The signs and symptoms of type 2 diabetes

Overview

Contrary to popular belief, it is not uncommon for many people to actually live with type 2 diabetes without realising. Most of the signs and symptoms of type 2 often progress gradually, and they can go unregistered or be misinterpreted for something else altogether. As a result of not being identified earlier on, the condition can progress along with a reduced likelihood of being able to achieve diabetes remission. In this blog we will look at what the main signs and symptoms are for type 2 diabetes, as the faster you can recognise them, the faster you can act upon them.

Frequent urination

One of the first, and perhaps the most noticeable, signs of type 2 diabetes can be identified from excessive urination, which you may hear a doctor or nurse refer to as polyuria. Why does this happen? Our kidneys act as the body’s filtration system to reabsorb nutrients that we want to keep, and remove harmful and unwanted waste products that we don’t want to keep. Under normal physiological circumstances, when filtering our blood, glucose is filtered by the kidneys, followed by being returned into our bloodstream. However, blood glucose levels can be excessively high in individuals with type 2 diabetes.  As a consequence, when blood glucose levels are excessively high, not all of that glucose can be reabsorbed after filtration. This results in the urine within our bladder having a high concentration of glucose. In order to balance out this imbalance, more water is absorbed into the bladder which as you can imagine, causes excessive urination- often up to 3 litres per day!

Increased feeling of thirst

We should all aim to consume at least 8 glasses of water per day as staying hydrated is vital for maintaining our body systems and overall health. However, as mentioned above, excessive peeing is one of the main signs of type 2 diabetes. This increase in urination can lead to dehydration which can, in turn, lead to an increased feeling of thirst. When thinking about this symptom, it is important not to jump to any conclusions, as we will all feel thirsty at some point during the day. However, in addition to tracking your fluid intake, the following may help you identify when it may be excessive and of concern:

• Passing more than 4-5 litres of urine per day and needing to go a lot more than normal
• Having a persistent and excessive feeling of thirst regardless of how much you drink 

Feeling tired all the time

Feeling tired, for many of us, is one of the inevitable parts of our day. However, feeling excessively tired, lethargic or fatigued, despite having a long night's sleep, can also be a sign of type 2 diabetes. Looking at why this is the case, our body’s primary source of energy comes from the glucose that is produced after metabolising carbohydrate from our foods. Every living cell within our body requires a constant and plentiful flow of energy to function effectively. As type 2 diabetes develops, this flow of energy into our cells becomes disrupted. Again, you may recall from one of our previous blogs, we discussed that there is a risk of developing insulin resistance from carrying excess weight; in particular, visceral fat that surrounds organs such as the pancreas and liver. This visceral fat secretes various harmful cell signalling proteins known as Adipokines that can reduce the insulin sensitivity of many of the cells throughout the body. When this happens, the flow of glucose into our cells to be used for energy becomes compromised which results in tiredness despite plentiful sleep.

This block in the flow of glucose into our cells can be thought of as a lock and key, where insulin acts like the key to open the lock on our cells to let glucose in. When insulin resistance occurs, the locks on our cells become harder to open. When less insulin is produced as type 2 diabetes progresses, less keys are available to open the locks.The result being the levels of glucose left in the blood are higher than they would be if this system was working efficiently.

Unintentional weight loss

 

This sign and symptom may come as a bit of a surprise given that excess weight is the primary cause of type 2 diabetes. However, unintentional weight loss is one of the later signs of type 2 diabetes. As we just discussed, carrying excess weight can result in visceral fat building up around organs such as the pancreas. As more visceral fat builds up, the ability of the pancreas to secrete insulin becomes significantly compromised. This decreased secretion of insulin significantly reduces the amount of glucose our body cells can absorb. As a consequence, we can no longer use the energy that we can derive from carbohydrates; this can also be visualised using the lock and key analogy where less keys in the form of insulin are produced. In order to make up for this loss of energy derived from carbohydrate, the body must now source its energy from fat. The result of this change in how the body sources energy is that we can experience unintentional weight loss, as the amount of fat within our diet is highly unlikely to be sufficient enough to maintain our weight.

Genitalia itching and thrush

The cause of genitalia itching and thrush from type 2 diabetes can occur as a result of the excess glucose that is within our urine. This, coupled with the warm and moist environments of the genitalia, provides a rich source of energy for bacteria such as yeast which can result in infections if left untreated.  Other signs of infection include:

• Feeling of burning when urinating
• Redness
• Soreness

Wounds taking longer to heal

In order for our wounds to heal, the wound site requires a flow of blood to deliver oxygen and vital repair proteins and nutrients. However, this process of repair and recovery can become compromised in those with type 2 diabetes. Over time, as the levels of glucose within our blood build-up, this can cause damage to blood vesicles which can lead to impaired blood circulation. Consequently, if a wound occurs, this impaired blood flow can result in the area of damaged tissue taking longer to heal or failing to adequately heal altogether.

Blurred vision

Our eyes are extremely delicate organs, and much the same as prolonged high levels of blood glucose can cause impaired wound healing from damage to blood vessels, the same is true for the blood vesicles within our eyes.  While it is common for our vision to naturally blur as we age. If you notice that blurring comes and goes or appears in one eye only, then this can be a sign of concern. As we have mentioned, it is common for the quality of our eyesight to reduce as we age. We should all attend regular eye appointments with an optician. In doing so, they will be able to monitor the health of your eyes and identify when it may be of concern.

The take home message

Unlike many medical conditions the signs and symptoms of type 2 diabetes are often a slow onset and as we discussed, they can be mistaken for something as simple as feeling tired or extremely thirsty. By having an understanding of them, this can help you to identify and act on them early on, and the faster you can do so, the greater the likelihood of being able to halt type 2 diabetes development and achieve remission. If you feel that you may have some of the signs and symptoms, it is always a good idea to speak with your doctor.