What're signs and symptoms of diabetes mellitus?
Type 2 diabetes almost always has a slow onset (often years), but in Type 1, particularly in children, onset may be quite fast (weeks or months). Early symptoms of Type 1 diabetes are often polyuria (frequent urination) and polydipsia (increased thirst, and consequent increased fluid intake). There may also be weight loss (despite normal or increased eating), increased appetite, and unreduceable fatigue. These symptoms may also manifest in Type 2 diabetes, though this seldom happens for some years, and sometimes not at all. Clincally, it is most common in Type 2 patients who appear at the doctor with frank poorly controlled diabetes.
Thirst develops because of osmotic effects - sufficiently high glucose (above the 'renal threshold') in the blood is excreted by the kidneys but this requires water to carry it and causes increased fluid loss, which must be replaced. The lost blood volume will be replaced from water held inside body cells, causing dehydration.
Another common presenting symptom is altered vision. Prolonged high blood glucose causes changes in the shape of the lens in the eye, leading to blurred vision and, perhaps, a visit to an optometrist. All unexplained quick changes in eyesight should force a fasting blood glucose test. These are now quick (less than 5 minutes total), inexpensive (materials less than US$1), and can be safely performed by almost anyone with trivial training.
Especially dangerous symptoms in diabetics include the smell of acetone on the patient's breath (a sign of ketoacidosis), Kussmaul breathing (a rapid, deep breathing), and any altered state of consciousness or arousal (hostility and mania are both possible, as is confusion and lethargy). The most dangerous form of altered consciousness is the so-called "diabetic coma" which produces unconsciousness. Early symptoms of impending diabetic coma include polyuria, nausea, vomiting and abdominal pain, with lethargy and somnolence a later development, progressing to unconsciousness and death if untreated.
Signs and symptoms of diabetes mellitus are due to the high amounts of sugar in the body. The signs and symptoms of Type 1 diabetes develop quicker and become more severe than those of Type 2 diabetes. However, the symptoms of Type 2 diabetes may not be noticed until a regular medical checkup. The more severe the diabetes is, the more sugar is in the blood and the longer high blood sugar levels last. The high amount of sugar in the blood means that more urine is needed to carry it out of the body. As a result, people with diabetes usually experience a strong urge to pee, high amounts of urination (peeing), and constant thirst. The strong urge to pee can occur at night and lead to low amounts of sleep. A high amount of peeing also leads to high amounts of water and electrolyte loss. Electrolytes are chemical substances that are able to conduct electricity after they are melted or dissolved in water.
For people with diabetes mellitus, the urine (pee) smells sweet because the extra sugar comes out in the urine flow. Weakness and tiredness occur because the cells in the body are not able to store or use the sugar that they need for energy. Thus, the body is being starved of one its main energy sources. The body still gets some energy, however, from breaking down stored fat. The breaking down of stored fat, in turn, leads to weight loss.
Although people with diabetes mellitus can break down stored fat for energy, the body has a difficult time doing so. People with diabetes mellitus also have a difficult time breaking down proteins. The difficulty in breaking down fats, especially when the body does not produce insulin, can lead to the production of acids and poisonous chemical substances called ketones. This condition is known as ketoacidosis. Ketoacidosis is a medical emergency because it can cause coma, severe loss of body fluids, and even death. A coma is a state of deep unconsciousness in which there are no voluntary movements, no responses to pain, and no verbal speech. The signs and symptoms of ketoacidosis are nausea, vomiting, abdominal pain, confusion, deep breathing, and foul-smelling breath. The foul-smelling breath smells like nail polish remover.
Emergency treatment for ketoacidosis includes giving the person fluids to correct for fluid loss and to bring back a normal chemical balance in the blood. Insulin injections are also given to allow cells to better absorb glucose from the blood. Ketoacidosis can occur in people with Type 1 and Type 2 diabetes. The difficulty with breaking down fats is especially true for people with Type 1 diabetes (see two sections down for a description) if they miss several doses of insulin or develop another disease. The reason for this is that developing another disease increases the body's use of insulin. Other symptoms of diabetes mellitus are blurry vision, increased hunger, boils, as well as tingling and loss of sensation in the feet and hands. Boils are inflamed, pus-filled areas of the skin. Pus is a yellow or green creamy substance sometimes found at the site of infections.
More information on diabetes mellitus
What is diabetes mellitus? - Diabetes mellitus is a a condition characterized by hyperglycemia resulting from the body's inability to use blood glucose for energy. Diabetes mellitus can result in coma. Over time, complications can include nerve injury, blindness, kidney failure, and premature atherosclerosis with all of its complications.
What causes diabetes mellitus? - Diabetes mellitus is a disorder caused by insufficient production of the hormone insulin by the pancreas, or insensitivity of cells to the effects of insulin. Insulin is responsible for the absorption of glucose into cells for their energy needs and into the liver and fat cells for storage.
What is insulin? - Insulin is a hormone that is produced by specialized cells (beta cells) of the pancreas. In addition to helping glucose enter the cells, insulin is also important in tightly regulating the level of glucose in the blood.
What types of diabetes mellitus are there? - There are four main types of diabetes mellitus. They are type 1 diabetes mellitus, type 2 diabetes mellitus, type 3, and Gestational diabetes mellitus (type 4).
What is type 1 diabetes? - Formerly known as juvenile diabetes or insulin-dependent diabetes, type 1 diabetes is a life-long condition in which the pancreas stops making insulin. Type 1 diabetes develops most often in young people but can appear in adults.
What is type 2 diabetes? - Type 2 diabetes is the most common form of diabetes mellitus. People with type 2 diabetes produce insulin, but either do not make enough insulin or their bodies do not use the insulin they make. Type 2, also known as non-insulin dependent diabetes, typically occurs after the age of 40 years.
What're signs and symptoms of diabetes mellitus? - Type 2 diabetes almost always has a slow onset (often years). Early symptoms of Type 1 diabetes are often polyuria (frequent urination) and polydipsia (increased thirst, and consequent increased fluid intake).
What is diabetes insipidus? - Diabetes insipidus (DI) is a disease characterized by excretion of large amounts of severely diluted urine, which cannot be reduced when fluid intake is reduced.
What is diabetic coma? - Diabetic coma is a medical emergency in which a person with diabetes is unconscious because the blood glucose level is too low or too high. Patients with diabetes mellitus type 1 are especially prone to this condition.
What are the complications of diabetes mellitus? - Many people with diabetes mellitus eventually develop complications. A very common short-term complication of diabetes mellitus is hypoglycemia (abnormally low blood sugar levels).
How to diagnose diabetes mellitus? - The diagnosis of type 1 diabetes is usually prompted by recent symptoms of excessive urination (polyuria) and excessive thirst (polydipsia), often accompanied by weight loss. The diagnosis of other types of diabetes is made in many other ways.
Diagnosis protocol for diabetes - People over age 45 should be tested for diabetes. If the first blood glucose test is normal, they should be re-tested every three years. A diagnosis of diabetes is made when any three of these tests is positive, followed by a second positive test on a different day.
What is the treatment for diabetes? - Diabetes is a chronic disease with no cure, but it can almost always be managed effectively. Nowadays, the goal for diabetics is to avoid or minimize chronic diabetic complications, as well as to avoid acute problems of hyperglycemia or hypoglycemia.
What type of diabetes diet is suggested? - For some people with diabetes mellitus, a healthy diet and weight loss is enough to keep glucose levels in the blood normal.
What medications are available for diabetes? - Oral diabetes medicines, or oral hypoglycemics, can lower blood glucose in people who have diabetes, but are able to make some insulin. Six FDA-approved oral diabetes medications are now on the market.
How to prevent diabetes? - Diabetes prevention is proven, possible, and powerful. Studies show that people at high risk for type 2 diabetes can prevent or delay the onset of the disease by losing 5 to 7 percent of their body weight.
What should a child diabetes do every day? - To control diabetes and prevent complications, blood glucose levels must be as close to a "normal" range as safely possible. Families should work with a health care provider to help set a child's or teen's targets for blood glucose levels.
Smoking and diabetes - There is a growing body of evidence to suggest that smoking is an independent risk factor for diabetes and that among people with diabetes, smoking aggravates the risk of serious disease and premature death.