deconditioned.

Nausea and Vomiting.

One of the important symptoms or signs of diabetes in patients type 1 diabetes in ketoacidosis. If the body starts to burn fat as a result, you will produce ketones. Ketones can make you feel sick to your stomach. Ketones can also build up in the blood and may lead to a life-threatening condition called “Diabetic Ketoacidosis”.

Even without diabetic ketoacidosis nausea can still happen as part of gastroparesis.  Gastroparesis is more common in type I diabetic patients.  On the other hand, patients with type 2 diabetes may also have this diabetic symptom or sign in the form of a lack of appetite or slight nausea in the mornings.  Since elevated blood sugars slow down the stomach, nausea may have happened to some patients.

Patients with type 2 diabetes who have abdominal obesity may also be suffering from gastroesophageal reflux disease.  Gastroesophageal reflux disease along with high blood sugars can worsen nausea in the mornings.

Warning Signs of Diabetes-Related Complications

Signs of Type 2 complications can include:

  • Recent weight gain:

Yes, weight gain can be a sign or a symptom of diabetes. Not everybody with diabetes will lose weight.  Typically weight loss happens when there is a lack of insulin in the body.  On the other hand, most patients with diabetes have a lot of insulin in their bodies due to insulin resistance.  Insulin resistance can lead to rapid weight gain which can lead to diabetes.  So your weight gain and diagnosis of diabetes can be a call incidental finding.Frequent yeast infections.

If you are having frequent yeast infections and your blood sugars are normal in the lab you may need more extensive testing as not every the lab is diagnostic of diabetes.

Itchy skin

As we discussed itchy skin can be due to a lot of different reasons.  He also need to pay attention to medications you are on.  Some medications such as SGLT2 inhibitors (Jardiance, Invokana, Steglatro, Farxiga) can also lead to itchy skin.

Dark skin discoloration of the neck, armpit or groin.

This is called acanthosis nigricans.  Those areas with a darker skin can also feel softer.  Acanthosis nigricans can happen due to insulin resistance.

Numbness and tingling in the hands and feet.

Numbness and tingling typically starts in the feet.  If you have numbness and tingling in your hands but not in your feet it may not be a diabetic sign or symptom.  You may want to see a neurologist in this case.

Slow healing cuts or sores.

As we discussed slow healing is a diabetic symptom or sign on the other hand is not the only reason.  Vascular insufficiency is the main reason for about diabetic and nondiabetic patients that have slow healing problem.

Erectile Dysfunction or impotence.

Erectile dysfunction is primarily a vascular problem.  Since diabetes weakens the blood vessels erectile dysfunction may happen before or after the diagnosis of diabetes.

Changes in vision.

Hypoglycemia (low blood sugar)

Hypoglycemia (low blood sugar) is not a diabetic sign or symptom by itself.  On the other hand some medications doctors give for diabetes can cause low blood sugars.  Also known as hypoglycemia occurs when sugar or glucose levels drop and become too low to provide for the body. With Hypoglycemia, you may feel:

  • Nervous or anxious.
  • Shaky
  • Annoyed, cranky, or impatient
  • Confused
  • Lightheaded or dizzy.
  • Sleepy
  • Hungry
  • Sweaty, clammy, or chilly.
  • Weakness
  • Numbness or tingling in your lips, tongue or cheeks.

With Hypoglycemia, you can notice:

  • Headache
  • Rapid heartrate
  • Blurred vision
  • Pale skin
  • Coordination problems
  • Nightmares
  • Seizures

 

If you are having these symptoms you may want to discuss your treatment with your diabetes doctor.  Most of the time patients are on either excessive insulin or oral medications that can drop blood sugars severely.

Also if you have the symptom or symptoms we mentioned above you should check your blood sugars.  If your blood sugars are low you should eat 15 to 20 g of simple carbohydrates and recheck your blood sugars.  If your blood sugars arise 15 to 20 mg/dL you should not continue to eat.  1 of the common reactions is panic reaction which leads to excessive eating.  That finally resulted in very high blood sugars.  Your blood sugar may go from 50 mg/dL up to 500 mg/dL with an hour or 2 if you can again eat too much to correct the low blood sugars.

Hyperglycemia (elevated blood sugars)

Of course, high blood sugars are the main reason for most of the diabetes signs or symptoms.  High blood sugar is also known as hyperglycemia can cause many warning signs.  These are very much similar to the diabetic signs and symptoms we discussed.  To summarize they can be;

  • Increased urination
  • Excessive thirst
  • Blurry vision
  • Hunger
  • Fatigue
  • Tingling or numb feet
  • Weight loss
  • Skin and vaginal infections
  • Sugar in your urine
  • Slow-healing cuts or sores
  • Blood sugar levels over 180mg/dL

 

Diabetic Coma

Of course, this is a consequence nobody wants to have.  This happens when basically the pancreas and goes bankrupt.  When there is almost no insulin coming out of pancreas diabetic coma, can happen especially in the setting of severe dehydration.  Diabetic coma in type II diabetics are typically different than diabetic ketoacidosis that the type I diabetic patients have.  We call diabetic coma in patients with type 2 diabetes Hyperosmolar Hyperglycemic nonketotic syndrome (HHNS).

Hyperosmolar Hyperglycemic nonketotic syndrome (HHNS)

This is a serious complication that can lead to diabetic coma or death with both type 1 and type 2 diabetes. This is more common with Type 2 diabetics. This occurs when blood sugar becomes too high and the body become severely dehydrated. Symptoms include:

  • Blood sugar levels over 600mg/dL
  • Warm, dry skin that doesn’t produce sweat
  • Extreme thirst
  • Fever over 101 F
  • Vision loss
  • Hallucinations
  • Sleepiness and or confusion
  • Weakness on one side of your body
  • Dry mouth

 

When should I call my doctor?

  • Regardless of you have a diabetic sign or symptom, anyone, over the age of 45 or if you have a higher risk of diabetes, you should get tested. The earlier we diagnose diabetes tomorrow we can avoid diabetic signs and symptoms as well as diabetic complications.  Contact us if you:
  • urinate a lot more than usual
  • Feel weak or tired
  • Sick to your stomach
  • Have sweet-smelling breath
  • Breathe faster or more deeply than normal

 

SugarMDs, we provide outstanding care to improve your health.  If you have diabetes we do everything in our power to put you into remission and possibly cure your diabetes.

Today diabetes is very easy to manage and experts hands.  We have a lot of options in addition to diet and exercise.  We believe accountability is the key.  We also believe convenience in reducing the burden of diabetes is essential for our patients.  See if you are having any of the diabetes signs or symptoms we discussed above do not wait to pick up to phone to call 561–462 5053.

If you have any of these diabetic symptoms or diabetic signs you may want to find a blood glucose monitor and check your blood sugars after a meal.  If your blood sugars are more than 200 with the symptoms, you may want to talk to a diabetes specialist.  Nowadays, you do not have to wait months to see a diabetes specialist either.  Now there is an online diabetes specialist service that allows you to consult with an endocrinologist.  This is practically telemedicine for diabetes with advanced features.  In this telemedicine practice, patients can also have their blood sugars monitored remotely.  This remote blood glucose monitoring system that is developed by www.SugarMDs.com eliminates the need for recording blood sugars.  Patients at www.SugarMDs.com also enjoy being monitored continuously.  They get contacted if their blood sugars are too high or too low or outside the range.

No more need to try to arrange a doctor’s visit, waiting months to see the doctor or waiting hours, and waiting room to see the doctor for a short time.  It is time for telemedicine and at this time to prevent and if not possible treat diabetes aggressively.

Dominate to your diabetes today and call or text 1 800–644–EZMD (3963) today.

 

This article was made possible by SugarMDs Diabetes Care Center

Ahmet Ergin, MD, FACE, CDCES, ECNU
www.sugarmds.com
Office phone: 561-462-5053

2260 Palm Beach Lakes Blvd. Ste 212 Unit #7 West Palm Beach, FL 33400

 

 

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