Clinical manifestations of diabetes: general manifestations

Clinical manifestations of diabetes:

The type and severity of diabetes vary, and so do its clinical manifestations. Type 1 diabetes is more common in children and adolescents, with fewer cases in adulthood. Generally, the disease is more severe when it occurs, and the symptoms are more prominent, easily attracting the patient’s attention. However, the slow-progressing type is also insidious. Type 2 diabetes usually occurs in adulthood, with a hidden onset. Sixty to eighty percent of patients have a history of obesity, and early cases may have no symptoms, accounting for 10% to 30%. Regardless of the type of diabetes, the typical symptoms are the same and mainly include the following:

1. Fatigue is the most common symptom, mainly due to muscle weakness. It is related to reduced glucose utilization, insufficient energy production, and accelerated decomposition metabolism.
2. Polyuria and polydipsia occur in most patients. Excess sugar in the urine causes increased urination, which removes a large amount of water and leads to polyuria. Polydipsia is a compensatory mechanism adopted by the body to replenish lost water to ensure that the body does not become dehydrated. These two symptoms are directly proportional to the severity of the diabetes. Due to increased urination, kidney expansion can cause lower back pain. The severity of polyuria and polydipsia is related to the amount of sugar excreted in the urine. Generally, when the amount of sugar excreted in 24 hours is equal to or greater than 25 grams, there are obvious symptoms of polyuria and polydipsia. The more severe the polyuria, the more thirsty the patient feels, and the more they drink. When the amount of sugar in the urine is less than 25 grams in 24 hours, there may be polyhydration and polyuria, but patients often ignore these sensations. Generally, obvious subjective symptoms occur when blood glucose levels are above 15mmol/L.
3. Excessive eating, characterized by a significant increase in food intake and persistent hunger. This is the body’s response to replenish the lost sugar in the urine. It should be noted that the more one eats, the higher the blood sugar, and the more sugar lost in the urine, the stronger the hunger. This forms a vicious cycle. In this case, it’s better to eat less, but the staple food cannot be less than 150 grams per day.
4. Weight loss: Good appetite but weight loss is a sign of severe diabetes. Due to insufficient insulin, tissue dehydration, increased protein and fat decomposition, it can manifest as thinness. Generally speaking, type 1 diabetes is often accompanied by significant weight loss, while type 2 diabetes is accompanied by weight loss but still exceeds normal weight. If the weight is significantly below the standard weight, it often indicates insulin beta-cell failure, severe illness, and requires insulin treatment.
5. Other symptoms: Children with diabetes often have nocturnal enuresis, and sudden continuous nocturnal enuresis can be a signal of disease onset. This phenomenon occurs occasionally in adults, and type 2 diabetes patients often have symptoms similar to hypoglycemia in the early stage of disease, which can be relieved after eating and lasts for several years. When the diabetes worsens significantly, these symptoms disappear.

One notable study on childhood diabetes was conducted by the University of Oxford, United Kingdom, in collaboration with other European institutions. This research focused on the genetic and environmental factors associated with the development of type 1 diabetes in children. The study, known as the Environmental Determinants of Diabetes in the Young (TEDDY) study, aimed to identify early life exposures that may increase or decrease the risk of type 1 diabetes.

The research involved extensive data collection from thousands of children across several countries, including Finland, Germany, Sweden, and the United States. The study monitored children from birth for up to 15 years, collecting information on diet, infections, vaccinations, and other environmental factors. Additionally, genetic testing was performed to identify genetic markers associated with type 1 diabetes risk.

The findings of the TEDDY study have provided valuable insights into the complex interplay between genetics and environmental factors in the onset of type 1 diabetes. The research has identified several potential environmental triggers, such as certain viral infections and dietary factors, which may influence the development of the disease. These findings are crucial for understanding the pathogenesis of type 1 diabetes and for the development of targeted prevention strategies.

Overall, the TEDDY study has significantly advanced the knowledge of childhood diabetes, contributing to the scientific community’s efforts to prevent and manage this chronic condition in children.