Surprising Warning Signs Could Signal Diabetes

Eye changes are but one of the less well-known symptoms

FRIDAY, March 12, 2004 (HealthDayNews) -- Imagine waking up one day to better vision out of the blue, without any fancy surgery.

It may sound like a miracle, but a sudden change in how you see the world could be a sign of something much more onerous: an undiagnosed case of diabetes.

While many people assume they'll know if they develop diabetes, experts caution that the list of warning signs is long and not all the symptoms are well-known. Among other things, the disease can cause changes in vision -- for better or for worse -- and contribute to everything from gum disease to weight loss to darkening of the skin around the eyes.

In fact, symptoms can last for months before patients bother to seek attention, experts say. By that point, the damage can be hard to reverse.

"People shouldn't be waiting around until they have vision problems and gum problems from their diabetes," says Dr. Joe Selby, director of research with the Kaiser Permanente Health Plan in Northern California. "Diabetes is something you're supposed to screen for, test for and find in advance."

An estimated 17 million Americans have diabetes, meaning their bodies cannot adequately process blood sugar. Those who have type 1 diabetes can't produce insulin at all, while those with type 2 diabetes don't process insulin properly. As many as a third of children born in 2000 are expected to develop diabetes over their lifetime.

Left untreated, diabetes can cause heart disease, stroke, blindness, kidney failure, pregnancy complications, amputations of the leg, foot, and toe, as well as deaths related to flu and pneumonia, doctors say.

In at least half of all cases, symptoms appear in patients as the levels of glucose in their blood begin to rise. The extra sugar attaches to proteins, causing damage in the process, and can harm internal tissues and organs from head to toe.

"The disease affects every single part of your body," says Dr. Athena Philis-Tsimikas, chief medical director of clinical operations at The Whittier Institute for Diabetes in San Diego.

Perhaps the most recognizable symptoms of diabetes appear as excess blood sugar sucks up water in the body, disrupting our internal waste-removal systems.

"You urinate more frequently and you get the sensation of thirst all the time," Philis-Tsimikas says. Dry mouth, weight loss, lethargy and dehydration can also occur.

Other serious symptoms serve as signs that diabetes has progressed. Changes in vision can strike, for instance, as high blood sugar levels affect water in the eye, actually reshaping the lens, Philis-Tsimikas explains. In some cases, vision actually improves, although it can also get more blurry.

Patients "think they need to go the optometrist to change their prescription," she says.

Other symptoms of diabetes include blackened skin around the eyes and knuckles, gum disease and bad breath. But these problems don't appear suddenly. "If you wait until you have gum disease or eye disease, you may well have had an abnormal test for five or 10 years," Selby says.

What to do? If you think you may have diabetes, a simple blood test will give your doctor a clue about whether you have anything to worry about. The test is often done in conjunction with a cholesterol test.

Doctors may try to confirm a diagnosis by ordering a second test in which blood is drawn from patients after they drink a sugary drink.

Even patients without symptoms may want to push for a blood test. An estimated 30 percent to 50 percent of diabetes patients don't suffer from any noticeable symptoms, says Dr. Robert Rushakoff, an associate clinical professor of medicine at the University of California, San Francisco. "That's why we screen appropriate people for diabetes."

People who should be screened include the overweight, those with family histories of diabetes, and those with high blood pressure and high cholesterol levels. Also, some ethnic groups are at higher risk of developing diabetes.

"Don't delay, and don't be fearful of the result," says Philis-Tsimikas. "There are many things we can do to intervene and reverse some of the complications or certainly prevent anything more serious from occurring for a long, long time. There's a lot of benefit to learning the diagnosis as soon as possible."

More information

For more information on diabetes, visit the American Diabetes Association or the Joslin Diabetes Center.

SOURCES: Robert Rushakoff, M.D., associate clinical professor, medicine, University of California, San Francisco; Joe Selby, M.D., director, division of research, Kaiser Permanente Northern California, Oakland; Athena Philis-Tsimikas, M.D., chief medical director, clinical operations, The Whittier Institute for Diabetes, San Diego
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