Diabetes, also known clinically as Diabetes Mellitus, is a serious and rising health issue worldwide. According to WHO, diabetes affects around 422 million people globally, and diabetes is directly responsible for 1.5 million deaths per year. In 2013–2014, approximately 3.0 million Canadians were diagnosed with diabetes. Over the last few decades, both the number of cases and the prevalence of diabetes have significantly increased. 

Diabetes is a chronic disease distinguished by increased blood glucose levels when your body cannot produce enough insulin or doesn’t use insulin properly. Uncontrolled high blood sugar can cause severe complications to your eye, kidney, nerves, and other body organs. 

There are four known types of Diabetes Mellitus: 

• Type 1 Diabetes mellitus: Either insulin production or secretion is abnormal.
• Type 2 Diabetes mellitus: It is a disorder when the body doesn’t use insulin effectively it produces, and eventually, the pancreas makes more insulin as a response, causing an elevation in blood glucose level than usual. 
• Gestational Diabetes: is a condition where high blood glucose level occurs during pregnancy and can cause health problems to mother and child.
• Prediabetes: is when the blood glucose level is higher than usual but still not high enough to be diagnosed as diabetes. 

Whether you have recently been diagnosed with diabetes or want to know the early signs and risk factors of diabetes for prevention, you have come to the right place. This is a first step in gaining a better understanding of the disease and its types in adults and infants, how you can effectively self-monitor your blood glucose level at home and when you should see your doctor. 

Early Signs and Symptoms of Diabetes

Is it possible to know whether you have diabetes? People are not aware of the signs and symptoms of Diabetes that appear in the early stages because the warning indicators might be so minor that they go unnoticed. That is why it is imperative to discuss the warning signs of preventing new cases and progression of this disease. 

The warning signs are: 

• Unexplained weight loss
• Recurrent fatigue
• Infections that frequently occur, particularly in: 

• Urinary tract 
• Genital areas
• Oral cavity
• The wound takes longer than usual to heal

• Dry mouth
• Burning, pain, or numbness of feet
• Itching

Several clinical investigations and experts have revealed that gender and sex can significantly affect the manifestations of any disease. This section aims to address the unique signs and symptoms of diabetes in men and women.

Symptoms in men:

• Fatigue
• Erectile dysfunction
• Retrograde ejaculation
• Inability to control urination
• Low testosterone level
• Decrease sex drive 
• Sexual dysfunction

Symptoms in women:

• Vagnial itching and irritations
• Vaginal discharge
• Painful urination and burning sensation
• Depression
• Weight gain
• Irregular period

Symptoms of Type 1 Diabetes

The onset of Type 1 diabetes symptoms can be remarkably rapid. Type 1 diabetes is associated with the occurrence of autoantibodies produced by the immune system to destroy 𝜷-cell of the endocrine pancreas. These autoantibodies are directed against insulin, glutamate decarboxylase 2, and others, which are found in more than 90% of recently diagnosed type 1 diabetic patients. This link between autoantibodies incidence and diabetes emphasizes the necessity of autoantibody screening in high-risk individuals before symptoms appear. 

Genetic, environmental, and immunologic are three factors that may have a role in destroying cells in the pancreas, resulting in insulin deficiency. It usually develops for several months or years before symptoms arise. 

Symptoms of Type 1 Diabetes in an infant or child

Parents should be aware of the early signs and diagnosis of diabetes in children to prevent the progression of the disease and provide adequate care for their children. Two of the most significant signs are thirst and excessive urination; however, some other signs and symptoms include:

• Shorter sleep duration 
• Weight loss
• Vomiting
• Behaviour changes such as attention problems and aggressive behaviour 
• Sweet/fruity-smelling breath
• Blurred vision
• Tiredness

Symptoms of Type 1 Diabetes in adults

The signs can be challenging to detect at first,  but they can quickly escalate. They are as follows:

• Fatigue
• Recurrent headache due to high sugars
• Diabetic ketoacidosis
• Repeated urination
• Chest burn and indigestion 
• Shortness of breath when exercising or walking 

Symptoms of Type 2 Diabetes

Insulin is a pancreatic hormone that regulates the amount of glucose in the blood for use as energy. Type 2 diabetes patients can’t regulate insulin normally in their bodies, which is clinically known as insulin resistance. As a result, the pancreas produces more insulin to stimulate cell response. Since the body can’t use this insulin properly, blood sugar levels will increase and cause significant health complications. 

Type 2 diabetes is more common in individuals in their forties and fifties. Overweight and physically inactive people are also more susceptible to type 2 diabetes.

One or more of the following signs and symptoms may be present:

• The increased appetite (feeling of hunger)
• Excessive thirst frequently
• Lack of energy
• Increased urination, especially at night
• Vision disturbances
• Frequent infections, mainly in skin and urine
• Tingling or burning sensation, particularly in your feet and legs 

Symptoms of Gestational Diabetes 

Gestational diabetes can occur during pregnancy because women produce hormones that can contribute to insulin resistance. Overweight women are more prone to experience gestational diabetes. Gestational diabetes can develop into Type 2 diabetes later in life if not managed.

Some diabetic symptoms seen during pregnancy include:

• Increased urination
• Tiredness
• Increased thirst

Risk factors associated with Prediabetes

Prediabetes is a stage in the disease process that occurs between normal and diabetes. It usually indicates the existence of impaired fasting glucose (IFG) or impaired glucose tolerance (IGT), or both. 

Impaired fasting glucose (IFG) and impaired glucose tolerance (IGT) are irregular glucose regulation conditions between normal glucose homeostasis and diabetes. IFG is a high fasting blood glucose concentration, whereas a two-hour test that checks your blood glucose level before and after having a sweet drink is IGT. 

Various studies have discovered evidence of both microvascular and macrovascular complications associated with prediabetes. The risk factors, such as a family history of type 2 diabetes mellitus or a clinical history of gestational diabetes, nonalcoholic fatty liver disorder, obesity, can significantly increase the probability of developing type 2 diabetes.

The microvascular abnormalities that significantly affect small blood vessels cause long term complications such as: 

• Chronic kidney disease
• Neuropathy
• Erectile dysfunction
• Abnormalities in sympathetic and parasympathetic nerve fibres
• Retinopathy

While macrovascular abnormalities, which are complications of large blood vessels such as the coronary artery, the aorta, and the arteries in limbs and brain that lead to:

• Increased rates of cardiovascular disease
• Strokes
• Peripheral vascular disease
• Sudden death

A periodontal disease that results in infection of gums and bone around the teeth, high blood pressure, obstructive sleep apnea, male hypogonadism, and cancer have also been linked to prediabetes.

Self Monitoring Tips 

Blood glucose self-monitoring is an effective tool in helping the control of diabetes. During consultations with diabetic healthcare practitioners, records of self-monitoring blood glucose can be helpful to build a strategy in controlling your blood sugars, which may involve physical exercise, diet modifications and glucose-lowering medications

The following are some basic but significant steps for ensuring reliable data from self-monitoring:

• Handle the meter and the test strips with clean, dry hands.
• To prepare your site,  make sure to clean the area with warm water and soap, and then dry it as food residue can be a factor of falsely elevated blood sugar levels.
• You should examine strips using the control solution included with each meter for reliability and check the expiration date.
• Store the meter and supplies out of direct sunlight and in a cool, dry place.
• Moisture can damage the integrity of test strips; thus, they must be stored in their original container.
• The patient needs to document blood glucose results in a logbook and information about food intake, exercise and medication to evaluate self-monitoring blood glucose by the health care providers.
• Bring the meter and blood glucose documentation to appointments with a primary care provider to compare the accuracy. This provides the opportunity to review results, clean the meter, and verify meter codes. 

When to see a doctor?

If you see any of the early signs and symptoms of diabetes, make an appointment with your healthcare provider. Your health care provider will examine you and check whether or not you have an issue that can be treated.  

Call your doctor if you experience slow-healing wounds or infections. If you are pregnant, Gestational diabetes usually develops around the 24th week of pregnancy so you should do an oral glucose tolerance test and the glucose challenge test between the 24th and 28th weeks of pregnancy to maintain your health and the health of your baby. 

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This article offers general information only and is not intended as medical or other professional advice. A healthcare provider should be consulted regarding your specific situation. While the information presented is believed to be factual and current, its accuracy is not guaranteed, and it should not be regarded as a complete analysis of the subjects discussed. All expressions of opinion reflect the judgment of the authors as of the date of publication and are subject to change. No endorsement of any third parties or their advice, opinions, information, products or services is expressly given or implied by Mednow or its affiliates.

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