• Excessive urination
• Increase in thirst
• Increase in appetite
• Weight loss
• Loss of vision
• Fatigue
• Slow healing
• Impotence in men

In the case of type 1 diabetes, these symptoms may develop very quickly. In the case of type 2 diabetes, there may be a lack of symptoms or their development may be slow.

Type 1 diabetes may produce rapid weight loss, despite normal or increased eating. Loss of weight may not be a typical symptom for type 2 diabetes.

Increased urination results in the replacement of blood volume by the water from the body’s cells. This leads to dehydration as well as an increase in thirst.

Glucose adsorption results from persistently high levels of glucose in the blood. This produces a change of shape in the lenses of the eye. These shape changes result in vision change and blurred vision. Type 1 patients may undergo rapid vision changes, whereas in type 2 patients, the changes may be gradual.
Some patients (usually type 1) may show symptoms of diabetic ketoacidosis. These include:

• Smell of acetone on the patient’s breath
• Deep breathing
• Nausea
• Vomiting
• Abdominal pain
• Altered states of consciousness

Severe cases may result in coma, which may end up in death. It is an emergency situation and requires hospitalization.

“Metabolism” is a term used for all of the physical and chemical activity that takes place inside the human body that requires or releases energy. Once food enters the human body, several processes become active. Large molecules of food are broken down into smaller molecules. Most of the carbohydrates in the food are converted into glucose.

This glucose is the source of energy for the body. Once glucose enters the bloodstream, it needs to be transported to muscles, cells, and other organs where it can be converted into energy. At this point in the chain, insulin becomes a major player as it is responsible for the movement of glucose to almost 70% of the body’s cells. Besides movement, insulin also plays a vital role in the conversion of glucose into glycogen, which is stored by the liver and muscle cells.

As the sugar level in the blood rises, insulin is released into the bloodstream. Beta cells residing in the islets of Langerhans (in the pancreas) are responsible for this release of insulin.

Vascular disease: If the blood glucose level stays abnormally high in the blood vessels, it may result in damaged blood vessels or angiopathy. Under these circumstances, cells lining the blood channels start taking more glucose than normal. This results in the enhanced formation of the surface glycoprotein, causing a thicker and weaker basement membrane. All of the problems resulting from this complication fall under the microvascular diseases.

If the damage happens to small blood vessels, it is known as microangiopathy. Microangiopathy may result in any of the following complications:
Diabetic retinopathy: Microangiopathy may result in weak and low-quality blood vessels in the eye, especially in the retina and macular edema. This results in the loss of vision and, in severe cases, it may lead to blindness. Damage of the retina as a result of microangiopathy is the most prevalent cause of blindness among non-elderly adults in the U.S.

Diabetic neuropathy: This abnormality is characterized by decreased and abnormal sensation in the nerves. Usually it starts in the feet and later spreads to the fingers and hands. It may result in a diabetic foot, in combination with damaged blood vessels. Diabetic neuropathy may take several forms. If muscle weakness results from neuropathy, it is known as diabetic amyotrophy.

Diabetic nephropathy: This type of complication arises if diabetes results in damage to the kidneys. This type of damage may lead to permanent kidney failure, which will require dialysis in order to sustain life. In developed countries, diabetes is one of the most common causes of kidney or renal failure.

Diabetic cardiomyopathy: Diabetes may lead to diastolic malfunction, which may end in heart failure. Macrovascular diseases act as triggers and contribute to cardiovascular disease. Atherosclerosis is the main contributor to:

• Coronary artery disease
• Stroke
• Peripheral vascular disease
• Diabetic myonecrosis

Diabetic foot: This complication is a result of neuropathy and vascular degeneration and its abnormalities. It usually results in skin ulcers and various infections. In severe cases, it may result in necrosis and gangrene. This is one reason for the higher rate of leg and foot infections in diabetic people. If care is not exercised, it may end in amputation of the toes or feet.

Carotid artery stenosis: This complication is not necessarily a direct result of diabetes, but healing and risks during operations are highly influenced by diabetic conditions.

Diabetic encephalopathy: This type of complication results in decreased cognition skills. It also involves the risk of dementia.

Lifestyle changes and proper medication under medical supervision is the key to the successful management of diabetes. Good luck!

Diabetic ketoacidosis or DKA is one of the most dangerous complications, which will always result in medical emergency. Insufficient insulin results in the use of ketones as fuel for the body. If this happens once in a while, it is normal, but if it becomes routine, it is dangerous. This results in the decrease of the pH value of the blood, which results in DKA. Typical symptoms include:

• Dehydration
• Rapid, deep breathing
• Abdominal pain

In an acute case, a person may have an altered state of consciousness, which leads to coma. This may prove fatal in case of delayed or improper medical treatment.

Nonketotic hyperosmolar coma or HNS is another acute complication that shares many symptoms of DKA, but the cause is very different. If blood glucose levels in a person are very high (above 300mg/dl), a higher level of glucose in the blood is disposed of by the kidneys. To compensate for fluid loss in the blood, water is drawn from the cells through osmosis. The result is water loss in great quantities, which ultimately leads to dehydration. The electrolyte balance is disturbed and may prove highly dangerous. Symptomatic lethargy may lead to coma. This is also dangerous and may prove fatal. Immediate medical attention is necessary.

Hypoglycemia or abnormally low levels of blood glucose is another severe complication. Under these conditions, the patient may behave abnormally. In extreme cases, the person may experience altered states of consciousness. Coma, seizures, brain damage, and death may be the outcome in extreme cases. There are a number of factors that lead to these conditions. Usual treatment for this complication is sugary drinks or food and, in severe cases, an injection of glucagons.

• Patient education
• Diet
• Exercise
• Weight control
• Glucose monitoring
• Regular medical care

The patient should be educated about the cause of the diabetic condition. This will help the patient understand symptoms of the disease. Proper knowledge of diet will help the person select the right foods.

Weight control, along with reasonable physical activity, is a must for the normal metabolic activity of the human body.

Glucose monitoring, along with proper medication under medical supervision, is the most significant element in the management of diabetes. In any diabetic condition, diet control, exercise, and weight management are significant factors beside medication. For type 2 diabetes, depending upon the glucose level and other factors, doctors may prescribe oral medication or insulin. For the type 1 diabetic condition, insulin is the only medication.

• Fasting blood glucose level
• Random
• Oral glucose tolerance test

In the fasting blood glucose level test, if the level is found to be higher than 126 mg/dl on two occasions, it indicates diabetes. Blood glucose levels between 100 and 126 mg/dl indicate pre-diabetes. Pre-diabetic blood glucose levels show strong susceptibility to type-2 diabetes. When you go in for this type of test, you should not eat for six hours before the test.

Random or non-fasting blood glucose level tests can be conducted at any time. What you have eaten before the test and your activity affects the results of the test. If results show a sugar level of more than 200 mg/dl, along with typical diabetes symptoms, diabetes is suspected. But this test needs confirmation with the fasting blood glucose test.

Oral glucose tolerance tests are the most common glucose tolerance test. When submitting to the test, you should not eat after midnight. You will be made to drink liquid for the test. The liquid contains a certain amount of sugar in it. Blood samples will be taken before you drink it. Once you drink the liquid, blood samples will be taken again every 30 or 60 minutes. Tests normally last for about three hours. Glucose levels in the blood, if found above normal levels, may indicate diabetes. This test can be used to diagnose type 2 as well as gestational diabetes. Tests of insulin levels may be used as complementary tests for the diagnosis.

Hemoglobin A1c tests (also known as HbA1c) are an ideal indicator of a patient’s average blood glucose levels over last few months. Your doctor will suggest how often you can take the test. It helps you and your doctor to know the effectiveness of the current treatment.

Another test that is used in case of type 1 diabetes is the ketones test. Urine samples are used for this test. Higher levels of ketones may lead to ketoacidosis. This test is used especially in situations where the blood sugar level is more than 240 mg/dl or during pregnancy.

Management of diabetes can be done with three methods: dietary control, oral hypoglycemic drugs and insulin. A diet for a diabetic patient should be low-energy and weight reducing. It should be low on fat content and alcohol intake should be avoided.

Oral hypoglycemic drugs like Sulphonulureas, Biguanides, Alpha-glycosidase inhibitors, Thiazolodinediones, Meglitinides and Amino acid derivatives might be used. Insulin is given through subcutaneous injection, which the patient can inject himself with little expertise.

Diabetes is of two types: TYPE I (insulin dependant diabetes mellitus) and TYPE II (non-insulin dependant diabetes mellitus). Causes of diabetes include: idiopathic, heredity, obesity, pancreatic disease, and drug induced, viral infections, associated with genetic syndromes like Turnerís syndrome, klienefelter syndrome, and Down syndrome.

Though different people may experience different symptoms the most common are:

• Frequent urination (even at night) 
• Excessive thirst 
• Dry skin 
• Itchy skin 
• Slow healing of cuts 
• Blurry eyesight 
• Always being very hungry
• Feeling tired and weak
• Weight loss
• Skin infections
• Numbness or tingling in feet