Millions of people all around the world have diabetes, yet are not aware of it. This is because diabetes often has no symptoms. The most accurate sign of diabetes is abnormally high levels of glucose in the blood. Healthcare professionals usually screen people who are at high risk to develop diabetes, and during these screening tests, many learn that they actually have this condition.
In some cases, however, people experience early signs and symptoms which could be caused by diabetes.
Type 2 diabetes. Early signs and symptoms
The early signs and symptoms of diabetes are the “3Ps”: polydipsia -which means increased thirst, polyphagia- increased hunger and polyuria- or increased urination.
- Increased thirst is perceived as feeling thirsty more than usual or constant feeling or dry mouth. Although increased thirst can be caused by dehydration or certain mental health issues, in diabetes it occurs due to increased blood sugar levels. When the blood sugar level increases above 160- 180 mg/dL ( 8.9- 10.0 mmol/L), glucose spills into the urine which triggers the production of more urine, as the kidneys try to dilute that large amount of sugar.
- Increased urination. The kidneys work harder to eliminate excess sugar by increasing urination. In this process the kidneys filter more water, and thus eliminate more urine than usual – about 3 liters a day (the normal amount of urine eliminated daily is -which is considered 1-2 liters). As more fluid is lost, a person will feel thirsty and drink more water and the cycle – polydipsia-polyuria continues. When a person experiences increased urination, it is important to rule out other causes of this condition like kidney problems, pregnancy, another form of diabetes called diabetes insipidus or side effects from certain medications.
- Increased appetite. Insulin resistance associated with diabetes leads to inability of the glucose to enter the cells and provide energy. As a result, an individual with diabetes will feel increased hunger and continue to feel hungry despite eating. This can differentiate hunger experienced naturally after fasting or an intense workout- in these situations, hunger is relieved after eating some food. Stress, hyperthyroidism and certain medications can also increase appetite. There is another reason why those who have diabetes tend to feel hungry. Excess calories are lost in the urine due to increased urination, and some experience weight loss. This problem can also lead to increased hunger, as a compensatory mechanism. Finally, increased hunger can be due to a dip in blood glucose levels.
- Signs and symptoms of low blood sugar levels (hypoglycemia). During early stages of diabetes, some may experience abnormally low levels of glucose levels in the blood -or hypoglycemia. Hypoglycemia manifests with sweating, feeling shaky or lightheaded and in severe cases with dizziness, confusion and even fainting. Overall, the feeling is described as being drunk.
More signs and symptoms of diabetes
- The blood sugar spikes associated with diabetes can often cause blurry vision. This is because high levels of sugar in the blood cause the eye’s lens to retain excess water and become inflamed. When the light passes through the lens this excess inflammation leads to blurred vision.
- Other people may feel drowsy, fatigue and nauseated when they have diabetes. Some may experience decreased strength and endurance when working out.
- In case of diabetes type 2, the body still makes some insulin. This means that ketoacidosis does not occur, unless the sugar levels are very high and diabetes is left untreated for very long. Still, blood glucose levels can get high- and even go over 1,000 mg/dL [55.5 mmol/L]) in case of excess stress or an infection. Ketoacidosis manifests initially with excess thirst and urination, weight loss, fatigue, nausea and vomiting and can progress to deep rapid breathing, confusion,severe drowsiness, and even coma and death. The breath has a fruity odor which is described as similar to a nail polish remover.
How symptoms progress over time and complications
In many cases, individuals with diabetes do not have any obvious signs and symptoms for many years and even decades before they get the diagnosis of diabetes. In the beginning, the symptoms are very mild and may go unnoticed. Increased urination and thirst gradually get worse over weeks and months. Despite an increase in appetite, some people lose weight. Next, people feel more fatigued than usual and later they develop blurry vision.
Diabetes damages blood vessels and nerves throughout the body, especially if the blood sugar levels are poorly managed. These complications can cause strokes, diabetic retinopathy (which is a leading cause of blindness), coronary artery diseases- including heart attacks, chronic kidney diseases, and diabetic neuropathy. )
Diabetes also increases the risk of infections, especially bacterial and fungal infections.
Be aware of all these signs and symptoms of diabetes. The best way to detect it is to get a blood test. The best way to avoid complications of diabetes is to keep the blood glucose levels well controlled, using lifestyle changes and prescription drugs.