Conditions
Diabetes
Short answer
Diabetes is a chronic metabolic disorder: because of insulin deficiency or a defect in the action of insulin, the body cannot properly use carbohydrates, protein and fat. The diagnosis is confirmed by any one of the four criteria below. The doctor's emphasis: “Diabetes is a metabolic disorder that is kept under control every day, not just on one day.”
International (ADA) criteria. Review your result with your doctor.
Diagnostic criteria
One of them is enough
| Test | Diabetes |
|---|---|
| Fasting blood sugar (≥8 hours of fasting) | ≥126 mg/dL (7 mmol/L) |
| At any time of day + diabetes symptoms (drinking a lot of water, urinating at night, dry mouth, etc.) | ≥200 mg/dL (11.1 mmol/L) |
| Glucose tolerance test (OGTT), at 2 hours | ≥200 mg/dL (11.1 mmol/L) |
| HbA1c | ≥6.5% (48 mmol/mol) |
General information
- Types:
- type 1 diabetes — insulin deficiency;
- type 2 diabetes and the stage before it — prediabetes;
- gestational diabetes.
Although the name is similar, diabetes insipidus (“sugarless diabetes”) is a different disease of hormonal origin; for this condition, too, people see an endocrinologist.
- Classic symptoms:
- thirst, dry mouth, drinking a lot of water;
- frequent urination at night;
- weight loss or unexplained weight gain;
- itchy skin, chronic skin infections (often fungal);
- constipation, insomnia.
- Non-classic symptoms. The doctor's note: “Diabetes may not always start with the classic complaints.” These symptoms can also point to diabetes:
- tiredness, a worn-out feeling, weakness;
- weak eyesight;
- dry skin, cracks in the skin, wounds that do not heal;
- sores in the mouth;
- constipation, nausea.
- Lesser-known symptoms (from the doctor's writing):
- Skin changes: acanthosis nigricans (darkened, thickened skin on the neck, armpits and groin); necrobiosis lipoidica (brownish-red, thin, shiny plaques, mostly on the legs); very dry, itchy skin.
- Mouth problems: constant dry mouth; hidden gum infections; breath that smells fruity — especially in diabetic ketoacidosis, which is an emergency.
- Nerve and muscle problems: a tingling or burning sensation in the arms and legs (an early sign of diabetic neuropathy); stiffness of the fingers in the morning (diabetic hand syndrome); sudden blurred vision.
- Sensory changes: changes in smell and taste — a sweet or metallic taste.
- Behavioral changes: irritability for no reason, depression; severe headache in the morning (during nighttime hypoglycemia).
- Risk factors: genetic predisposition (diabetes in a first-degree relative — mother, father, sister, brother), inactivity, excess weight, insulin resistance.
- Complications. Because high blood sugar does not cause visible changes in the short term, it gives patients a false sense of security. Over the long term, it can lead to serious complications in the heart and blood vessels, brain, eyes, feet, hands and kidneys. In the doctor's words: “Today's high numbers can sometimes show up as complications after a while. Normal is always normal.”
In the doctor's practice
treatment approach → Diabetes treatment and follow-up. The doctor's observation: “Diabetes is neither dangerous nor unbearable as long as you don't let it get close to you.”
Topics
- Prediabetes and type 2A fasting blood sugar above 100 mg/dL is a warning sign; above 110, see an endocrinologist. Prediabetes, type 2 diabetes, family…
- Type 1 diabetesIn type 1 diabetes, insulin is the main treatment: no pill or product advertised on social media replaces it. Endocrinologist Dr.…
- HypoglycemiaHypoglycemia — blood sugar below 70 mg/dL. Symptoms, first aid (15–20 g of sugar), glucagon. Very low blood sugar is more…
- Diabetes complicationsTreating diabetic neuropathy needs stable blood sugar. Diabetic foot, metformin and B12, target blood pressure in diabetes — an…