There are a number of symptoms that can indicate diabetes mellitus.
Symptoms
There may be several symptoms that are unspecific for diabetes, such as
- Persistent fatigue
- Mattness
- Lassitude
- Performance reduction
- Susceptibility to infections
- Poorly healing wound
- Frequent urination
Symptoms of diabetes due to high blood sugar levels include great thirst, weight loss and frequent visits to the toilet to urinate. The skin of diabetic patients may show itching, fungal infections, redness in the facial area and brownish discoloration on both lower legs. Due to diabetes, nerve disorders and thus diseases from the field of neurology are more common.
In men, symptoms such as erectile dysfunction can occur and in women it is possible that the monthly menstruation fails to occur. The diabetic involvement of the lens of the eye can lead to visual impairment. While type 1 diabetics show so-called “hyperglycemic acute symptoms” such as weight loss, increased thirst and frequent urination, chronic consequences of diabetes, e.g. occlusion of the leg arteries (pAVK = peripheral arterial occlusive disease), give rise to complaints in type 2 diabetes.
Diabetes can be diagnosed from a typical medical history (anamnesis): The diabetic complains of increased thirst, frequent urination, weight loss and tiredness. The doctor continues to look for symptoms of a metabolic derailment and checks whether there are already diabetic late damages. Both type 1 and type 2 diabetes have a genetic component, so information about other cases of diabetes in the family can point the way to a diagnosis of diabetes.
In order to diagnose diabetes, it is necessary to determine the blood sugar level. The diagnosis of diabetes is confirmed when The oral glucose tolerance test proceeds as follows: The patient eats carbohydrate-rich food for 3 days (at least 150g per day). After 10-16 hours of food and alcohol withdrawal, the patient drinks 75g of glucose within 5 minutes in the morning while sitting or lying down and remains under medical supervision.
The blood sugar level is determined fasting and 2 hours after drinking the glucose solution. Values above 140mg/dl and below 200 mg/dl indicate impaired glucose tolerance, values above 200 mg/dl indicate diabetes mellitus. Further important information about this test can be found here: Glucose tolerance test – You should know this!
The glucose in the urine should also be determined. With few exceptions, the repeated occurrence of glucose in the urine indicates diabetes mellitus. The reason for this is as follows: If the blood sugar level in a diabetic patient exceeds 160-180 mg/dl, which is due to the lack of insulin action, glucose is filtered from the kidney into the urine.
This value is called the “kidney threshold”, because from here on the excess of glucose is excreted via the kidneys. The filtration of glucose causes water to be removed from the body and the urine volume to increase. The increased urine volume explains the typical symptoms of the patient:
- Frequent urination and
- Enormous thirst.
- In a patient with symptoms, the casual blood glucose level, i.e. without the patient having maintained a fasting phase, is greater than or equal to 200 mg/dl (milligrams per deciliter).
- The blood glucose level in the fasting patient is above 126 mg/dl in two independent measurements.
Fasting means that no food intake took place for 8 hours before the examination. For comparison: In healthy subjects, the blood glucose level in the fasting state is normally below 110 mg/dl.
- In an oral glucose tolerance test (oGTT), the blood sugar level is still above 200 mg/dl 2 hours after glucose administration.
Another diagnostic tool is the determination of ketone bodies in urine. Ketone bodies are substances that are produced when insulin is deficient.
If their concentration in the urine is increased, this indicates a lack of insulin and is a warning sign of a metabolic derailment. Further tests can be performed to detect concomitant diseases and diabetic secondary damage to other organs. These include: A fasting blood glucose test is performed every 3 years as a screening test for diabetes mellitus in persons over 45 years of age.In the case of risk groups, this examination is carried out earlier, namely
- Testing the kidney function
- The determination of blood fat values and cholesterol
- One ocular fundus examination after dilation of the pupil
- Vascular and neurological examinations (neurology)
- As well as the evaluation of the function of the thyroid gland.
- If the patient suffers from symptoms such as high blood pressure, overweight or a fat metabolism disorder,
- When a first-degree relative has diabetes,
- After delivery of a child with a birth weight over 4500 g,
- After gestational diabetes in the medical history,
- If a patient has a history of impaired glucose tolerance.