Overview

Diabetes is a chronic health condition that causes blood sugar levels in the body to be abnormally elevated, which has serious ramifications on a person’s overall health. There are two main types of diabetes, Type 1 and Type 2 diabetes each has different causes but a similar symptomatology. It is important that we are all aware of the early signs and symptoms of diabetes, as early detection and treatment is essential to minimize the health complications that can arise from the condition. If you or someone you know shows signs of the condition, please consult your GP or medical professional who will provide you with advice. 

What is diabetes?

Diabetes is a condition characterised by elevated blood sugar levels. There are two main types of diabetes, Type 1 and Type 2 diabetes, and although they share similar symptoms, they each have different causes. 

• Type 1 Diabetes occurs when the body’s own immune system attacks and destroys the Beta cells of the pancreas. These are the cells that produce insulin and help to regulate blood sugar levels. It is a life-long condition, for which sufferers will need to take insulin to regulate their blood sugar levels.
•  In Type 2 diabetes, either the pancreas does not produce enough insulin, or the cells in the body do not react to it, thereby causing high blood sugar levels. Type 2 diabetes more often occurs in middle aged or older people and can be related to lifestyle factors, such as obesity, poor diet and lack of exercise.¹
• There is also a third type of diabetes, gestational diabetes, which occurs when pregnant and usually disappears after birth. 

What causes Diabetes?

Type 1 Diabetes

Type 1 diabetes is a life-long autoimmune condition in which your body’s immune system destroys the beta-cells in your pancreas (i.e., the cells that produce insulin). Although the condition can affect any age group, it most frequently occurs between the ages of 10 and 14.³ The exact causes of Type 1 diabetes are still unclear, but it is thought to be caused by a combination of genetic and environmental factors. Approximately 90% of Type 1 diabetes patients have a gene that increases their susceptibility to developing the condition.³ Certain environmental factors, such as viral infections, also seem to trigger off the immune response which destroys the Beta-cells. 

Type 2 Diabetes

In type 2 diabetes, unlike in type 1, Beta-cells are not destroyed. Instead, elevated blood sugar levels are caused by either the underproduction of insulin by beta-cells, or from the body’s cells being less able to react to the insulin, a phenomenon called insulin resistance. 

Insulin resistance is more likely to occur in people who are overweight, as they have too much fat stored in and around their liver and pancreas.⁴ However, it can also occur in people of a healthy weight. Both of these mechanisms ultimately lead to hyperglycemia, which occurs when blood glucose levels are too. When beta-cells produce less insulin, less glucose is absorbed. In the case of insulin resistance, the body’s cells take up less glucose from the bloodstream, also leading to high blood glucose levels. When both beta cell dysfunction and insulin resistance occur, type two diabetes progresses rapidly.⁵ 

Hyperglycemia is not usually a problem on a short term basis. However, over an extended period of time, it has serious side effects, including permanent damage to the nerves in the hands and feet, problems with your eyes, and it can even turn out to be life-threatening. 

Type 2 diabetes is most common amongst middle aged and older people.  Recent years have seen the amount of people with Type 2 diabetes quadrupling, and approximately 9 out of 10 cases of diabetes are now Type 2.⁴ This staggering increase could be related to the global rise in obesity, more sedentary lifestyles, poor diets and an ageing population.⁴ Other possible causes of Type 2 diabetes include genetics and ethnicity, with higher incidences amongst black, hispanic and asian populations.⁴

What are the early signs of diabetes?

Frequent Urination (Polyuria)

One of the early signs of diabetes is more frequent urination, usually also involving higher volumes of urine, than normal. Whilst the normal daily urine output for adults is about 1-2 litres a day, those with polyuria can pass more than 3 litres a day.⁶ Polyuria occurs in both type 1 and type 2 diabetes. Normally, when kidneys produce urine, all the sugar is reabsorbed back into the bloodstream. However, as the level of sugar in the blood is too high in diabetes, the kidneys are unable to reabsorb all the glucose. As a result, excess glucose ends up in the urine, where it pulls more water out of the blood, creating large amounts of urine. 

Excessive Thirst (Polydipsia)

We all get thirsty throughout the day. However, polydipsia refers to the feeling of thirst all the time, or more than normal. This is a common sign of diabetes, and it is caused by the high levels of glucose in the blood and frequent urination.  

Unexplained Weight Loss

 Unexplained weight loss can be an early sign of diabetes because a lack of insulin stops the body from absorbing glucose from the blood and using it as energy. As a result, the body starts to burn fat and muscle, which causes people to lose weight. Unexplained weight loss is one of the most common early symptoms of type 1 diabetes, as the destruction of the beta-cells in the pancreas results in a sudden lack of insulin. Other conditions can also cause weight loss, so if you have unintentionally lost more than 5% of your body weight, you should always consult your doctor. 

Increased Hunger (Polyphagia)

Polyphagia refers to an increase in appetite that occurs in diabetes when blood glucose levels are abnormally high and it cannot be absorbed into the cells to be used as energy. Eating does not get rid of hunger as it merely amplifies the raised glucose levels. 

Fatigue and Weakness

Fatigue refers to extreme tiredness that does not improve with sleeping. It is a common symptom of diabetes because the uncontrollably high sugar levels mean the body cannot effectively absorb glucose into the cells to fuel our bodies.

Blurred Vision

Blurred vision involves losing sharpness to your vision, in one or both eyes.  Blurred vision occurs in diabetes as the high levels of blood glucose can cause the lens in the eye to swell.⁷ Occasionally, it can also happen from very low blood sugar levels. Long term, diabetes can also affect your vision through diabetic retinopathy. If you are having any issues with your vision, it is important to seek the advice of a healthcare professional as soon as possible. 

Slow Healing of Wounds

If wounds take too long to heal, this might signal diabetes. This is because overtime, high blood sugar levels lead to poor blood circulation, which then makes it harder for the skin to repair. It particularly affects areas of the body further away from the heart, such as your feet and legs. 

Frequent Infections

People with diabetes are more likely to succumb to frequent infections and illnesses, such as flu, pneumonia, urinary tract infections and skin infections.⁸ This is because the high blood sugar stresses your body and makes it more susceptible. Furthermore, it can also trigger inflammation which eventually starts to damage your organs.⁸ 

Tingling or Numbness in Hands and Feet

Tingling in your hands and feet can also be a sign of diabetes. This is because, over time, the high sugar levels in the blood cause damage to the small blood vessels that supply nerves. This damages the nerve fibres, and they become less effective at carrying messages, leading to numbness and tingling. The hands and feet are furthest away from the heart so are the first areas to be affected. 

What are the specific Early Signs in Different Types of Diabetes?

The symptoms of type 1 and 2 diabetes are quite similar, and both cause the following symptoms: 

• Increased need to go to the toilet
• Being really thirsty
• Fatigue 
• Unintentional weight loss 
• Cuts or wounds taking longer to heal
• Blurred eye sight

However, they differ drastically in how the symptoms appear. Type 1 diabetes symptoms come on extremely quickly and severely, due to the beta-cells being destroyed and unable to produce insulin. In particular, increased thirst, increased urination, tiredness and loss of weight are the 4 key symptoms for Type 1 diabetes.⁹ By contrast, people with type 2 diabetes will often have the condition for a while before they notice the symptoms start to slowly appear. 

Why is early detection key in Diabetes?

It is important to be able to recognise the early signs of diabetes to help reduce the risk of serious health complications from the condition. With Type 1 diabetes, the much more rapid onset of symptoms means early detection is needed to avoid life-threatening problems. With Type 2 diabetes, early intervention can even help to put the condition into remission.¹⁰ The most effective way to achieve this is through physical activity, low calories and low carbohydrate diets. You can find out more about this on the Diabetes UK website or the NHS website, but please always consult your doctor before starting a new diet or exercise regime. 

Summary

Diabetes is a chronic condition caused by abnormally high levels of glucose in the blood. Both Type 1 and Type 2 diabetes cause similar symptoms, but in type 1 diabetes this onset is much more rapid and severe. Early symptoms of diabetes include increased thirst, increased hunger, increased urination, tiredness, weight loss, and vision problems. If you feel you may be suffering with any of these symptoms, please see your GP as soon as possible as early identification of diabetes is essential to reduce the risk of further health complications.