Clinical Symptoms

Clinical Nutrition
Lesson 24: Diabetes Mellitus- Clinical symptoms and Diagnosis

Clinical Symptoms

  • Hyperglycaemia Glucose cannot enter the cells in the absence of insulin and builds up in the blood leading to hyperglycemia.
  • Glucosuria When the level of glucose in blood exceeds the renal threshold of 180mg/dl, it spills over into the urine leading to glucosuria
  • Dehydration – As glucose is excreted in the urine it takes water along with it, leading to dehydration.
  • Polyuria –Frequent and abnormal out flow of urine is seen and Nocturia is more common.
  • Poly dipsia – Excessive thirst because water is being lost through the kidneys.
  • Poly phagia – increased hunger as the cells are not receiving the glucose for their energy needs.

Weight loss is generally seen in type I diabetes. In type II diabetes generally obesity is seen.

Blurred vision – skin irritation/infection as well as a feeling of weakness are other possible symptoms as the blood glucose levels become uncontrolled. If the blood glucose levels are not checked and controlled even at this stage, it leads to more complications like-

  • Fluid and electrolyte imbalances
  • Keto acidosis occurs as fats are broken down for energy. This is more commonly seen in type I diabetes. Acidosis is not common in type II diabetes.
  • Coma occurs if the acidosis become severe and it may be fatal. If severe hyperglycaemia is not detected or if stress or illness occurs, the individual may go into coma.

Adults with type II diabetes are likely to develop the hyperglycaemic, non ketotic state with glucose values exceeding 750g/dl without significant ketonemia. This hyperglycaemic, non ketonic state can be precipitated by excessive sugar intake, dehydration, heat exposure, illness or drug therapy.

Individuals with type I diabetes are vulnerable to diabetic ketoacidosis characterised by hyperglycaemia and ketonemia which occur either in insulin deficiency or from stress.

Hyperglycaemia with keto acidosis or in non ketotic state can be fatal.

Vigorous therapy in the form of insulin, fluids and electrolytes is given.

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Last modified: Saturday, 5 November 2011, 12:20 PM