Signs and Symptoms of Diabetes
Diabetes (also known as Diabetes mellitus) is a metabolic condition often caused by genetic and environmental factors, that results in unusually high blood glucose levels (hyperglycemia). Normally, blood glucose levels are tightly controlled by an array of signaling molecules and hormones, most importantly insulin. The condition of diabetes occurs, when insulin action or insulin secretion are compromised. All cases of diabetes develop because of a reduction in insulin secretion (type 1) or due to a resistance to its effects (Type 2 or gestational).
The major signs of diabetes:
- Excessive urine production: when the glucose concentration in the blood rises too high (hyperglycemia), the kidneys are unable to reabsorb some of the excess glucose and glucose remains in the urine. This causes the osmotic pressure to go up, which prohibits some water re-absorption by the kidneys resulting in increased urine production (polyuria)
- Increased Thirst (Polydipsia): due to increased urine production, people with diabetes develop increased thirst. Drinking of beverages containing high amounts of sugar will actually increase the thirst and polyuria
- Increased appetite: since glucose is not effectively utilized by the cells and tissues, the brain will signal the body to increase food intake
- Blurred vision: due to prolonged hyperglycemia, the shape of the lens changes, resulting in blurred vision. This happens more quickly in type 1 diabetes than in type 2 diabetes
- Ketone breath: diabetic ketoacidosis, which is caused by a disregulated metabolism, results in an acetone-like (as in nail polish remover) smell of the breath in patients with diabetes
Other symptoms of diabetes include heavy breathing, lethargy, fatigue, vomiting and abdominal pain.
Type 1 diabetes is caused by a diminished secretion of insulin, due to a loss of insulin-producing cells in the pancreas. Type 1 diabetes can develop acutely and is a chronic condition that needs to be treated by injection of artificial insulin. Without insulin, diabetic ketoacidosis will develop, which can lead to death or coma. Type 1 diabetes has some genetic basis, however the majority of type 1 diabetes cases are triggered by (viral) infections (such as pancreatitis), stress or environmental factors.
Type 2 diabetes (the most common form of diabetes) develops more slowly than type 1 and is characterized by a resistance to insulin or a reduced insulin sensitivity. It most likely involves the insulin receptor. It has a much stronger genetic component than type 1 diabetes. First degree relatives of type 2 diabetes patients have a very high chance of developing the disease. The main symptom of type 2 diabetes is elevated insulin levels in the blood and the condition can be controlled very well with either medications that increase insulin sensitivity or lifestyle changes that reduce the intake of sugar and simple carbohydrates. Type 2 diabetes often needs to be treated with insulin in later stages of the disease. Obesity is a common risk factor for developing type 2 diabetes: abdominal fat is known to secrete many hormones that could impair glucose tolerance.
Gestational diabetes: diabetes can also develop during pregnancy, a condition affecting 2-5% of pregnancies which results from a combination of reduced insulin secretion and sensitivity. It can often be treated successfully, but it requires close medical supervision as it can be damaging to the health of the fetus and mother.
Complications of diabetes include changes to blood vessels (both small blood vessels and arteries), which can become weaker. This leads to a number of conditions such as diabetic retinopathy (vision loss due to improper formation of small blood vessels in the retina), diabetic kidney failure (diabetes is the leading cause of kidney failure), neuropathy due to diabetes (abnormal and reduced sensation caused by nerve damage), damage to the heart, which can lead to heart failure, stroke, peripheral vascular disease and breakdown of muscle tissue.
Diabetes can be kept under control with proper insulin treatment and other diabetes medications as well as lifestyle changes such as following a healthy diet, weight loss and regular exercise.
