What to look out for with diabetes

Millions of people across the UK have either type 1 or type 2 diabetes. Here, Dr Matthew Capehorn, medical director at weight loss organisation LighterLife, shares his expertise on the possible signs and symptoms of the condition

DIABETES is a common condition affecting approximately 5% of the adult population. In the UK there are already more than three million people with diabetes and, on current trends, this could reach 5.5 million by 2030.

Diabetes patients have difficulty in controlling blood-sugar levels, which in the long term can result in serious complications including blindness, kidney disease and nerve damage.

Without adequate treatment, up to 80% of people with diabetes could die of cardiovascular disease.

By far the most common form of the condition is type 2, which accounts for up to 95% of all cases in the UK.

And of these, up to 85% are associated with poor lifestyle. Being overweight or obese, eating an unhealthy diet and not getting enough physical activity can increase the likelihood of having the dangerous visceral fat that leads to the insulin resistance.

Initially, and for many years, type 2 diabetes may have no noticeable symptoms at all, making it difficult to diagnose unless it’s picked up by routine health screening programmes.

But if you have lots of the following symptoms of diabetes, or if you feel any are severe, then it increases the likelihood that you may have diabetes, and it certainly means you should get checked out by a healthcare professional as soon as reasonably possible.

1. Sudden weight or muscle loss

Unless it is controlled weight-loss as part of a diet, a sudden drop in your weight may not be a good thing.

A drop of more than 5%, or unexplained weight-loss in the region of half a stone per month or more for a few months, needs investigating.

In the case of diabetes, it’s much more likely to be associated with type 1 diabetes. Carbohydrates in the food you eat are broken down into glucose (a type of sugar), but the lack of insulin (or, in the case of type 2 diabetes, the body’s resistance to it) results in this glucose not being taken up by the body’s cells, and ultimately it’s lost in your pee.

The energy (calories) in the sugar that is peed out is one reason for weight-loss, but it’s made worse by the fact that the body may then have to break down fat or even muscle for fuel, making the weight-loss more noticeable.

2. Feeling TATT

Feeling tired all the time (or TATT for short) is a very common symptom but could also be due to undiagnosed diabetes, as the body is not metabolising the sugars in the diet for energy in the correct way, causing chronic tiredness even when sleeping well.

3. Persistent hunger

The feeling of being hungry is complicated. You may be hungry for physiological reasons – when your body is telling you to eat because it’s low on fuel.

However, many of us eat when we’re not really hungry – out of habit or for comfort – and we know that people’s emotional relationship with food is a contributing factor to the growing rates of obesity in society.

After your evening meal you should be full for six to eight hours, so if you get the munchies an hour or two later in front of the television, it’s more likely to be psychological hunger.

However, if your body isn’t correctly metabolising the sugars you eat and using them for fuel, you may be left feeling persistently hungry, so it’s always worth considering a diagnosis of diabetes.

4. Unquenchable thirst

It’s speculated that we as a nation in the UK generally don’t drink enough fluids, so we’re living in a state of mild chronic dehydration.

On a hot day, after exercise or after a particularly salty meal, you might feel especially thirsty – all normal and expected.

However, it’s not normal to be knocking back the water all of the time and feeling like you can never quench your thirst.

This is a classic symptom of diabetes, but again it’s most likely to be associated with type 1 diabetes.

The reason for the thirst is complex, but it can be thought of simply as your kidneys wanting the extra fluid to flush out the excess sugar.

5. Peeing more often

Needing to pass urine much more frequently, perhaps with a degree of urgency, and especially during the night, should always be investigated.

It could just be as a result of having drunk too much (especially of bladder stimulants such as caffeine or alcohol).

If it hurts when you pee, you could have a bladder infection or it could mean that you have an irritable bladder that your doctor may be able to help you manage.

However, it can also be a symptom of more sugar in the blood, increasing the kidney’s role to excrete it, by making us want to pee more often.

Having sugar in your urine can mean other problems too, so it’s definitely worth getting it checked.

6. Itchy bits

Most of the time, genital itching is caused by a yeast infection, when the fungus Candida albicans that is naturally present in your vagina grows unchecked.

Most women experience it at some point, but if it’s happening regularly, it’s vital to speak to your doctor.

High blood-sugar levels provide the perfect conditions for vaginal yeasts to multiply, so an increase in thrush or other yeast infections can occur.

Type 2 diabetes can also suppress your immune response, making thrush more likely.

7. Skin disorders

A change in season, temperature or even shower gel can irritate your skin, but some conditions are closely linked to type 2 diabetes.

However, some skin conditions, including acne and recurrent or persistent cysts or other infections, are associated with poor control of blood sugar levels, so they should alert you to the possibility of a diagnosis of diabetes.

8. Cuts that won’t heal

Chronically high blood glucose levels reduce your immune system’s ability to fight infection, restrict your circulation so it takes longer for blood vessels to deliver healing substances to a wound, and damage nerves so you might not be as aware that you’ve hurt yourself because of a lack of sensation.

Plus, an untreated open wound can lead to further health complications – in fact, poorly controlled type 2 diabetes is one the most common cause of amputation in the UK.

9. Blurred vision

Blurred vision can be caused by damage to the lens inside your eye from high sugar levels, which can also harm the tiny blood vessels in your retina.

Most routine optician checks look for damage to the those blood vessels, and if any is detected you need to book a check-up with your doctor.

Untreated, this eye damage (retinopathy) can lead to blindness, and in adults it’s actually one of the leading causes of sight-loss.

Unfortunately, in the same way that insulin resistance can have been present for many years before someone is diagnosed with diabetes, the vision damage may have been occurring for some time too.

The good news is that with early diagnosis and sticking to the management plan recommended by your healthcare providers – whether this is with diet and lifestyle change such as weight-loss or with medication – you can avoid most, if not all, of these risk factors.

But it’s always important to consider a diagnosis of diabetes, especially if you are in the two-thirds majority of the adult population in the UK who are overweight or obese.