Diabetes is a serious chronic metabolic disease where the body does not produce or properly use insulin. It is characterized by increasing blood sugar at levels that damage organ functions such as the eyes, the kidneys, the nerves, the heart, and blood vessels.

Insulin is a hormone that controls the glucose level in the blood. Glucose is the main source of energy for body cells. After every meal, the blood sugar rises and the pancreas gland located behind the stomach secretes insulin. Insulin enters and circulates in the blood, acting on the insulin receptors that are present in muscles, fat cells, and other tissues in the body. The insulin binds to these receptors, enabling the glucose transporters to come to the cell surface and facilitate the glucose to enter the cells. Diabetes occurs when there is little production of insulin or the resistance to its effects.

There are many types of diabetes. Type 1 Diabetes has been universally used for diseases that include child-onset diabetes, juvenile diabetes, and insulin-dependent diabetes (IDDM). The term Type 2 Diabetes has also replaced former terms such as adult-onset diabetes, obesity-related diabetes, and non-insulin-dependent diabetes (NIDDM). There are also types known as Gestational Diabetes and Pre-diabetes.

Type 1 Diabetes results from the body’s failure to produce insulin. Type 2 Diabetes, on the other hand, happens when there is insulin resistance or the inability of the body to use insulin. Gestational Diabetes occurs in 2-5% of all pregnancies. About 20-50% of affected women develop Type 2 Diabetes later in life. Pre-diabetes is a condition wherein an individual’s blood glucose levels are higher than normal but not high enough for Type 2 Diabetes.

First Signs of Diabetes

Less production or resistance to insulin lead to hypoglycemia, or low blood glucose, which causes the possible indicators of diabetes. These include excessive hunger (polyphagia), thirst and increased fluid intake (polidipsia), frequent urination (polyuria), unexplained weight loss, blurred vision, lethargy, leg pain when walking (claudication), itchiness (pruritus), dizziness, fatigue and changes in energy metabolism.

Polyuria

Polyuria is a condition characterized by excessive urination. Often considered as one of the first signs of undiagnosed diabetes, it can trigger other symptoms including polyphagia, polydipsia, and weight loss.

Polyuria occurs when glucose is removed from the body through urine due to the large amounts of the sugar building up in the bloodstream. To dilute the glucose, additional water is excreted. This results to excessive urination that creates an increase in thirst. Furthermore, since calories and water go with the urine, the individual gradually loses weight. To compensate for the weight loss, the individual may then experience an increase in hunger.

Other factors included, an average adult releases about a quart and a half urine each day. The US National Institute of Health describes polyuria as the release of 2.6 quarts of urine a day. The Diabetes Insipidus Foundation, however, describes it as the release of 3.5 quarts by a 150-pound adult a day. A person experiencing frequent urination for several days without medical explanation or increase in fluid intake is advised to consult a physician.

Polyuria can be caused by poor or ineffective diabetes management. Changes in diabetes management, such as a healthy diet, regular exercise and intake of insulin or anti-diabetic agents, plan can achieve a better control on glucose levels.

If left untreated, polyuria can lead to dehydration that can be life threatening.

Polyphagia

Polyphagia is the medical term for excessive hunger or eating. It is also known as hyperphagia and hyperalimentation. These terms both mean a heightened increase in appetite. Those with polyphagia consume excessive amounts of food before feeling fullness or satiety.

In Type 1 Diabetes, polyphagia may be accompanied by unexplained weight loss. Due to the lack of insulin, glucose is unable to enter the cells and instead builds up in the bloodstream. This, in turn, makes the body unable to use this glucose for energy. The cells, lacking insulin, enter a state of starvation despite an excess of sugar in the blood. Instead of normally burning glucose for fuel, the body burns fat instead.

In Type 2 Diabetes, however, patients with the disease gain weight after overeating. Since the body is unable to detect insulin in the body or use it properly, the body is unable to transfer glucose from the bloodstream to the cells. Insulin resistance and overeating can result to excessive insulin production called hyperinsulinemia. This results to excess food storage that increases body fat.

Low glucose or hypoglycemia can trigger polyphagia, causing the autonomic nervous system to produce symptoms. These include hunger and shakiness, and diabetic ketoacidosis, wherein the body burns fats instead of glucose for energy. Aside from hypoglycemia, other causes of polyphagia may include eating disorders, anxiety, pregnancy, and hyperthyroidism or an overactive thyroid gland.

Polyphagia is treated directly at its cause. In Diabetes insulin or anti-diabetic agents are prescribed to lower the blood sugar. Exercise and diet can also be helpful.

Polydipsia

Polydipsia is a symptom wherein the patient drinks abnormally large amounts of fluids. One of the initial symptoms of diabetes, polydipsia is also found in patients who fail to take their anti-diabetic medications or in those whose dosages have become inadequate. It is commonly associated with dehydration due to polyuria and appears in diabetics with normally functioning kidneys.

According to the Diabetes Insipidus Foundation, polydipsia may be defined as an adult consumption of more than a gallon or 3.8 liters of beverage everyday. This leads to overhydration, wherein the body loses less water than it takes in and causes insufficient levels of sodium in the blood. This condition is called hyponatremia. Closely linked with polyuria, with an addition of polyphagnia, fatigue, unexplained weight loss, dizziness and fainting, polydipsia suggests Diabetes.

Diabetes Insipidus or “water diabetes” is an uncommon form of diabetes that causes large amounts of diluted urine to be produced by the body. This results to imbalanced water levels in the body, and with the increased depletion of water, leads to an excessive thirst that is a common symptom of Diabetes Insipidus.

Extreme polydipsia can mark dangerous conditions that involve severe hyperglycemia (low glucose levels), diabetic ketoacidosis (a high deficiency of insulin levels), and hyperosmolar hyperglycemic nonketotic syndrome or what is commonly known as diabetic coma.

Other Symptoms

Dehydration happens when large amounts of fluids are lost by the body, causing it to reabsorb fluid from the blood and other body tissues. In diabetes, dehydration is contributed by high blood sugar levels. Excessive glucose in the bloodstream causes the body to lose more water than is needed.

Dizziness is a sensation of lightheadedness, confusion, or disorientation that leads to loss of balance. Insulin shock (hyperglycemia) or low blood glucose (hypoglycemia) can cause dizziness. It may also be caused by diabetic neuropathy or nerve damage and this can lead to numbness and weakness in the legs.

Syncope, also known as fainting, is a sudden temporary loss of consciousness generally caused by insufficient oxygen or inadequate blood flow to the brain. Abnormality in glucose levels, cardiovascular disorders, dehydration, and autonomic neuropathy are major causes of fainting in people with diabetes. Low glucose levels and intense high blood sugar levels or hyperglycemia in diabetic patients can be treated by maintaining glucose levels within the recommended range.

Kussmaul breathing is sometimes known as “air hunger” and is characterized by a gasp-like breathing that is labored and irregular. It has been linked to metabolic acidosis wherein acid levels in the blood are too high. Kussmaul breathing is also a sign of diabetic ketoacidosis, an insulin-deficient type of diabetes. Lack of insulin prevents the body to use glucose for energy; the body, therefore, begins to break down fats for energy. This produces a waste product called ketones, which raise the acidity of the blood.

Missed doses of insulin or failure of an insulin pump can lead to diabetic ketoacidosis and Kussmaul breathing. A patient with undiagnosed Type 1 Diabetes may experience Kussmaul breathing as its first symptom. Air hunger can be treated by administering intravenous fluids and insulin to balance a patient’s acid-base or pH levels.

Fatigue and general weakness happen when the glucose is ineffectively used by the cells in the bloodstream, mainly because of the absence of insulin. Since glucose is what cells use to produce energy, the lack of it makes an individual tired.
Nueropathy or the tingling or numbness in the hands or feet gradually occurs when high glucose in the blood damages the nervous system. Glucose control is needed to improve neuropathy.

Blurry Vision is also one of the early symptoms of diabetes. A rapid rising of blood sugar levels causes fluid shifts in the eye parts that lead to problems.

Yeast infections that occur frequently also happen due to high blood sugar levels. Yeast feeds on sugar and a high blood sugar levels makes more food available for yeast to feed on.
Slow-healing wounds is also a very important symptom of non-insulin dependent Diabetes. High blood sugar levels prevent the immune system from effectively cleaning damaged tissues and building new skin cells.