Do You Have Diabetes? Early Warning Signs

© Stephanie Hicks January 2008

Diabetes is an epidemic in the United States. Millions of people have been diagnosed with the disease, the most prevalent form being "Type 2," commonly known as adult onset. Both Type 1 diabetes and Type 2, can strike children and adults alike, however. And both diseases can be deadly. There are similarities between the symptoms, but many people either are not aware of them, or choose to ignore them until their blood sugars reach dangerous levels. At this point, hospitalization is often necessary. Death may occur in some cases. For these reasons, it is important to learn the early warning signs of diabetes.

If you suspect you have diabetes, it is best to face this possibility and see your doctor as soon as possible. Certainly, if you ignore the early warning signs of diabetes, it will not go away and will likely get worse with more complications. Often, a simple change in diet and exercise plan may be all that is prescribed. As you age, your doctor may recommend regular blood tests to make sure that your blood sugar levels, as well as your cholesterol and other numbers are where they should be. Treatments are improving and easier for everyone across the board that suffers from this ailment.

Type 1 Diabetes: Some people may know this as "juvenile diabetes," but some adults may be diagnosed with the disease (yours truly included), as well. The major distinguishing factor between Types 1 and 2 is that, the disease occurs as a result of an autoimmune reaction that causes the body to literally attack itself - specifically, the pancreas - killing off the cells that make insulin. As a result, any sugar that is ingested, or any carbohydrate that is converted in the digestive process into blood sugar cannot be "unlocked" to be used by the muscles as energy. The sugar simply builds up in the blood, and will continue to do so until medical intervention.

Type 2 Diabetes: This used to be referred to as "adult onset," until the epidemic of childhood obesity gave rise to many more cases of Type 2 diabetes in children under the age of 18. This disease may be the result of a metabolic strain on one's system, often due to being overweight and/or lack of exercise. Sometimes it just occurs as one ages. The individual's pancreas may have difficulties producing enough insulin to keep up with the amount of blood sugar in the system. Obviously, with less sugar or carbohydrate ingested, the less strain on the overworked pancreas. Also, exercise naturally helps lower blood sugar, which has a positive effect, as well. These are generally the first steps recommended to a newly diagnosed Type 2 diabetic.

If you are exhibiting early warning signs of diabetes, your doctor will likely have you come in for a series of lab tests. The first value will be taken after fasting overnight. A healthy nondiabetic person should have a blood sugar reading in the range of 80-115 mg/dl, before eating. Levels higher than this may indicate the need for additional tests or monitoring, or may be the basis for a diagnosis. A reading over 200 mg/dl is generally accepted as indicative of diabetes. The lab may then have you drink a sugary drink with a certain amount of carbohydrates. Two hours "post-meal," another blood draw will be taken to see how (or if) your pancreas is producing insulin in response. Blood sugar levels over 150 mg/dl may show some compromise in your system, as a result of diabetes.

If you are heeding the early warning signs of diabetes, good for you for getting this information. But I know, it's tough. If you are diagnosed with Type 2, you catch it early on, and you are relatively young, you may be able to make some dietary changes and exercise, all while monitoring your blood sugar, to see if you can avoid further medical intervention. Weight loss is a great first step, if you are clinically obese. You will probably do well to attend some sessions with a dietitian to learn serving sizes and count carbohydrates. This will be to your benefit - and your blood sugar levels will fall into line if you pay attention and follow their advice! Managing diabetes is intensive, but not impossible.

For those with more advanced cases of Type 2, or for Type 1, your physician will likely have an intensive training session for you - perhaps at the hospital. But don't let the fear or shots of finger pricks scare you. The shots are subcutaneous - that is, right under the skin, and not into the muscle. Generally speaking, they are less painful. Shots are typically taken into the stomach, but may also may be taken in your buttocks or thighs, if your doctor approves. You may start out with only one or two shots a day. With finger pricks for blood testing, many lancets have dials for you to set how "deep" they go, and the needles are so fine, you can barely feel them these days. Many meters and test strips now allow for testing on the forearm, instead of fingertips, allowing for less pain and callouses.

If diet and exercise is determined not to be effective for a Type 2 patient, there are a number of oral medications that may be prescribed if the warning signs of diabetes are accurate. These generally work by helping the metabolism of sugars in the blood. Depending on the medication, carefully follow prescribing instructions. Low blood sugar (hypoglycemia) may result, which can leave you disoriented, shaky, and you may even pass out.

Over time, and with a combination of weight loss and exercise, some Type 2 patients may stave off the prospect of ever needing to take insulin shots. Others, depending on their own metabolism, family history, or personal factors, may advance over time, to having to take insulin, despite best efforts. Just as with the initial diagnosis, you should not avoid this end result, if it is necessary. Overall health and longevity likely hangs in the balance.

While it is true that you may have to prick your finger to check your blood sugar, on a daily (or more often basis), a diabetic will also have to have lab tests at least quarterly to check their average blood sugar levels for the past 12 weeks - this is commonly known as the A1C test. A nondiabetic would probably have a result of 5.0 or lower. Diabetics aim to have a value under 7.0 to prevent long-term complications. Your test results will be evaluated at appointments at least 4 times a year with an endocrinologist, a specialist trained in metabolic diseases like diabetes.

Healthy daily blood sugar levels are in the range of 80-120, with fasting blood sugars at about 100. Any reading higher than 240 may require a call to the doctor. Higher than 350 and you may need to go to the ER.

If you have a child, medical advances in the diabetes field in the past 5 years have been tremendous. Your pediatrician can provide some assurances if you are faced with the difficult diagnosis of diabetes for a young person in your life. Insulin pumps and sensors, while daunting at first, actually provide much more freedom and security for a "normal" life in the long run. You need not be too afraid if you see the early warning signs of diabetes in your son or daughter.

If you are prescribed oral medications and/or insulin with diabetes, your doctor will likely recommend that you test your blood sugar more frequently than once a day. The possibility of extreme low blood sugar (hypoglycemia) is a side effect of these medications. Once your blood sugar dips below 65 mg/dl, you may become confused, shaky, dizzy and disoriented. At this point, it may become difficult to treat the low blood sugar without assistance. Carrying glucose tablets or candy to provide a quick response to raise blood sugar in these circumstances is always a good idea. Always test your blood sugar before driving, or operating machinery.

Illness, on the other hand, may have the effect of raising blood sugars, even if you are not able to eat anything. Type 1 diabetics in particular must monitor more frequently in these circumstances to prevent hyperglycemia (high blood sugar) and/or ketoacidosis - the dangerous build-up of ketones in the system which can lead to coma or worse.

Use Your "Diabetes Team"

Do not panic if the early warning signs of diabetes turn out to be true. You will probably feel overwhelmed if you have a new diagnosis of diabetes. It is true that there is so much information to digest and understand. Don't get too discouraged - there is even hope on the horizon for a diabetes cure. In the meantime, rely on your "diabetes team" of experts to provide you the specific information you need, as it relates to your specific condition and health. This will include your endocrinologist (a doctor that specializes in metabolic diseases like diabetes), nurses, opthamologist, physician, dentist, nutritionist, and potentially others. In the first weeks and months after a diagnosis, you may find yourself calling these people frequently! Do so!

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