Today, as I am writing this article, all over the world Diabetes Mellitus is spreading like wildfire with barely any solution to end it. What we as human beings, have achieved is control over the signs, symptoms, and complications of the disease.
Is there any way to eliminate DM? Well, as far as I have known, in all my 35 years of medical practice, you cannot do away with it totally.
But, in the early stages, also known as Impaired Glucose Tolerance or Pre-diabetes, you can prevent it from advancing to its full-fledged form. This can save one from the suffering and the cost of treatment, not to mention man-hours lost due to co-morbidities like heart failure, kidney failure, stroke, urinary tract infection, obesity, etc.
As mentioned in my last post, there are 4 types of diabetes. In this article, I will be highlighting the signs and symptoms of DM.
The signs and symptoms [S/S] common to all the types of diabetes are in the form of this 3 Ps:–
1] Polyuria– meaning frequent urination;
2]Polydypsia– meaning excessive thirst;
3]Polyphagia– meaning excessive hunger.
Apart from these 3 signs and symptoms [S/S], there are a plethora of S/S due to the co-morbidities of DM, which I will cover as we move forward. Clicking on the picture below will show you in short what we can expect in Type 1 DM:
In Type 2 DM, apart from above 3 Ps, the patient may have:-
1] Yeast [candida] infections of-
2]Slow healing of wounds.
3]Tingling/pinprick sensation and numbness in the legs and arms[neuropathy].
5] Blurring of vision [early cataract, retinopathy].
6]Fungal infection of nails[onychomycosis] and scalp[tinea capitis]
7] Passing of proteins in the urine [nephropathy].
8] Darkening or velvety appearance of the skin in areas like axilla, nape of the neck known as acanthosis nigricans- ↓
Sometimes you need amputation of the gangrenous part like the picture shown here⇒
The picture shown here is of one of my patients who had to undergo amputation of the toes due to severe infection leading to gangrene. Had it not been amputated, the patient would have lost his foot and probably his whole leg.
Some of the S/S is a part of complications of DM[those in brackets], which I will discuss in detail when I come to the complications part of the series.
Depending upon the signs and symptoms of diabetes your doctor will initiate the appropriate treatment. Patients should comply fully and follow the instructions of his/her family physician. This will get the best results and prevent complications of diabetes.
Having said this, we will now proceed to find out what are the lab tests we have to carry out to confirm if one is a diabetic:-
1] Blood sugar fasting and post-lunch;
2] Hba1c [glycoslated haemoglobin];
3] C-peptide test to know the level of insulin in the blood and the health of the pancreas.
4] Serum insulin level to know whether it is Type 1 or Type 2 diabetes in adults.
We will study the interpretation and implications of these tests in Part 4 of this series on diabetes.