MD 24 House Call ~ Signs & Symptoms of Diabetes

Diabetes Mellitus is the name given to a group of conditions that occurs when the level of glucose (a type of sugar) in the blood becomes higher than normal. Insulin is a hormone that moves glucose from your blood-stream, into the cells of your body where it is used for energy. Diabetics cannot make enough insulin or the insulin that is being made does not work properly.  This causes blood glucose levels to become too high while impacting your short and long term health. 

In type 1 diabetes, your immune system destroys cells in your pancreas that make insulin. In type 2 diabetes, the pancreas is not under attack. It usually makes enough insulin. But your body does not use it well. The symptoms of the two forms are similar, but usually come on more quickly in people with type 1. 

Individuals can experience different signs and symptoms of diabetes, and sometimes there may be no signs. Some of the signs commonly experienced include:

• More thirsty than usual
• passing more urine
• feeling tired and lethargic
• slow-healing wounds
• itching and skin infections, particularly around the genitals
• blurred vision
• nausea and vomiting
• weight loss
• mood swings.

Often in type 2 diabetes signs and symptoms may not be present. 

Type 1 diabetes, once known as juvenile diabetes or insulin-dependent diabetes, is a chronic condition in which the pancreas produces little or no insulin, a hormone needed to allow sugar (glucose) to enter cells to produce energy. The far more common type 2 diabetes occurs when the body becomes resistant to insulin or does not make enough insulin.

Various factors may contribute to type 1 diabetes, including genetics and exposure to certain viruses. Although type 1 diabetes usually appears during childhood or adolescence, it also can begin in adults.

Despite active research, type 1 diabetes can be managed but has no cure.  With proper treatment offered today, those infected can expect to live longer, healthier lives than those of the past. Type 1 diabetes can happen at any point in life. But it is mostly diagnosed before the age of 19.

Having high blood sugar for a long time can damage many of your body's systems. Type 1 diabetes can make you more likely to have:

• Heart disease and stroke
• Kidney failure
• Blindness or other problems seeing
• Gum disease and tooth loss
• Nerve damage in the hands, feet, and organs

Type 1 diabetes signs and symptoms can surface rapidly and may include:

• Increased thirst
• Frequent urination
• Bedwetting in children who previously did not wet the bed during the night
• Extreme hunger
• Unintended weight loss
• Irritability and other mood changes
• Fatigue and weakness
• Blurred vision
• In females, a vaginal yeast infection

Type 2 diabetes, once known as adult-onset or noninsulin-dependent diabetes, is a chronic condition that affects the way your body metabolizes sugar (glucose). Your body either resists the effects of insulin — a hormone that regulates the movement of sugar into your cells — or does not produce enough insulin to maintain a normal glucose level.

More common in adults, type 2 diabetes increasingly affects children as childhood obesity continues to grow. There is yet to be a cure, but you may be able to manage the condition by eating well, exercising and maintaining a healthy weight. If diet and exercise are not enough to manage your blood sugar well, you also may need diabetic medications or insulin therapy.

Type 2 diabetes is sometimes described as a ‘lifestyle disease’ because it is more common in those struggling with obesity while ignoring physical activity.  Also known as non-insulin dependent diabetes or mature onset diabetes, It’s strongly associated with high blood pressure, abnormal cholesterol levels, or the ‘apple’ body shape. (excess weight around the waist.) While most diabetics are mature adults (over 40), younger people are also now being diagnosed in greater numbers as rates of obesity increase.

Type 2 diabetes symptoms often develop slowly. In fact, you can have type 2 diabetes for years and not know it. Look for:

• Increased thirst and frequent urination. Excess sugar building up in your bloodstream causes fluid to be pulled from the tissues. This may leave you thirsty. 
• Increased hunger. Without enough insulin to move sugar into your cells, your muscles and organs become depleted of energy. This triggers intense hunger.
• Weight loss. Despite eating more than usual to relieve hunger, you may lose weight. Without the ability to metabolize glucose, the body uses alternative fuels stored in muscle and fat. 
• Fatigue. If your cells are deprived of sugar, you may become tired and irritable.
• Blurred vision. If your blood sugar is too high, fluid may be pulled from the lenses of your eyes. This may affect your ability to focus.
• Slow-healing sores or frequent infections. Type 2 diabetes affects your ability to heal and resist infections.
• Areas of darkened skin. Some diabetics have patches of dark, velvety skin in the folds and creases of their bodies — usually in the armpits and neck. This condition, called acanthosis nigricans, may be a sign of insulin resistance.

Pre-diabetes is a risk factor leading to the development of type 2 diabetes. It’s a condition in which blood glucose levels are higher than normal, but still not diabetic. There are no defined symptoms, but risk factors include obesity, smoking, heart disease, polycystic ovary syndrome and high blood pressure. Without treatment, 33% of pre-diabetics will develop type 2 diabetes and cardiovascular disease.

There are two types of pre-diabetes: Impaired Glucose Tolerance and Impaired Fasting Glucose. 

Impaired Glucose Tolerance (IGT) occurs when blood sugar levels are higher than non-diabetic ranges post-meals. IGT typically occurs in overweight and physically inactive people - and a greater risk in those with heavy midsections. 

There are often no symptoms associated with IGT and we recommend an immediate assessment if you notice one or more associated risk factors. An oral glucose tolerance test is required to help your doctor determine if you have IGTY. All you need to do is submit a sample of your blood the a lab for your physician to examine.

Impaired Glucose Fasting (IGF) occurs less frequently than IGT and incorporates fasting blood glucose levels that are higher than non diabetic ranges, but not classified as diabetic. 

Pre-diabetes is diagnosed by a blood test that checks your blood glucose level. Any blood glucose test that shows higher than normal blood sugar levels needs to be examined and diagnosed. An oral glucose tolerance test (OGTT) may be required and it’s results will show whether your blood sugar levels are normal.

Women, especially those expecting, should be aware of the symptoms of gestational diabetes. The complications of diabetic women are difficult to pinpoint and women can experience the following symptoms:

• Thrush and yeast infections
• Itchiness around the vagina
• Female sexual dysfunction

Vulvovaginal Candidiasis, or vaginal thrush, can be a symptom of diabetes as high blood sugar levels can cause glucose to be excreted through urine. Glucose in urine can create yeast infections. Here are some symptoms to consider:

• Soreness and itching around the vagina
• Reddening of the skin
• A white curd like appearance on the skin
• White vaginal discharge
• Pain during intercourse

Oral yeast infections can also occur as a symptom of diabetes. High blood sugar can also lead to a lack of natural vaginal lubrication which makes sex difficult or painful. 

The symptoms of diabetes in men and women are similar but some are more noticable in men. Specific male diabetic symptoms may include:

• Reduced strength from loss of muscle mass
• Recurrent episodes of thrush around the genitals
• Itching of or around the penis
• Erectile dysfunction

Reduced strength and loss of muscle mass, unexplained loss of muscle mass may be a sign of high sugar levels in men. If blood sugar levels remain high for a long time, the body begins to break down fat and muscle for energy. The resulting weight loss is usually most noticeable in people with type 1 diabetes, but can affect those with long-term undetected type 2.

More than 33% of diabetic cases occur in seniors over the age of 65. At the same time, almost 210,000 U.S. children and adolescents are said to be diabetic - and counting.  It’s important to catch children’s diabetic symptoms quickly. Here’s what you should look for:

Early symptoms:

• feeling tired or weak
• Mother comforting daughter in bed
• frequent peeing (urination) in large amounts (polyuria)
• increase in thirst (polydipsia)
• weight loss
• increase in appetite (polyphagia)
• dry mouth or throat

More serious symptoms:

• These symptoms appear if the diabetes is not treated, or in some cases when it is undiagnosed.
• drowsiness
• weight loss
• nausea and vomiting
• heavy, rapid breathing (Kussmaul breathing)
• stomach aches

Excessive thirst and urination are typically the first indications of high blood glucose levels in kids. While younger children may begin enuresis (wetting the bed), some get up in the middle of the night to use the bathroom (nocturia).​. The loss of sugar in the urine, together with dehydration, and lack of blood sugar is a bad combination. This can lead to weight loss despite an increase in appetite (polyphagia). As the symptoms develop and worsen, a child can become tired, drowsy, and weak.

Diabetic signs and symptoms may not be as clear in newborns and toddlers as a language barrier, regular growth spurts, and changes in appetite throw off the analysis. In these cases, your child can develop serious symptoms before diabetes is even recognized. Fungal or yeast diaper rash that doesn’t improve with the use of medicated cream should also be considered as a sign - even though common. 

Diabetes is a complex condition, which can affect the entire body. Understanding this disease is truly important even if you don’t have it. In your lifetime, you’ll most likely know a diabetic. 

MD24 House Call is one of the leading institutions for Arizona diabetes care. MD24's specialists work closely with diabetic educators, dieticians, and podiatrists to help patients to develop insight into their condition, manage symptoms, and relate more positively to others. The first step in seeking help is to visit MD24 House Call and arrange a health assessment. Call (888) 632-4758 for registration inquiries or visit our website www.md24housecall.com and “Request a Visit.” 

MD24 House Call is proud to be able to assist the patients we already serve and look forward to serving the healthcare needs of new residents who register with us.

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