‘Diabetes’, this word is heard more often these days than ever before. Friends, family members, colleagues at work place, or someone we know seems to develop this condition regularly. Men and women, young and the aged, no one seems to be immune. Then the question arises, am I prone and how to identify the signs of Diabetes.
Before we go on to discuss about the signs and symptoms of Diabetes, it makes sense to first understand what Diabetes is. Diabetes is a disease in which the ‘blood Glucose’ commonly known as ‘blood Sugar’ is higher than normal. No wonder most of the signs and symptoms of Diabetes tend to revolve around this high blood Sugar levels and the consequences of such high blood Sugar.
Insulin production is insufficient for the bodily needs in people who develop Diabetes. Lack of adequate Insulin results in high blood Sugar levels as Glucose cannot enter the cells from blood without Insulin. The high blood Sugar results in various symptoms and signs.
Polyurea is passing large quantities of urine. If one is passing large volumes of urine, for instance more than about three litres in a day, one has to suspect Diabetes amongst other health ailments. As the blood rich in Glucose passes through Kidneys, the high Glucose content in the blood draws excess water along with it and results in excess urine production. For the same reasons, waking up several times at night time to pass urine, called Nocturia is well described as a presenting symptom in Diabetes. ‘Increased Thirst’ is a common symptom with which many Diabetics present to the physician and this is due to loss of water from the body in the form of excess urine.
Weight loss not explained by other reasons may sometimes point towards underlying Diabetes. Unexplained tiredness could be due to Diabetes as well. Fungal infections such as Candida, commonly known as Thrush is not an uncommon presenting feature in some Diabetics, more so in women. The good old adage that a slow healing wound warrants a screening for ‘Sugar problem’ still holds true!
While this is so, some Diabetic patients do present with the complications of Diabetes, such as Heart problems, for instance Heart attacks, loss of sensation in the feet due to damage to the nerves, blurred vision, Cataracts at a younger age, and impaired kidney function. In fact, several cases of Diabetes are detected serendipitously when a person has a routine health check-up, or blood tests as part of an insurance screen. It is also not uncommon for a new diagnosis of Diabetes to be made when admitted to a hospital for other reasons like a medical or surgical emergency.
It is pertinent to state that some hither-to undiagnosed Diabetics with a type of Diabetes called Type1 Diabetes may present to doctors extremely unwell, or even in a comatose state with very high blood glucose readings as there is little or no Insulin left in their bodies. This type of Diabetes is much common in children and youngsters although adults are not completely spared. The symptoms in this variety of Diabetes are rather more severe and develop within a short span of time, over days to weeks and it is of paramount importance to identify this early so as to treat the condition.
After a thoughtful read of the above, one might wonder what makes him or her prone to Diabetes in general. There are some risk factors that increase the risk of Diabetes. Having a first-degree relative, parent or sibling with Diabetes makes a person prone to Diabetes, emphasizing the role of genes in the development of the disease. South-East Asians are at higher risk of developing Diabetes than their Caucasian counterparts due to their genetic makeup.
Being overweight, a larger waist circumference- 80 cm in men and 85 cm in women predispose a person to risk of Diabetes. Sedentary life style with desktop jobs, little exercise and unhealthy diets, all these increase the risk of Diabetes. If one were to have a slightly elevated Glucose level that is not yet in the ‘Diabetes range’ but not in the ‘normal range’ either, it is called Impaired Glucose Tolerance or Pre-Diabetes and such people are at higher risk of developing Diabetes. Those women with higher than normal blood Sugar detected first time during pregnancy, known as Gestational Diabetes are at higher risk of developing Diabetes during their life time. Similarly, those women with a health condition called Polycystic Ovarian Syndrome are at higher risk for Diabetes as well.
To summarise, it is pertinent that everyone is aware of the risk factors that predispose one to developing Diabetes and address such risk factors early on in life by trying to lead a healthy lifestyle. It is equally important to know the various signs and symptoms of Diabetes so as to detect it early on and treat Diabetes effectively to prevent the various complications.
Dr. Ravi Sankar Erukulapati, MBBS, MRCP(UK), CCT- GIM,
Consultant- Apollo Hospital, Jubilee Hills,