Type 1 diabetes symptoms,Information

Type 1 diabetes symptoms

Type 1 diabetes is different to its more common counterpart, type 2 diabetes.

Whilst the major symptoms of diabetes are similar for type 1 and type 2, it is worth knowing the specific symptoms of type 1 diabetes as well as more general diabetes symptoms.


The 4Ts - symptoms of type 1 diabetes

Some of the most noticeable and most common symptoms of type 1 diabetes are:

Excessive thirst
Unusually high levels of urination
Feeling tired all the time
Loss of muscular bulk and unexplained weight loss

The main symptoms of type 1 diabetes are often referred to as the 4Ts of type 1 diabetes.

Other symptoms which may accompany the above symptoms are:


Itchiness around the penis or vagina
Blurring of vision (caused by dryness of the eyes)
Unexpected cramping
Skin infections
Emergency diabetes symptoms

Seek urgent medical attention if diabetes symptoms combine with any of the following:

A serious loss of appetite
Nausea and vomiting
A temperature
Pains in the stomach

A fruity, chemical smell on the breath (most often likened to pear drops or nail varnish)
The symptoms above could be a sign of diabetic ketoacidosis (DKA), a dangerous condition that can be life threatening if medical treatment is not provided immediately.

Around 1 in 4 people diagnosed with type 1 diabetes are suffering with ketoacidosis at the time of diagnosis. Recognising the 4 main symptoms of type 1 diabetes can help to get a diagnosis before ketoacidosis sets in.

How long does it take to develop type 1 symptoms?

The symptoms of type 1 diabetes in children and young adults tend to develop quickly over a few weeks or few days.

Type 1 diabetes is a dangerous condition if it is left untreated for too long. It is therefore important to seek a diagnosis from your doctor if you or your child is showing the symptoms of type 1 diabetes.

Type 1 diabetes can develop at any age. Adults may develop a specific form of type 1 diabetes known as LADA (latent autoimmune diabetes of adulthood).

LADA tends to develop more slowly than type 1 diabetes in children and young adults and people with LADA may sometimes be misdiagnosed as having type 2 diabetes.

Can a blood glucose meter help to diagnose type 1 diabetes?

A blood glucose meter may be helpful in indicating whether you or a family member may have diabetes.

It is not essential to have a blood glucose meter but it may be considered useful in a family with a history of type 1 diabetes or autoimmune conditions.

A blood glucose result, taken over 2 hours after eating, of over 7.8 mmol/l could indicate a presence of diabetes.

If high results are being recorded 2 hours after eating for consecutive meals, contact your GP who will be able to carry out a diagnosis.

It is important that devices used to draw blood from fingers are not shared to prevent the risk of blood borne illnesses.


Polydipsia


Polydipsia is a symptom of both diabetes mellitus and diabetes insipidus

Polydipsia is the term given to excessive thirst and is one of the initial symptoms of diabetes. It is also usually accompanied by temporary or prolonged dryness of the mouth.

We all get thirsty at various times during the day. Adequate daily intake of water (several glasses) is very important as water is essential for many bodily functions, including regulating body temperature and removing waste.

However, if you feel thirsty all the time or your thirst is stronger than usual and continues even after you drink, it can be a sign that not all is well inside your body.

Causes of polydipsia

Increased thirst is often the reaction to fluid loss during exercise, or to eating salty or spicy foods. It can also be caused by:

Diarrhoea
Vomiting
Profuse sweating
Significant blood loss or
Certain prescription medications

Increased thirst can also occur as a result of high blood sugar levels in people with diabetes or yet to be diagnosed diabetes.


Persistent excessive thirst can be the result of one of the following:

Diabetes mellitus
Diabetes insipidus - a condition unrelated to diabetes mellitus that affects the kidneys and the hormones that interact with them, resulting in large quantities of urine being produced
Dehydration
Loss of body fluids from the bloodstream into the tissues due to: burns or severe infections (sepsis) or heart, liver, or kidney failure
Psychogenic polydipsia - compulsive water drinking associated with mental/psychiatric disorders

Excessive thirst can be caused by high blood sugar (hyperglycemia), and is also one of the ‘Big 3’ signs of diabetes mellitus.

Increased thirst and diabetes

Increased thirst in people with diabetes can sometimes be, but certainly not always, an indication of higher than normal blood glucose levels.

People with diabetes with access to blood glucose testing equipment may wish to test their blood sugar levels when they are thirsty to determine whether their blood sugar levels are going too high.

If you do not have blood glucose testing equipment and are experiencing regular thirst which you think may be connected with your diabetes, speak with your health team who should be able to advise you.

Recognising symptoms of polydipsia

As anyone and everyone will have experienced the sensation of feeling thirsty, it is very important not to jump to conclusions.

However, the symptoms of polydipsia are recognised as:

Having persistent and unexplained thirst, regardless of how much you drink
Passing more than 5 litres of urine a day
When to see your doctor

If you have diabetes and experience increased thirst for a number of days, you should make an appointment to see your doctor/healthcare team.

If you don’t have diabetes, you should see a doctor if the reason for thirst cannot be explained and particularly if you have other symptoms of diabetes - in paticular polyuria and polyphagia.



Polyuria - Frequent Urination

Polyuria is defined as urinating more than 3 litres a day

Polyuria is a condition where the body urinates more than usual and passes excessive or abnormally large amounts of urine each time you urinate.

Polyuria is defined as the frequent passage of large volumes of urine - more than 3 litres a day compared to the normal daily urine output in adults of about one to two litres.

It is one of the main symptoms of diabetes (both type 1 and type 2 diabetes) and can lead to severe dehydration, which if left untreated can affect kidney function. 

Causes of polyuria

Polyuria is usually the result of drinking excessive amounts of fluids (polydipsia), particularly water and fluids that contain caffeine or alcohol.

It is also one of the major signs of diabetes mellitus. When the kidneys filter blood to make urine, they reabsorb all of the sugar, returning it to the bloodstream.

In diabetes, the level of sugar in the blood is abnormally high. Not all of the sugar can be reabsorbed and some of this excess glucose from the blood ends up in the urine where it draws more water.

This results in unusually large volumes of urine.

Other causes of polyuria include:

Diabetes inspidus - a condition unrelated to diabetes mellitus that affects the kidneys and the hormones that interact with them, resulting in large quantities of urine being produced.
Kidney disease
Liver failure
Medications that include diuretics (substances that increase the excretion of water from the body/urine)
Chronic diarrhoea
Cushing’s syndrome
Psychogenic polydipsia - excessive water drinking most often seen in anxious, middle-aged women and in patients with psychiatric illnesses
Hypercalcemia - elevated levels of calcium in the blood
Pregnancy
Polyuria as a symptom of diabetes

As well as being one of the symptoms of undiagnosed diabetes, polyuria can also occur in people with diagnosed diabetes if blood glucose levels have risen too high.

If blood glucose levels become too high, the body will try to remedy the situation by removing glucose from the blood through the kidneys. When this happens, the kidneys will also filter out more water and you will need to urinate more than usual as a result.

If you are frequently experiencing an increased need to urinate, it could be a sign that your sugar levels are too high. If you have access to blood glucose testing strips, you may wish to test your sugar levels if you are urinating more often than normal.

Your health team should be able to advise whether the problem may be related to diabetes and any remedial action you can take.

Recognising the symptoms of polyuria

The most common sign of polyuria is producing abnormally large volumes of urine at regular intervals throughout the day and at night.

If you are concerned about the amount you urinate and think you may have polyuria, you should make a note each day of how much you drink; how often you urinate and how much urine you produce every time you go to the toilet.

When to see your doctor about polyuria

You should consult your doctor if you have excessive urination over several days that cannot be explained by an increase in fluids or medications.



Polyphagia - Increased Appetite

Polyphagia is also known as hyperphagia

Polyphagia is the medical term used to describe excessive hunger or increased appetite and is one of the 3 main signs of diabetes.

An increase in hunger is usually a response to normal things such as intensive exercise or other strenuous activity, but polyphagia can also be the result of more severe issues such as depression or stress.

Also known as hyperphagia, it is one of the three main symptoms of diabetes, along with:

Polydipsia (increased thirst) and
Polyuria (frequent, excessive urination)

Causes of polyphagia

Polyphagia can be caused by:

Diabetes mellitus
Hypoglycemia (low blood sugar levels)
Hyperglycemia (high blood sugar levels)
Anxiety
Stress
Depression
Bulimia
Binge eating disorder
Hyperthyroidism (raised level of thyroid hormone)
Premenstrual syndrome
Certain prescription drugs such as corticosteroids
Some psychiatric conditions
Rare medical conditions such as Kleine-Levin Syndrome and Prader-Willi Syndrome

Hunger and hyperglycemia

In uncontrolled diabetes where blood glucose levels remain abnormally high (hyperglycemia), glucose from the blood cannot enter the cells - due to either a lack of insulin or insulin resistance - so the body can’t convert the food you eat into energy.

This lack of energy causes an increase in hunger.

Simply eating will not get rid of the hungry feeling of polyphagia in people with uncontrolled diabetes, as this will just add to the already high blood glucose levels. The best way to lower blood glucose levels is to exercise as this can help to stimulate insulin production and reduce blood sugar levels.

However, if the hunger persists, you may need to consult your doctor or diabetes health care team.

Hunger and hypoglycemia

Increased appetite can also be caused by abnormally low blood glucose (hypoglycemia).

If blood glucose readings fall below 4 mmol/l, the body usually responds by releasing stored glucose from the liver to raise glucose levels back to normal.

However, people with diabetes that take medication such as insulin and sulfonylureas are at risk of developing a severe form of hypoglycemia and should therefore treat low blood glucose levels by eating something sweet as soon as hypoglycemia is recognised.

Recognising the symptoms of polyphagia

The main sign of polyphagia is excessive hunger that doesn’t go away by simply eating more food or eating more regularly than normal.

If you are worried by your sudden increase in appetite, you should consult your doctor. They will examine you to check whether your hunger is a symptom of diabetes or another medical condition.


Dizziness

Dizziness can often be caused by medication

Because diabetes is such a diverse disease with many complications, it can cause dizziness in many ways by affecting different parts of the body.

Dizziness is an episode of unsteadiness and unbalance as a result of something affecting the brain or ears.

However, dizziness can also be a symptom of many things other than diabetes. So if you are experiencing recurrent dizzy spells, you should contact your doctor who will be able to diagnose the cause.

Causes of dizziness

A dizzy spell can be brought on by many things, but in cases of diabetes the most common causes are:

Low blood pressure

Dizziness can be cause by the heart's inability to pump blood up to the brain sufficiently, especially when suddenly standing up from a sitting or a lying position.

As the blood momentarily fails to reach the brain, a spinning sensation, unsteadiness or even fainting can occur.


Dehydration

High blood sugar levels (hyperglycemia) can cause polyuria, which in turn can lead to dehydration by passing too much fluid out of the body in an attempt to remove excess glucose.

With low levels of water in the body, the brain may struggle to function correctly and cause light headedness.

Hypoglycemia

Having a low amount of sugar in your blood (hypoglycemia) can lead to dizziness by causing the brain cells to malfunction.

Certain medications

Some medications, including those used to treat people with diabetes, can cause dizzy spells. The instruction leaflet that comes with a medicine will list any possible side effects of the drug.

When to see your doctor

If you are suffering from bouts of dizziness that are recurrent or persistent you should go and see a doctor. They will likely ask questions to gauge whether there is a pattern to the feelings of dizziness, so keeping a record of dizzy spells prior to your appointment may be helpful.


Extreme Tiredness (Fatigue)

Most adults require 6-8 hours of sleep

In the medical world, extreme tiredness and exhaustion that doesn’t disappear with rest or sleep is known as fatigue and this can be a telling symptom of diabetes.

Causes of fatigue

There are many things that can cause you to fell fatigued. The most common and obvious is a lack of sleep.

Most adults need between 6 and 8 hours of sleep a day, but this can vary quite a lot from person to person. It's also important to remember that most people require less sleep as they get older.

Other common causes of fatigue include:

Anaemia -  a condition that occurs when you don't have enough red blood cells

Cancer - most types of cancer cause fatigue to a certain degree

Chronic Fatigue Syndrome - a condition that causes unexplained exhaustion and fatigue

Depression - constant tiredness is a major indicator of depression or emotional stress

Diabetes - sudden and extreme tiredness is one of the main symptoms of diabetes mellitus

Infections - fatigue can be brought on by various infections such as the flu (influenza)

Coeliac Disease - an autoimmune condition in which inflammation in the lining of the small intestine affects the body’s ability to absorb nutrients properly. 

Diabetes and fatigue

With diabetes, fatigue is caused by a number of factors, including:

High blood sugar levels, either from a lack of the insulin horomone or from insulin resistance, can affect the body’s ability to get glucose from the blood into cells to meet our energy needs
People on stronger diabetes medication such as insulin, may also experience fatigue as a symptom of low blood glucose levels.
Blood glucose testing can help to determine whether high or low sugar levels may be the cause of fatigue.
Recognising fatigue

Symptoms of fatigue include:

A lack of, or no energy
Difficulty in carrying out simple everyday tasks
Feeling down or depressed (mental fatigue)

Regular exercise combined with a healthy diet and a good night’s rest can often boost your energy levels.

In addition, mindfulness and other meditation-based techniques are ideal for combating stress and depression and improving mental health.

When to call your doctor

If you are suffering from extreme tiredness that is not simply due to a lack of sleep and has gone on for three to four weeks, you should seek advice from your doctor and make an appointment for a check-up.



Unexplainossed Weight Loss

Unexplained weight loss is weight loss of 10lbs or 5% of your body weight without trying

Unexplained weight loss is the term used to describe a decrease in body weight that occurs unintentionally and can be a warning sign of diabetes.

The amount you weigh is determined by a number of factors including age, your calorie intake and overall health.

Once you reach middle adulthood, your weight should remain relatively stable from year to year.

Losing or gaining a few pounds here and there is normal, but unexplained weight loss that is significant (10 lbs/4.5kg or more or over 5% of your body weight) or persistent may signal an underlying medical condition. 

Unexplained weight loss means weight loss that occurs without trying through dieting or exercising.

What are the possible causes of unexplained weight loss?

Unintentional or unexplained weight loss can be caused by a number of things, including depression, certain medication and diabetes.

Potential causes of unexplained weight loss include:


Addison’s disease
Cancer
Coeliac disease
Chronic diarrhoea 
Dementia
Depression
Diabetes mellitus
Eating disorders (anorexia and bulimia)
Exocrine Pancreatic Insufficiency
HIV/AIDS
Hypercalcemia
Hyperthyroidism
Infection
Malnutrition
Medicines, including chemotherapy drugs, laxatives, and thyroid medications
Parkinson’s disease
Recreational drugs, including amphetamines and cocaine
Smoking
Tuberculosis

Diabetes and sudden weight loss

In people with diabetes, insufficient insulin prevents the body from getting glucose from the blood into the body's cells to use as energy.

When this occurs, the body starts burning fat and muscle for energy, causing a reduction in overall body weight.

Unexpected weight loss is often noticed in people prior to a diagnosis of type 1 diabetes but it may also affect people with type 2 diabetes.

When to call your doctor

If you have unintentionally lost more than 5% of your normal body weight, or more than 10 lbs (4.5 kg) in 6 - 12 months or less, you should consult your doctor.

They will be able to determine what's causing the weight loss (e.g. undiagnosed diabetes) and the best way to treat the problem.


Blurred Vision

Blurred vision is a common sign of diabetes mellitus

One of the common signs of diabetes mellitus is blurred vision, which refers to the loss of sharpness of vision and the inability to see fine details.

Blurred vision can affect one eye (unilateral blurred vision) or both (bilateral blurred vision) eyes, and can occur often or rarely.

Regardless of how often it occurs, it should never go untreated as it could be an indicator of another, more serious eye problem.

Causes of blurred vision

Blurred vision can occur by simply forgetting to wear your prescribed corrective lenses. But in many cases, it is usually a sign of an underlying eye disease.

Eye diseases include:

Age-related macular degeneration
Glaucoma
High blood sugar levels

Other causes of blurry vision include:

Cataracts and other eye conditions such as conjunctivitis, dry eye syndrome, and retinal detachment
Certain medications (including cortisone, some antidepressants and some heart medications)
Diabetes mellitus
Stroke
Migraines

Diabetes and blurred vision

High levels of blood sugar resulting from diabetes can affect your ability to see by causing the lens inside the eye to swell, which can result in temporary blurring of eyesight.

Blurring of vision may also occur as a result of very low blood sugar levels. If this is the case, your vision should return once your blood glucose levels have returned to the normal range.

If your blood sugar levels are fluctuating over time, you may notice that your vision improves and worsens for periods of time.

Recognising blurred vision

There are various different interpretations/understandings of what blurred vision is, but in most cases the term is used to describe the inability to see fine details and a lack of sharpness of vision.

When to see your doctor

If you’re experiencing sudden blurred vision together with eye pain, you should go see your doctor and have your eye(s) checked.

If your vision has become blurred over time, it could be a sign of an underlying condition, which could be diabetes amongst other possible causes.

Your doctor should be able to help distinguish why your vision may have worsened


Genital Itchiness

Genital itchiness can be a symptom of high blood glucose levels

Genital itching in either sex is an irritating problem that can simply be caused by allergies and skin irritations, or by more serious disorders and diseases such as diabetes.

In cases where genital itching is caused by irritation or allergy, avoiding exposure to the irritant or allergen may be all that is needed for the itching to resolve.

However, other causes of the condition may be more difficult to treat or may require more intensive treatment and could ultimately lead to serious complications.

What are the causes of genital itchiness?

Itching in the genital region can result from a wide range of things, including:

Allergic reactions
Bacterial vaginosis - a disease of the vagina caused by bacteria
Cancer (penile and vulval cancers) - rare types of cancer that occur in the skin or tissues of the penis and a woman's external genitals (vulva), respectively
Diabetes mellitus
Chemical irritants such as detergents, fabric softeners, soaps, creams, ointments and sexual lubricants
Menopause - a drop in the hormone estrogen causes vaginal dryness
Pubic lice - parasitic insects, also known as crabs, that typically live in pubic hair
Scabies - a contagious, extremely itchy skin disease caused by tiny mites
Sexually transmitted diseases, such as genital herpes and trichomoniasis 
Skin conditions - such as psoriasis and eczema
Tinea cruris - a fungal skin infection also known as ringworm of the groin
Vaginal yeast infection
Vaginitis - inflammation of the vaginal tissues

Note that many of the infectious causes of genital itching, such as STDs and yeast infection, are contagious.

Diabetes and genital itching

Genital itching and burning can indicate a female or male yeast infection.

Regular yeast infections are a sign of type 2 diabetes.

In diabetes, blood glucose levels can go abnormally high, which can therefore provide ideal conditions for naturally present yeast to grow and also diminishes the body’s ability to fight infection.

Diabetes can also cause a higher glucose content in the urine – another extremely suitable place for yeast to thrive.

Recognising genital itching

Genital itching is the term used to describe itching, burning or redness/soreness in and around the vagina or penis.

If you have genital itching that does not disappear after a couple days or more, or causes you concern, talk to your doctor or another healthcare professional.

Failure to seek professional medical advice could lead to further problems, such as spread of infectious disease through close body contact (usually sexual contact) or a secondary skin infection.

Additionally, it could mean an underlying disease, such as type 2 diabetes, is left diagnosed, thus increasing your risk of diabetic complications.

If you have diabetes and are regularly getting genital itching, it could be a sign that your blood glucose levels are too high. Your health team may be able to advise whether this is the case and, if so, how to bring your blood glucose levels under better control.


Slow Healing of Cuts and Wounds

High sugar levels can slow down the body's ability to heal wounds
Wounds or sores that take more than a few weeks to heal might be infected and require medical treatment, and often indicate an underlying disease such as diabetes.

When you cut or burn yourself, your body begins a three-stage process to repair the damaged skin.

First, an immune response causes the wound to become inflamed to prevent infections.

Second, new cells (a scab) form over the wound, and finally scar tissue forms to heal the wound.

Some wounds heal easily while others can take longer, particularly if they are severe or the individual has a poor state of health.

Causes of slow wound healing

There are a number of things that can delay or complicate the healing of wounds, including:

Diabetes mellitus
Low HGH (human growth hormone)
Rheumatoid arthritis
Vascular or arterial diseases
Zinc deficiency

Diabetes and slow healing wounds

High levels of blood glucose caused by diabetes can, over time, affect the nerves (neuropathy) and lead to poor blood circulation, making it hard for blood - needed for skin repair - to reach areas of the body affected by sores or wounds.

This can cause them to remain open and unhealed for months, increasing the risk of:

Fungal infections
Bacterial infections
Gangrene

Keeping blood glucose levels under good control can help to reduce the risk of slow healing wounds now and further in the future.

Slow healing wounds can be a symptom of undiagnosed diabetes, particularly if other symptoms are also present.

Slow healing of wounds, including cuts, grazes and blisters, can be particularly problematic if they affect the feet of someone with diabetes and if not treated properly, can raise the risk of amputation.

It is important therefore that people with diabetes check their feet daily and report any signs of damage to their health team.

When to see your doctor

If you do not have diabetes and a cut or burn is taking a long time to heal or showing signs of infection, consult a healthcare professional to have the wound examined.

In some cases, a slow healing wound could signal an underlying medical condition such as diabetes.

Because of the risk of amputation, it is important, if you have diabetes, to consult your health team if you have any signs of damage to your feet.

Wounds on the feet, or any other part of your body, should be closely monitored.


Nausea and Vomiting

Nausea can be a sign of diabetes as well as a side effect of diabetes medications

Most, if not all of us will be familiar with the feeling of nausea, which is basically the feeling of needing to be sick, felt in the stomach area.

Both nausea and vomiting can be a sign of a number of underlying health conditions, including diabetes.

When there is an issue that can affect the stomach or gastric system of their body, people can feel sick.

Even if it is a fairly tenuous connection, such as angina affecting blood flow, the sufferer may still feel queasy.                                                                   

Causes of nausea

Both type 1 diabetes and type 2 diabetes can cause nausea or vomiting in several ways.

Hyperglycemia and Hypoglycemia

As the blood glucose levels rise and fall, the body's metabolism can get interrupted and confused which can lead to a mixed feeling of nausea.

Low blood pressure (Hypotension)

Low blood pressure often leads to dizzy spells which, for some people, can induce a feeling of nausea as the world appears to spin around them.


Certain medications

The side effect of a lot of drugs is a feeling of nausea, and even vomiting. Metformin, the most widely used diabetes drug, is known to have nauseating side effects.

Gastroparesis

Due to neuropathy, the body may not be able to move food from the stomach or along the intestines.

This can cause a back log of food, which can result in sickness.

Bezoars

Bezoars are stone like formations created from undigested food matter, which can block the gastro-intestinal track and stop food processing and digesting.

This can eventually cause nausea and vomiting.

When to see your doctor

If you are having recurrent or consistent bouts of nausea or vomiting, then it is a good idea to go and see your doctor to get the issue sorted as soon as possible.

Keeping a diary of nausea or vomiting episodes and what you ate or were doing beforehand may help the doctor in determining the underlying cause of your nausea.

Can a blood glucose meter help to diagnose type 1 diabetes?

A blood glucose meter may be helpful in indicating whether you or a family member may have diabetes.

It is not essential to have a blood glucose meter but it may be considered useful in a family with a history of type 1 diabetes or autoimmune conditions.

A blood glucose result, taken over 2 hours after eating, of over 7.8 mmol/l could indicate a presence of diabetes.

If high results are being recorded 2 hours after eating for consecutive meals, contact your GP who will be able to carry out a diagnosis.