Website design By BotEap.comThe most common symptom my patients have of the onset of diabetes is: none!

Website design By BotEap.comMost of my patients are adults whom I see regularly, many of whom have regular blood tests. Patients who are at risk for diabetes, who are overweight or have a family history of diabetes, are often diagnosed on routine blood tests done for other reasons. In general, these patients do not present specific symptoms.

Website design By BotEap.comHistorically, excessive thirst, frequent urination, weight loss, and increased hunger have been cited as classic diagnostic signs. Sweet-tasting urine is another, but modern doctors rarely use this diagnostic test. (Most doctors don’t know what regular urine tastes like, anyway.) The Latin words, diabetes mellitus, mean “running honey.”

Website design By BotEap.comHowever, when a patient’s blood sugar level is high enough to cause these symptoms, diabetes is usually quite advanced.

Website design By BotEap.comWhat causes thirst and frequent urination in a diabetic? The kidney is normally capable of absorbing all the glucose that flows through it. However, above a certain threshold, usually around a blood sugar level of 200 to 300 mg/dL, the kidney can no longer absorb all the glucose in the blood, causing the sugar to “spill over” in the urine. Glucose in the urine acts as a diuretic, causing an increase in the volume of urine and, therefore, an increase in urinary frequency.

Website design By BotEap.comBecause some of the calories in the diet pass directly through to a patient with diabetes, weight loss can occur, especially in children with type I diabetes. Children with type I diabetes tend to be thin and eat more to compensate. that they are losing. Most type II diabetics (representing the majority of adults with diabetes) are overweight to begin with and may not show weight loss. Some are pleased if weight loss occurs and thus delay seeking medical attention. Type II diabetes is no longer a disease limited to adults. Overweight teens and tweens are also at risk.

Website design By BotEap.comThe current definition of diabetes is a fasting blood glucose reading of just 126 mg/dl, much lower than the level at which patients exhibit the above symptoms. However, recognizing the more subtle symptoms of diabetes can lead to a diagnosis of blood sugar levels below those that cause thirst and frequent urination. Sometimes a patient will complain of fatigue (mental or physical). In women, recurrent vaginal yeast infections or a fungal rash under the breast may be associated with diabetes. Occasionally men complain of a yeast rash in the groin area. Some patients describe mild discomfort when urinating or a change in vision.

Website design By BotEap.comThe laboratory definition of diabetes has changed in recent decades, with the threshold for diagnosis falling lower and lower. Along with this, blood sugar treatment goals now aim at normal or near-normal blood glucose levels. With our better understanding of how obesity leads to diabetes, insulin resistance is now recognized as a prediabetic condition.

Website design By BotEap.comInstead of waiting for symptoms to appear, if you’re at risk for diabetes, see your doctor, who may want to do a simple blood test. Or take advantage of your local health fair or pharmacy chains, which often offer free diabetic testing.

Website design By BotEap.comCopyright 2010 Cynthia J. Koelker, MD