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Diabetes: Symptoms often are hidden, subtle

January 04, 2001

Diabetes: Symptoms often are hidden, subtle



By MEG H. PARTINGTON / Staff Writer



There are 15.7 million people in the United States - 5.9 percent of the population - who have diabetes.

5.4 million of them are not aware they have the disease.

The number of people ages 18 and older with diabetes:

  • In Washington County: 7,125
  • In Frederick County, Md.: 8,363


- Latest figures are from 1998.

  • Berkeley County, W.Va.: 2,643
  • Jefferson County, W.Va.: 1,189
  • Morgan County, W.Va.: 457


- 1993-97 statistics

  • Franklin County, Pa.: 5,355
  • Fulton County, Pa.: 592


- 1997 statistics

- Sources: American Diabetes Association; Pennsylvania Department of Health, Diabetes Control Program; West Virginia Health Statistics Center, Behavioral Risk Factor Surveillance Survey;

Centers for Disease Control Behavioral Risk Factor Surveillance Survey




Many Americans are living longer. That's the good news.

The bad news is that many people are eating too much and not exercising enough, which puts them at risk for diabetes in adulthood.

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The bodies of diabetics do not produce or properly use insulin, a hormone needed to convert sugar, starches and other food into energy, according to the American Diabetes Association's Web site, www.diabetes.org.

There are three main types.

Those with Type 1 diabetes don't produce insulin and must take daily insulin injections, according to American Diabetes Association. This form, most prevalent in children and young adults, accounts for 5 percent to 10 percent of diabetes cases.

In Type 2, the body can't make enough insulin or properly use it. American Diabetes Association said the prevalence of this variety is reaching epidemic proportions because people are living longer, are heavier and more sedentary.

Family history plays a role in Types 1 and 2, according to American Diabetes Association.

Gestational diabetes occurs in 2 percent to 5 percent of pregnancies, but disappears when a pregnancy is over, according to American Diabetes Association. Women who develop gestational diabetes are at an increased risk of developing Type 2 later in life.

Symptoms


Type 1 diabetes may mimic the flu in children, according to American Diabetes Association. Other symptoms include frequent urination, weight loss, fatigue and irritability, according to the association.

Increased thirst because the blood is more concentrated is another symptom, said Beverly Horn, a certified diabetes educator at Chambersburg Hospital in Chambersburg, Pa. Hunger may also increase because sugar is not getting into the cells, Horn said.

Symptoms of Type 2 diabetes include all of those for Type 1. Patients may also experience blurred vision, slow healing of cuts and bruises, tingling or numbness in hands or feet, and recurring skin, gum and bladder infections, according to American Diabetes Association.

Frequent yeast and urinary tract infections may be another indicator, according to Bonnie Humphreys, a diabetes clinical specialist and certified diabetes educator at Robinwood Medical Center in Hagerstown.

Some people with Type 2 diabetes may exhibit no symptoms.

"Diabetes is so hidden and subtle," Humphreys said.

While Type 2 is more prevalent in adults, Type 1 can be diagnosed anytime in a person's life, Horn said.

People with Type 2 usually develop the disease after age 45, according to American Diabetes Association. About 80 percent of those with Type 2 are overweight, Horn added.

Tests


Urine tests used to be a common way to diagnose diabetes, but their accuracy is questionable, Horn said.

Those already diagnosed with diabetes take urine tests annually, though, to look for high protein levels, which can indicate the kidneys are malfunctioning.

In diagnosis, plasma glucose tests are now done on the blood. Patients fast for eight to 12 hours before having blood drawn, said Pam Gesford, a certified diabetes educator at City Hospital in Martinsburg, W.Va. If glucose readings of 126 milligrams per decileter are found on two occasions, a diagnosis of diabetes is given.

Glucose tolerance tests may be given, too, though they are expensive and aren't used often, Gesford said. They may be given to pregnant women to check for gestational diabetes, however.

After diagnosis, Hemoglobin A1c tests are given three or four times a year.

The blood test measures the average blood sugar levels over three months, Horn said.

Gesford called Hemoglobin A1c the "gold standard of overall control."

"It doesn't cheat. You can't fake it out," Gesford said.

After diagnosis, diabetics should have several things checked annually, including cholesterol levels, weight, vision and feet, Horn said.

After diagnosis


After a person is told he has diabetes, learning about the disease is the best defense.

"The next step is education," Horn said.

"Knowledge is power with diabetes," agreed Gesford.

Patients will be advised to meet with a dietitian, who will help them improve their diets by reducing sweets and starchy foods, which convert to sugar in the body, Horn said.

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