The most important signs of diabetes are increased thirst, polyuria, tiredness and weight loss. Diabetes signs and symptoms are produced due to increased blood sugar level and failure to convert glucose into energy. The glycosuria and salt loss lead to mild dehydration which increases thirst and due to loss of sugar in the urine significant amount of energy is lost in the urine hence the weight loss. Diabetes signs and symptoms may be non-specific. Feelings of tiredness, weakness and irritability are not uncommon but patients often think that these may be due to depression, poor sleep or increasing age.
Minor difference in normal levels of blood glucose produces few symptoms. In most cases the diabetes signs and symptoms start slowly and are due to excessive loss of fluid and imperfect nourishment. Symptoms of diabetes such as increased thirst, increased urination, increased appetite, dryness of the skin and itching of the skin especially of the genitals, progressive muscular weakness results from decreased utilization of carbohydrate by our body. Decreased utilization of carbohydrate leads to increased utilization of fat and finally ketosis. Passing of glucose in the urine favors bacterial growth causing inflammation and infection of the private parts, also yeast and other fungal growth on the genitals and surrounding skin causing pruritus and eczema.
Urine has high specific gravity, glucose and in severe cases acetone, albumin, granular casts is also present. Blood sugar and blood lipids are increased, if weight loss is apparent, hypoprotenemia with decreased serum albumin is present. Patient experiences numbness in the hands and the feet. It is common to find mild to moderate levels of liver abnormality in patients with diabetes.
Development of ketosis
In severe diabetes, glycosuria increases with an increase of nitrogen excretion due to formation of new glucose. This increases the amount of lipids in the blood and increased catabolism of fats. This breaking of fat leads to increased ketones which makes unable for our body to utilize completely and it accumulates in the blood causing ketosis. The ketones accumulated in the blood, disturb the acid-base equilibrium. To balance the acid base equilibrium, the body starts using sodium, potassium and calcium to neutralize the acid. This means that these chemicals are lost to the body and a toxic condition develops affecting the brain, the central nervous system and also the heart. During ketosis symptoms start slowly with increasing weakness, restlessness, dull headache, constipation and nausea. The respiration is slow, pulse is quick, and blood pressure is low. In severe ketosis, signs of dehydration such as sunken eyes, dry lips and tongue, persistent thirst and flaccid skin are present.
Effect of diabetes on human body
This depends upon the time period of diabetes and many other factors such as high blood pressure, intake of alcohol and smoking habits. High blood pressure, particularly uncontrolled, is related to an increased risk of micro and macrovascular complications.
After 20-25 years, some mild diabetic changes occur in eyes of the diabetic patients. If there is poor control of diabetes laser treatment may be needed. Cataracts occur more frequently in older patients. Diabetic retinitis, a serious condition involving the eyes, is seen when disease is not properly under control and it is frequently seen in diabetic children.
Kidney changes are seen after 10 years. More severe signs such as proteinuria and kidney failure are seen in 5-10% of the cases. The patients loses albumin, suffers from high blood pressure, swelling of various parts of the body. Younger patients are more prone to develop these serious kidney diseases. Such patients should be cautious about any kind of infection at all times.
Heart diseases and stroke result later in life with progressive age. These are the most common killers for people with type 2 diabetes. Hardening of the arteries occurs much more frequently in diabetic patients. This is particularly seen in the lower extremities where deep ulcers may form in the feet or legs and gangrene may result.
Some people will exhibit minor nervous changes, often with few or no diabetes signs and symptoms. Severe damage to nerves leading to gangrene or amputation is seen in 5% cases of diabetes.
Diabetic patients are prone to infections of the skin, such as boils, carbuncles and generalized itching. Whenever a person develops a boil or other skin infection, which is taking time to heal up, his urine must be tested for the presence of sugar.
Most of the important complications do not exhibit significant symptoms. Renal impairment, visual loss and nervous symptoms are irreversible. Prevention of further deterioration is usually best to achieve.
Many diabetic patients do not have marked diabetes signs and symptoms in the early stages of the disease. But unless properly treated they may reach to a serious problem. The younger the patient, the more serious is the disease, and usually the more rapid its progress the greater the need for immediate treatment.