Signs, Symptoms and Complications of Diabetes
Diabetes is a growing health epidemic. Most of the time people are diagnosed incidentally, by chance during a regular blood work or occasionally with typical symptoms of diabetes. One of the diagnostic criteria of diabetes is a random blood sugar above 200 mg/dL with the symptoms. So, what are the symptoms of diabetes?
Let’s review the common symptoms of early diabetes or uncontrolled diabetes.
Excessive thirst and urination:
The most common symptom of diabetes is excessive urination followed by excessive thirst and excessive urination.
This happens because kidneys start to excrete excessive blood sugar above a certain threshold that is typically blood sugars above 180 mg/dL. In patients with long-standing uncontrolled diabetes that threshold can be higher such as 220 mg/dL. When the body urinates glucose, a process called glucosuria, it creates osmotic diuresis. Osmotic diuresis means water excretion along with glucose excretion. Since water is also excreted along with glucose dehydration and thirst are 1 of the most common symptoms of diabetes. There are other causes of excessive thirst and urination such as diabetes insipidus which is a totally different disorder than diabetes mellitus. It is very important to ask the opinion of an endocrinologist to make sure you get the correct diagnosis.
Because the body excretes excessive glucose, and calorie deficit starts to happen which leads to excessive hunger. Hunger also happens because of insulin resistance and the inability to utilize glucose due to diabetes. Due to the excessive hunger patients start eating a lot more to try to compensate for the energy loss. Eventually this becomes habitual and when diabetes care is given, they may start gaining weight especially if they are on insulin. Excessive hunger can be from other hormonal disorders such as hyperthyroidism or Cushing syndrome. An endocrinologist can do the correct workup to differentiate between these hormonal disorders that can give similar symptoms.
Since the body cannot utilize her glucose which is the primary source of energy fatigue sets itself. Fatigue is generally chronic, persistent. Patients may wake up unrefreshed. They may also start feeling extremely exhausted by the afternoon and fell asleep very early at night. Fatigue is the most nonspecific symptom, in the absence of other symptoms related to diabetes fatigue only may not indicate diabetes. A diabetes specialist will go over other symptoms he may experience and ordered the necessary biochemical evaluation.
Because of excessive loss of glucose in the urine and the body’s inability to utilize the glucose lead to excessive weight loss. Some patients think that weight loss is a result of their minor efforts however most of the time unless a strict diet was applied weight loss is generally an indicator of significant health problems. If you are experiencing weight loss obtain the opinion of an endocrinologist or diabetes specialist for further insight.
Excessive blood sugars can lead to slow down in stomach emptying which can lead to nausea. Certain medications that are taken for diabetes also can lead to nausea. Food allergies and certain other medications can also lead to nausea. Medical conditions that are common such as gastrointestinal reflux disease is also common causes for nausea. Monitoring blood sugars and keeping them stable will help prevent nausea during diabetes care as well.
Due to the dehydration from excessive glucose and the water excretion in the urine dry mouth is a common presentation of diabetes. Some patients, unfortunately, continue to drink sugary beverages that feel fire and makes to dehydration worse. Remember, dry mouth can also be a symptom of rheumatologic disorders such as Sjogren’s syndrome or psychiatric disorders and many other disorders.
When dehydration happens it directly affects the skin which ultimately causes itching diffusely. Instead of taking over-the-counter supplements for itching patients should consider the possibility of dehydration which could be due to significant health problems. Glucose monitoring and diabetes care are very important but also avoiding the hot showers or bath and drying soaps will help. Using moisturizers is an important part of diabetes care.
When dehydration happens due to excessive glucose and water excretion and not replaced with the appropriate hydration dizziness can happen as a result of excessive volume loss and reduction in blood pressure. Dizziness typically happens upon standing up. If this is happening, you need to be careful and get up slowly. Along with hydration using compression stockings can help especially for patients with more advanced age.
Because of excessive urination of the glucose patients become more susceptible especially to urinary tract infections since glucose makes the growth of bacteria and fungus easier. Also, patients with diabetes are typically prone to infections due to the suppressed immune system. Strict diabetes control with an appropriate diabetes care plan infection should resolve. Of course, the doctor in charge of your diabetes care more than likely will prescribe antibiotics or antifungals depending on the type of infection.
Decreased or blurry vision:
This happens because of the changes in the lens as the lens swells up due to excessive glucose which attracts water in the lens. Early retinal disease is also possible which can lead to a reduction in vision. It may not be a bad idea to also obtain a visit with an ophthalmologist while you are seeing an endocrinologist or diabetes specialist. Once appropriate diabetes care is given symptoms should resolve unless there is a significant underlying problem.
Dark, velvety skin
This is also called acanthosis nigricans which typically presents behind the neck and under the armpits that look like a darker softer skin area. It is very suggestive of insulin resistance which typically leads to diabetes. It is not a pleasant look on the skin however, beyond that this is something you do not want to ignore. Insulin resistance is the initial stage of diabetes and cardiovascular disease. Talking to your diabetes specialist will reduce her chances of progressing to diabetes or dealing with the complications of diabetes such as heart attacks and strokes that can happen very early in the diabetes course.
Numbness, tingling or pain in the feet:
Neuropathy is one of the earliest complications of diabetes type 1 or type II. The only symptoms of neuropathy can be numbness or tingling on both feet. This pain is typically worse at night. Cramps in the calves are also not uncommon. Protecting the feet against cuts, corns or calluses is very important. Unnoticed problems such as these can lead to more serious problems such as foot ulcers.
Sometimes neuropathy is silent and only presents itself as the inability to feel the ground which leads to corns and calluses and eventually foot ulcers. Foot ulcers can be infected and if not noticed and or treated timely can lead to gangrene and amputation. Foot ulcers sometimes can be extremely complicated to treat. The reason is that patients with diabetes generally have underlying vascular disease, they are immunosuppressed and blood sugars continuously running high. All these factors contributed to delayed healing or progression of the infection into the underlying soft tissue and bone.
Aggressive diabetes care in a multidisciplinary approach with an endocrinologist, podiatrist, vascular surgeon is the best way to treat for the ulcers and prevent palpitations.
Erectile dysfunction, impotence:
This symptom is also very common. It is a result of neuropathy and vascular dysfunction. Unfortunately, this complication can have been very early and can cause significant interpersonal family problems. This can lead to a reduction in self-confidence and feelings of rejection. Aggressive diabetes care will help prevent the occurrence or progression of this problem. The most common treatment for erectile dysfunction is medication pills such as Viagra, Cialis. There are also penile injectable agents and/or penile implants as a final resort.
Chest pain, heart attack, and stroke:
Although most people believe that the uncontrolled long-standing diabetes as a result of heart attack and stroke, the truth of the fact is cardiovascular disease establishes itself very early in the disease process. As a result, aggressive diabetes care early in the disease is crucial. Your diabetes specialist not only will treat your blood sugars but also cholesterol and blood pressure control will be of equal value in order to prevent cardiovascular complications.
Remote glucose monitoring and online diabetes care if you have symptoms of diabetes
If you have any of these symptoms 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.
Ahmet Ergin, MD, CDE, ECNU
Endocrinologist and Founder of SugarMDs