Symptoms of diabetes

The symptoms of diabetes can be divided into two categories: one is the performance related to metabolic disorder, especially the "more than three and less" related to hyperglycemia, which is mostly seen in type 1 diabetes, and type 2 diabetes is often not very obvious or only partially manifested; The other is the manifestation of various acute and chronic complications.

1. Polyuria is due to high blood sugar, which exceeds the renal glucose threshold (8.89~10.0mmol/L). The glucose filtered out through the glomerulus cannot be completely reabsorbed by the renal tubules, forming osmotic diuresis. The higher the blood sugar is, the more urine sugar is excreted and the more urine volume is. The 24-hour urine volume can reach 5000~10000 ml. However, in the elderly and those with kidney diseases, the renal glucose threshold is increased, and the urinary glucose excretion is impaired. When the blood sugar is slightly or moderately increased, polyuria may not be obvious.

2. Excessive drinking is mainly due to the obvious increase of plasma osmolality caused by hyperglycemia and excessive water loss due to polyuria, which leads to intracellular dehydration, aggravating hyperglycemia, further significantly increasing plasma osmolality, stimulating the thirst center, leading to thirst and excessive drinking. Excessive drinking further aggravates polyuria.

3. The mechanism of eating more is not very clear. Most scholars tend to be caused by the decrease of glucose utilization rate (the difference in the concentration of glucose in the blood of arteries and veins before and after entering and leaving the tissue cells). The glucose concentration difference in the blood of arteries and veins of normal people shrinks when they are on an empty stomach, which stimulates the feeding center and produces a sense of hunger; After feeding, the blood sugar increased, the concentration difference in the arterial and venous blood increased (more than 0.829 mmoL/L), the feeding center was inhibited, the satiety center was excited, and the feeding requirement disappeared. However, due to the absolute or relative lack of insulin or the tissue is not sensitive to insulin, the ability of the tissue to absorb and utilize glucose decreases. Although the blood sugar is at a high level, the concentration difference of glucose in the arterial and venous blood is very small, and the tissue cells are actually in a "hungry state", thus stimulating the feeding center, causing hunger and overeating; In addition, the body cannot make full use of glucose, and a large amount of glucose is excreted from urine, so the body is actually in a semi hungry state, and the lack of energy also causes hyperappetite.

4. Although the appetite and appetite of diabetic patients with weight loss are normal or even increased, the weight loss is mainly due to the absolute or relative lack of insulin or insulin resistance. The body cannot make full use of glucose to produce energy, resulting in increased fat and protein decomposition, excessive consumption, negative nitrogen balance, gradual weight loss, and even emaciation. Once diabetes is properly treated and well controlled, weight loss can be controlled, or even recovered. If the weight of diabetic patients continues to decline or lose weight significantly during treatment, it may indicate that metabolic control is poor or other chronic wasting diseases may be combined.

5. Fatigue is also common in diabetic patients. Because glucose cannot be completely oxidized, that is, the human body cannot make full use of glucose and effectively release energy, and at the same time, tissue dehydration, electrolyte imbalance, negative nitrogen balance, and so on, the whole body feels tired and mentally depressed.

6. Impaired vision Many diabetic patients complain of decreased or blurred vision when they seek medical advice at an early stage, which may be mainly due to changes in crystal osmotic pressure caused by hyperglycemia and changes in crystal diopter. In the early stage, most of them are functional changes. Once the blood sugar is well controlled, the vision can quickly return to normal.

7. Complications There are many diabetic complications, including diabetic ketoacidosis, hypertonic non ketotic diabetic coma, diabetic lactic acidosis, diabetic skin infection, diabetic foot, diabetic gastroparesis, diabetic cardiomyopathy, diabetic heart disease, diabetes and hypertension, diabetic nephropathy, diabetes complicated with urinary tract infection, diabetic neuropathy Diabetic peripheral neuropathy, diabetic myelopathy, diabetic retinopathy, uveitis associated with diabetes, diabetes and tuberculosis, etc.