What Is Diabetes And Recognizing Its Symptoms

Posted on Wed., September 3, 2008
By Craig Desoer, MD

(Editor´s note: this is the first in a series of columns about diabetes)

Diabetes " it´s a term we are all familiar with " from the news, from health professionals and from our own family and friends. But what is diabetes, why is it so common and why so important?

Actually, the full name for "sugar diabetes" is "diabetes mellitus," which can be loosely translated from ancient Greek as "sweet urine." That´s because, if untreated, the urine of diabetics contains sugar, and therefore tastes sweet. (Nondiabetic urine has no sugar, and is not sweet.)

A second type of diabetes is "diabetes insipidus", loosely translated from the Greek to mean "dilute urine." This is a much less common illness, and is unrelated to "diabetes mellitus."

Diabetes mellitus is a disease in which sugar accumulates in the blood, and overflows into the urine because the body cannot either properly produce or use the hormone insulin.

Insulin is responsible for helping sugar get from the blood into the cells of the body´s organs and muscles, which use it as fuel to perform their functions.

So, when a person eats food, much of it is turned into sugar by the stomach, intestines and liver. From the digestive system, the sugar normally flows into the blood stream.

Insulin allows the sugar to go from the blood into the various cells of our body (muscle, brain, kidney, fat, etc.) which "burn" the sugar, as well as oxygen, to perform their vital functions, such as thinking, moving our arms and legs and pumping blood.

Without sufficient insulin, or if the organs become resistant to insulin, the sugar can´t get into the cells of our organs, continues to accumulate in the blood, until at some point it starts to overflow into the urine.

This excess sugar in the urine actually draws more water out of the body, so the untreated diabetic often feels thirsty, has to urinate frequently (often every 30 minutes, even at night), and eventually loses weight, since the body has to use as fuel its own fat and protein (from our muscles) to replace the sugar that´s trapped in the blood.

One consequence of burning protein is that substances called ketones begin to accumulate in the blood and urine. These are the same ketones that one detects in the urine when on a diet without carbohydrates.

Currently, it is still unclear exactly what causes diabetes, although certain characteristics and lifestyle habits play a contributing role.

In the US, almost 24 million adults and children have diabetes, which is almost 8 percent of the population, or about one out of every 13 people. And almost one-quarter of the people with diabetes don´t know they have it.

As noted above, the most unique symptom of untreated diabetes is frequent urination at night, often more than five times a night, every night. Other symptoms, such as thirst, yearning for sweets, and weight loss can be caused by diabetes, but also by other conditions.

Diabetes is diagnosed by a blood test taken after not eating anything except water for 16 hours. A fasting blood glucose (sugar) level from 100-125 is called "pre-diabetes." A person with a fasting blood glucose of 126 or higher has diabetes, and should consult a doctor.

For more information about diabetes, visit cchealth.org.

Desoer practices family medicine at the Pittsburg Health Center, part of Contra Costa Health Services.