Oct 21 2008
Symptoms and Signs of Diabetes
Learning to identify the signs of diabetes can make a big difference to the impact it has on your health and well being. If you have Type 2 diabetes, your body cells are resistant to the action of insulin and/or your pancreas produces decreasing amounts of insulin. As a result, your blood glucose level becomes progressively higher over time and your body cells receive an inadequate supply of glucose – your body’s primary energy source.
This may result in a range of symptoms including fatigue, lack of energy passing large amounts of urine, thirst, and gradual weight loss. To make up for insufficient glucose, your body may break down fat and protein (from muscle) as additional energy sources. Because your pancreas still produces some insulin, however, your body doesn’t become entirely dependent on fat as an energy source (as in Type 1 diabetes) and you do not develop diabetic ketoacidosis.
Hypoglycemia
If you take insulin or insulin-stimulating tablets, your blood glucose level may sometimes fall below 4 millimoles per liter. This is referred to as hypoglycemia, or a "hypo".
Reasons for hypoglycemia include:
- Taking too high a dose of diabetes medication, or the wrong sort of medication for you.
- Being more active than usual.
- Missing or delaying meals.
- Drinking too much alcohol without compensating with food.
- Taking insulin-stimulating tablets together with other drugs, such as co-trimoxazole, trimethoprim (antibacterials), monoamineoxidase inhibitors (a type of antidepressants and ranitidine (an anti-ulcer drug).
- Other conditions, such as under active thyroid or reduced kidney function, which mean that insulin or tablets are not excreted efficiently.
The main symptoms of a hypo are feeling shaky, sweaty, hungry, and getting pins and needles in your lips, but the symptoms vary from person to person. If your blood glucose level gets very low (below 2.5 millimoles per liter), less glucose reaches your brain, making concentration difficult. People may notice that you are acting strangely. For example, you might struggle to carry out a simple task or your speech might be slurred.
If you feel a hypo coming on, you need to eat or drink something that quickly raises your blood glucose level, such as glucose tablets, a glucose drink, or sugar lumps. If you are confused because your blood glucose is very low, you may need other people’s help to take something.
This is why it can be useful to tell friends and colleagues that you have diabetes. If your hypo is not treated, you may lose consciousness.
Hyperglycemia
A high level of glucose in your blood is referred to as hyperglycemia. If your blood glucose level rises above the recommended 7 millimoles per liter but is below 10 millimoles per liter, you are likely to still feel well. Above this level, however, the symptoms of hyperglycemia start to appear. Although mild and temporary hyperglycemia won’t damage your body, a high blood glucose level over months or years can lead to long-term complications of diabetes.
Reasons for hyperglycemia include:
- Not taking enough medication to lower your blood glucose level, either or because you haven’t been able to take it regularly.
- Being less active than usual.
- Eating very large meals or lots of high-sugar foods.
- Being ill.
The symptoms of hyperglycemia include passing large amounts of urine, intense thirst, fatigue, and infections, such as thrush and cystitis – the same symptoms that may have prompted you to seek treatment before you were diagnosed with diabetes. If your blood glucose level continues to rise and you have Type 1 diabetes, you may develop diabetic etoacidosis; if you have Type 2 diabetes, you may develop excessive dehydration, which may lead to coma, known as non-ketotic hyperosmolar state. Both need hospital treatment.
If you frequently have a low or high blood glucose level or swing between the two, the type, quantity, or timing of your medication, physical activity, or eating may need to change. Your health professional can discuss causes of hypoglycemia and hyperglycemia and suggest appropriate action.