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.
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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.
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, 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.
J. Dusick is the editor of the Diabetes Information Source, at [http://www.diabetes-information-source.com], your guide to diabetes, its effects and its management, providing an in-depth introduction that is understandable even if you do not have a background in science or medicine.
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