Diabetes is present in 8% of people in the United States. 90-95% of the people with diabetes have Type 2 diabetes.
Diagnosis of diabetes depends on laboratory documentation of an elevated fasting blood sugar >125 mg/dl, an elevated 2-hour blood sugar of 200 mg/dl or more 2-hours after a 75 gram oral glucose tolerance test, or a random blood sugar of 200 mg/dl or more with typical diabetes symptoms.
An HA1c of 6.5% or more may also be used as another method of diagnosis. The HA1c must be obtained from a laboratory (not one of the mail-order or pharmacy self-test kits).
Before diabetes is diagnosed, many people complain of symptoms which suggest elevated blood sugar levels.
Although symptoms typically appear when blood sugar levels are greater than 200 mg/dl, there is considerable variability.
Some people notice symptoms with sugar levels in the mid-100’s, while others may deny complaints even when sugar levels rise well above 200 mg/dl.
Lack of symptoms is especially common when sugar levels have been elevated for prolonged periods of time.
Increased frequency of urination is the most common reason that people seek medical attention for diabetes.
There is no threshold for diagnosis of increased urinary frequency. It is simply an increase from your baseline.
Increased urinary frequency may also be due to increased fluid intake, a urinary tract infection, or, less commonly an inability of your body to hold on to water.
The different causes of urinary frequency can often be diagnosed in your physician’s office by obtaining a careful history and providing a urine sample.
Once blood sugar levels return to normal, urinary frequency also quickly returns to normal.
If increased urinary frequency persists in the setting of normal blood sugar levels, alternative causes need to be considered.
#2)Changes in Vision
Visual changes are another reason people seek medical attention to rule out diabetes.
Changes may include complaints of “double vision”, difficulty reading printed materials or watching TV, or a significant change in prescription glasses.
Visual symptoms are due to sugar-induced changes in the shape of the lens of your eye.
Since similar complaints can be caused by eye problems not related to elevated sugars, evaluation by an ophthalmologist is critical.
Once sugar levels are normalized, visual complaints gradually resolve. Unlike urinary frequency, the return to normal vision may take several weeks.
Another common complaint associated with elevated blood sugars is numbness.
The numbness typically occurs in the feet, but may also involve the hands.
Characteristically, the numbness begins in the toes, then “spreads” to the feet. Numbness may later extend to the foot and mid-leg. The thigh is rarely involved.
Numbness is worse at rest (people often complain of symptoms at night when trying to go to sleep), and is almost always bilateral.
The numbness may be accompanied by severe, stabbing pains as well as extreme sensitivity to touch.
Although symptoms typically resolve soon after sugar levels have returned to normal, some people note continued complaints.
Since other nerve-related problems may cause numbness of the feet and hands, careful medical evaluation is needed. Other causes should be considered if the numbness or pain is associated with exercise, if the symptoms are one-sided, or if there is associated back pain.
Other symptoms of high blood sugar include unintentional weight loss, increased hunger, increased frequency of infections (especially vaginal yeast infections in women), slow healing of wounds and unexplained fatigue.
If you have any of these symptoms, contact your physician to schedule further evaluation.
Remember that there can be significant variability in the severity and duration of these symptoms.
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