Pre Diabetes Symptoms

The term pre-diabetes has been adopted by the American Diabetes Association (ADA) and the National Institute of Diabetes and Digestive and Kidney Diseases. 

Before developing type 2 diabetes, people go through a stage in which blood sugar levels are higher than normal but less than the levels to be classified as diabetes. Nearly 20 million people in the United States are affected by this condition. 

According to the current criteria, you will be diagnosed with this condition if your blood sugar values in a lab test are: 

Fasting blood sugar ranging from 100 to 125 mg/dL, (5.6 to 6.9 mmol/L), a condition also called impaired fasting plasma glucose. 

or 

Blood sugar, ranging from 140 to less than 200 mg/dL (7.8 to 11.1 mmol/L) in a glucose tolerance test (2 hours after taking glucose mixed in water). This condition is also called impaired glucose tolerance. 

A peculiar feature of this condition is that although you may not be aware, your heart and blood vessels are silently undergoing some long-term damage in this stage. People who are at increased risk of developing type 2 diabetes (noted earlier in this chapter) should be screened for this. 

A timely detection of this condition, followed by simple lifestyle changes, can prevent it from developing into full-fledged diabetes and halt the damage it has been causing to the body.

Pre Diabetes –The Pre Cursor

Before people develop Type 2 Diabetes, they almost always have "pre-diabetes" -- blood glucose levels that are higher than normal but not yet high enough to be diagnosed as diabetes. There are 54 million people in the United States who have pre-diabetes and most don't even know it. Recent research has shown that some long-term damage to the body, especially the heart and circulatory system, may already be occurring during pre-diabetes. Research has also shown that if you take action to manage your blood glucose when you have pre-diabetes, you can delay or prevent Type 2 Diabetes from ever developing. People with pre-diabetes can expect to benefit from much of the same advice for good nutrition and physical activity. If you take action in time you may forestall the onset of diabetes or eliminate it all together. There are two different tests your doctor can use to determine whether you have pre-diabetes: the fasting plasma glucose test (FPG) or the oral glucose tolerance test (OGTT). The blood glucose levels measured after these tests determine whether you have a normal metabolism, or whether you have pre-diabetes or diabetes. If your blood glucose level is abnormal following the FPG, you have impaired fasting glucose (IFG); if your blood glucose level is abnormal following the OGTT, you have impaired glucose tolerance (IGT). If your FPG is below 100 you are normal; if you are in the 100-125 range you are pre diabetic; and if you are above 126 you are diabetic. A high score may indicate that you have pre-diabetes or at risk for pre-diabetes. Take the test and find out for sure. Pre-diabetes is a serious medical condition that can be treated by making changes in their diet and increasing their level of physical activity. You may even be able to return their blood glucose levels to the normal range. A recent study showed that some medications may delay the development of diabetes- diet and exercise worked better. Just 30 minutes a day of moderate physical activity, coupled with a 5-10% reduction in body weight, produced a 58% reduction in diabetes.

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New Advancements in Diabetes

Discovery of insulin more than 80 years ago was a miracle; and treatment of diabetes with insulin injections saved lives of millions of people in the world. Insulin administration, however, is not a cure. 

Scientists are actively engaged in finding a cure for diabetes and related complications. A few of the many remarkable advances made recently and some ongoing promising efforts in diabetes research are noted below.

GENE RESEARCH.

It is believed that several genes are involved in causing both type 1 and type 2 diabetes. Researchers are trying to identify all these genes. A better understanding of these genes will be helpful in prevention, treatment, and cure of diabetes. 

Researchers have made some progress in discovering the genetic connection of diabetes and its complications: 

Type 1 Diabetes.

A gene known as HLA (human leukocyte antigens) has several types or variations. Scientists have learned that the disease type of this gene is present in about 85 to 90 percent of people with type 1 diabetes. This gene is strongly associated with the destruction of beta cells in the pancreas, resulting in absolute insulin deficiency. 

This knowledge will enable the scientists to develop methods to prevent or slow down destruction of insulin producing cells, thereby reducing the occurrence of type 1 diabetes.

Type 2 Diabetes.

Because type 2 diabetes is closely associated with obesity, high blood pressure, and abnormality in blood cholesterol and other blood fats, it has been difficult to identify the specific gene responsible for causing type 2diabetes. Scientists are using advanced technology for genetic analysis to discover the exact gene or genes that increase the risk for the development of type 2 diabetes. 

Recently, a gene named Calpain 10 has been shown to contribute to the onset of type 2 diabetes in Mexican Americans. Research is exploring if this gene is also involved in other populations in causing type 2 diabetes.

Diabetes Complications.

Many research studies are in progress to discover how to overcome diabetes complications.

Two research efforts related with the genetic connection of these complications are:

A diabetes research program aims to develop gene therapy in which a gene will be delivered in the patient’s body that will increase or decrease growth factors to treat diabetes complications. For example, to improve blood circulation to the heart and brain and reduce nerve damage in the legs and feet caused by diabetes, the gene will be transferred in the patient’s body to stimulate growth of new blood vessels. Or, to prevent the growth of easily breakable vessels in diabetic eye diseases and reduce the risk for blindness, a gene will be transferred in the patient's eye that will block the growth factors in the diabetic eye. 

Research has recently shown that diabetic kidney disease runs in families. The National Institutes of Health (NIH) has designed a study named Family Investigation of Nephropathy and Diabetes (FIND). This study aims to identify the gene responsible for the development of kidney and diabetic eye complications in people with type 1 and type 2 diabetes.

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Is diabetes preventable?

The Diabetes Prevention Program (DPP) was a remarkable study conducted by the National Institutes of Health on the prevention of type 2 diabetes. The study was carried out at 27 centers in the United States that enrolled more than 3,000 men and women.

These participants had impaired glucose tolerance (pre-diabetes), the condition that increases the likelihood of developing type 2 diabetes. The study recruited people who are known to be at a high risk of developing type 2 diabetes. These people included individuals aged 60 years or older, women who in the past had diabetes during pregnancy, people with a first degree relative with type 2 diabetes, and people belonging to the minority groups such as African Americans, Hispanic Americans, Asian Americans and Pacific Islanders, and American Indians. 

The findings of this study, released in August 2001, firmly proved and conclusively established that even people at increased risk of developing type 2 diabetes can reduce their chances of getting this disease by about 58 percent when they make simple lifestyle changes. In addition to the DPP, there are other population studies, which show that lifestyle changes can prevent type 2 diabetes up to 90 percent. 

The following lifestyle changes, as shown by the DPP and other studies, are helpful in preventing type 2 diabetes: 

Regular exercise usually walking or other moderate intensity exercise for about 30 minutes every day. Newest research, however, suggests that at least 60 minutes a day of moderate intensity exercise such as brisk walking is more effective than 30 minutes of exercise in preventing chronic diseases, including type 2 diabetes. This means that an increased amount of physical activity may increase the number of people preventing type 2 diabetes.

Low fat healthy diet.

To prevent type 2 diabetes, the DPP recommended its participants to consume fat less than 25 percent of their total calories. If this approach did not work alone, the DPP recommended, in addition, to limit daily calorie intake such as:

• 1,200 calories for people weighing 120 to 174 pounds
• 1,500 calories for people weighing 175 to 219 pounds
• 1,800 calories for people weighing 220 to 249 pounds
• 2,000 calories for people weighing greater than 250 pounds

Consumption of low fat low calorie diet will help you achieve healthy weight and maximize your chances of preventing type 2 diabetes when you are at its increased risk.

Saturated fat such as found in red meat and whole milk is associated with producing insulin resistance in the body and glucose intolerance, thereby increasing the risk of getting type 2 diabetes. To reduce this risk, your diet should be very low in saturated fat and cholesterol. 

According to the newest recommendations, saturated fat and dietary cholesterol are not beneficial for health, and therefore should be very limited in a healthy diet. You should use healthy fats such as monounsaturated fat and polyunsaturated fat in place of saturated fat. 

Rich sources of monounsaturated fat include nuts, olive oil, canola oil, and peanut oil. 

Polyunsaturated fat is found in corn, sunflower, and soybean oils. These fats, when used in place of saturated fat, help improve your glucose tolerance and enhance the action of your insulin, helping prevent type 2 diabetes. 

However, excessive intake of any fat, good fat or bad fat, is unhealthy. Its one disadvantage is that it produces glucose intolerance and insulin resistance in the body, increasing the risk for developing type 2 diabetes. Research shows that limiting your total daily fat intake within the range of 20 to 35 percent of your total calories is helpful in promoting good health and reduction of your risk for chronic diseases, including diabetes. 

Reduction of excess weight by about 5 to 7 percent. Such a reduction helped the participants of the DPP to prevent the onset of type 2 diabetes. Research shows that more than 80 percent of the people with type 2 diabetes are overweight. 

This is because excess weight tends to depress the action of insulin, resulting in raised blood sugar levels. Because weight reduction increases your body’s sensitivity to insulin, it helps prevent and manage type 2 diabetes. Keeping weight within the BMI range of 21 to 23 (see chapter 9) has been shown to help prevent type 2 diabetes (The BMI range of 24.9 regarded normal by the NHLBI may not be as effective in preventing type 2 diabetes as the more strict range of 21 to 23).

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Diabetes Treatment Drugs

Diabetes treatment drugs pills, also called oral hypoglycemic agents (OHA), are medications or pills to lower blood sugar.

These pills work by interacting with natural insulin in the body and are given to a person with type 2 diabetes in whom the pancreas is still producing at least some insulin. Diabetes pills will not work if you have type 1 diabetes and your pancreas has stopped producing insulin.

TYPES OF DIABETES PILLS.
Currently, six different classes of diabetes pills are available:

• Sulfonylurea
• Biguanide
• Alpha-Glucosidase Inhibitor
• Thiazolidinedione (TZD)
• Meglitinide
• D-phenylalanine (amino-acid) Derivative
• Metformin Mixtures

Each class of these pills lowers blood sugar in a different way. 

SULFONYLUREA.
Sulfonylurea is the oldest class of diabetes pills to lower blood sugar. The pills in this class are usually the first line of drugs used in treatment of type 2 diabetes.

How the drug works?
The principal action of sulfonylureas is to stimulate secretion of insulin from beta cells of the pancreas. The secondary effect of this drug is to reduce production of sugar by the liver. Both these actions lower blood sugar.

Important facts about the drug:

• Sulfonylureas are especially useful for controlling blood sugar in
thin people with type 2 diabetes who fail to control blood sugar by
diet alone.

• When sulfonylureas are used alone to treat high blood sugar, they
lower hemoglobin A1C by about 1 to 2 percent.

• The effectiveness of this class of drug varies with individuals: some
people may never achieve full control of blood sugar or many lose
control after its prolonged use.

• When a single dose of a sulfonylurea does not lower blood sugar to
the desired target, dividing the dose and taking these doses in the
morning and evening may help.

• When sulfonylureas alone are ineffective in achieving good blood
sugar control, pills from the other class or classes may be added.

• Arecent study suggests that sulfonylureas mask the severity of heart attacks. When a person is having a severe heart attack, and he or she has been using the sulfonylurea class of pills to control blood sugar, the EKG may not indicate the true electrical changes in the heart.

As a result, such a person may not get proper treatment.

Risk of low blood sugar.
Sulfonylurea pills can cause a severe fall in blood sugar, especially when you take this class of drug, and skip a meal, or exercise vigorously.

Effect on lipids.
These pills do not improve cholesterol and other blood fats.

Effect on weight.
It may increase weight.

Main side effect. Low blood sugar.

Other possible side effects. Stomach pain and itching.

Caution. This drug is not recommended if you ever experienced reaction with sulfa pills in the past. 

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Diabetes-The Not So Secret

As devastating as the disease is; as fast as it is growing in the U.S.; as many people as it kills every year directly or indirectly thru its' complications; one thing stands out: IT IS ALMOST ENTIRELY PREVENTABLE And it is one of the few major diseases that can be prevented. Given the level of obesity in the U.S. someone needs to wake up.

Studies show that if you are pre diabetic or have Syndrome X and you take certain steps and maybe even some medication the good news is that the more serious problems can all be prevented. 

Even if diabetes runs in your family, diet and exercise can help you prevent the disease. And if you've already been diagnosed with diabetes, the same healthy lifestyle choices can help you prevent potentially serious complications.

- Eat healthy foods. Choose foods low in fat and calories. Focus on fruits, vegetables and whole grains. Strive for variety to help you achieve your goals without compromising taste or nutrition. 

- Get more physical activity. Aim for 30 minutes of moderate physical activity a day. Take a brisk daily walk. Ride your bike. Swim laps. If you can't fit in a long workout, break it up into smaller sessions spread throughout the day. 

- Lose excess pounds. If you're overweight, losing even 10 pounds can reduce the risk of diabetes. To keep your weight in a healthy range, focus on permanent changes to your eating and exercise habits. Motivate yourself by remembering the benefits of losing weight, such as a healthier heart, more energy and improved self-esteem. 

Sometimes medication is an option as well. Oral diabetes drugs such as metformin (Glucophage) and rosiglitazone (Avandia) may reduce the risk of Type 2 Diabetes — but healthy lifestyle choices remain essential.

Weight loss of up to 10 % of your current weight will have an impact on lowering your blood pressure and raising your HDL or good cholesterol. A diet low in refined carbs such as soda, high fructose corn syrup, sugar and white flour bread and pasta will help with weight loss and getting your triglycerides down. And of course exercise-even a 30 minute walk a day can do wonders.

So be good to yourself, your spouse and children; lose the weight, exercise, and change your diet. If you don’t the evil downward spiral of Type 2 Diabetes will ruin your life for sure and maybe kill you.

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Diabetes-The Emotional Side

The physical complications of diabetes get most of the publicity and rightfully so. Dealing with the emotional side of the disease presents a whole new set of problems not to be taken lightly. 

Looking back nearly fifteen years ago when I first suspected I had diabetes, several emotions played a rather substantial part in my disease’s development. Any one of them at any given time could have made the disease much worse and made my life in general worse.

The physical aspects of diabetes are well chronicled. The emotional aspects maybe not so well. Here is a partial list of the emotions I experienced and the impact they had on me.

DENIAL. When I first was told I had diabetes this was the first emotion I had. Maybe it was the nonchalant way the Dr. told me I had the disease in my life. He didn’t handle it very well which set the stage for my feelings. Those feelings only prolonged my getting control of the disease. Getting control of diabetes at an early stage of development is critical.

ANGER. The next emotion I remember having was anger. After the news set in and I began to get a grip on my situation I was mad. Mad at my Dr., mad at GOD, just mad at everything for getting my simple life so complicated. Mad at my new disease for turning my life up side down in my very prime.

WITHDRAWAL. I have always been an outgoing type. The retail food biz sort of demands that. When I got the news of my new disease (looking back in hindsight) I can see how slowly I began to withdraw and become more introverted. My personality slowly started changing as well. I became more serious and less fun loving.

DEPRESSION. Without sounding overly dramatic, there were/are times when I became depressed with my new found disease. All the changes I had to make in my diet; the long list of meds arising from complications; the never ending (for me ) battle of weight loss; the stress of knowing the complications that can develop from my inaction; the list goes on.

Those were the major emotions I experienced-there are others. What to do about it?The most important thing is to have a great support team surrounding you-family, spouse, doctor, nutritionist, etc. all those who can provide the emotional support you will need to cope with this disease. There are support groups at most hospitals that may help too.

The next thing is to know as much as you can about the disease. Only thru knowledge can you have any chance of success in fighting this horrific disease.






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Diabetes- The Weight Connection

There is no doubt that being overweight is a huge risk factor not only for diabetes but also many other serious diseases like hypertension, cardiovascular disease, sleep apnea, and on and on. In a recent study the World Health Organization (WHO) lists countries that have the highest percentage of population over 15 years of age that are overweight. According to WHO, being overweight is having a Body Mass Index (BMI) of 25 or more. Obesity starts at a BMI of 30 or more. At the top of the list is the tiny Republic of Nauru, an island nation in the Micronesian South Pacific. Nauru is the world's smallest island nation, covering just 21 km, and the only republican state in the world without an official capitol. They top the charts at an amazing 94.5% of the population overweight. Not surprisingly they have the highest rate of diabetes in the world too at 31%. The United States comes in ninth with 74.1 % of the population being overweight.  Experts say it is not surprising that people across the globe are increasingly becoming overweight. They blame urbanization and the influx of Western ways of life including myriad fast food choices, little exercise and stressful jobs. This change in lifestyle is most evident in the South Pacific. On the list of "fattest" countries, eight of the top 10 are in the Pacific region.  Developing countries are dealing with what many experts call a nutrition transition--economies that are used to dealing primarily with under nutrition must now fight obesity. "Obesity has become a problem of poverty," says Daniel Epstein of the WHO Regional Office of the Americas. “Poor people have an easier time of eating junk food. People fill up on things that have a high caloric value but little nutritional value.”   A Journal of the American Medical Association study in May of 2006 by researchers from Johns Hopkins University showed that teens living at or below poverty line were more prone to be over weight than their peers living above the poverty line. There are currently 1.6 billion overweight adults in the world. In just 10 years, the WHO projects that number will grow by 40%.  The increase in these health conditions due to obesity makes the future seem even bleaker to some experts. The best chance to reverse this is education about diet and the affects of obesity on lifestyle in general.

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Diabetes and Syndrome X

Many years ago I went to a health practitioner who told me I had Syndrome X. Back then not many people knew about it and there certainly wasn't much information available either.

It is estimated that one in three Americans-that's 100 million- have it with most of them not even knowing it.

WHAT IS IT? Syndrome X is a sexy name for insulin resistance a condition that leads to Type 2 diabetes. It takes years to develop. The cells of the body become resistant to insulin forcing the body to make more. The symptoms for it are slowly increasing blood pressure and cholesterol, gaining weight slowly but surely, and feeling tired after you eat. 

WHAT CAUSES IT? Some think that metabolic syndrome is inherited. Insulin resistance is caused by eating too many/much refined carbohydrates like breads, pasta, and sugary foods including sodas. Other factors can include a sedentary lifestyle and obesity.

As we said this takes a long time to develop. As long as the pancreas is able to produce enough insulin to overcome this resistance, blood glucose levels remain normal but when the pancreas can no longer produce enough insulin, the blood glucose levels begin to rise. It begins after meals when blood glucose levels are at their highest and more insulin is needed, but eventually is present in the fasting state too. This is when type 2 diabetes starts. 

HOW TO AVOID IT. It usually begins with people in their early 30's or 40's who have a relatively sedentary lifestyle. Folks who love their snacks and pasta are prime targets. Slow weight gain and slow increases in blood pressure and cholesterol can be avoided. Being aware of the prevalence of the problem and the consequences of inaction are a necessary first step. 

The best thing you can do to avoid it is to eat better, maintain a healthy weight, and exercise daily.

As my doctor once told me "It is all about the weight." Keep a healthy weight and you can avoid Syndrome X and the inevitable consequence of the disease of Diabetes. Isn't that worth it?

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Diabetes Treatment Plan

On diagnosis that you have diabetes, the immediate concern should be to control your blood sugar safely and keep it within the normal or near to normal range. This is necessary to protect you from the long-term organ damage and organ failure due to diabetes. Your doctor will set your treatment goals and devise a plan according to your individual needs and conditions. You should remain under ongoing professional care. A treatment plan for diabetes has certain components such as outlined below.

SETTING the BLOOD SUGAR TARGET.

The first step in starting your plan is to assess your condition and set a blood sugar target to be achieved. Your blood sugar target will be set according to treatment goals individualized for you. The American Diabetes Association (ADA) recommends specific targets of blood sugar for people with and without diabetes (see table III.1). Blood sugar goals for pregnant women are different as identified in "Prevent, Treat and Self-Manage Diabetes and it's related Complications".

METHODS OF TREATMENT.

After setting the blood sugar target, the next step is to choose a treatment method or methods to control your diabetes. 

Treatment methods include:

Healthy Lifestyle.

A healthy lifestyle consisting of healthy weight, regular exercise, stop smoking if you currently smoke, and managing your stress are essential elements in every prevention and treatment plan of diabetes. These are essential components of healthy living also. 

Healthy Eating.

In any diabetes treatment plan, healthy eating has a key role. The new food pyramid, the food exchange lists, the carbohydrate counting, and the consistent carbohydrate meal planning presented in this Part are useful tools for healthy meal planning. These are helpful tools for choosing healthy foods, and to use nutrition as a therapy to control blood sugar, and prevent and manage diabetes related complications.

Medication.

When healthy eating and healthy lifestyle measures together fail to control blood sugar, drug treatment is added. The medical treatment of diabetes may consist of using diabetes pills, or administration of insulin, or both. Insulin can be administered through insulin injections or continuous infusion of insulin through an insulin pump. At present, insulin injections are the most common form of insulin delivery. 

Pancreas Transplantation.

In an extreme form of uncontrolled diabetes that does not respond even to intensive insulin treatment, pancreas or islet cell transplantation may be considered for people with type 1 diabetes.

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Diabetes-What Is It

Both Type 1 and Type 2 Diabetes cause serious long term health problems if left untreated or undiagnosed. They both affect the way the body uses digested food for energy. Here's how it is supposed to work.  After eating the digestive system breaks food down into various components one of which is glucose. The blood stream carries glucose or sugar throughout the body causing blood sugar levels to rise. In response the hormone insulin is released to signal the body to metabolize the glucose for energy causing the blood sugar levels to return to normal. Glucose the body doesn't need or use goes to the liver or fat for storage for later use. That is how it normally works. Type 1 Diabetes used to be called juvenile diabetes because it usually struck people under 20. It is simply the pancreas not making enough insulin. Insulin is the key that "unlocks" cells to glucose and other nutrients allowing them to grow. Without insulin these cells literally start dying. The result is Type 1 Diabetics are hungry all the time trying to make up for the shortfall of insulin. Amazingly though since the body cannot process the nutrients weight loss is symptomatic along with extreme thirst and excessive urination. The kidneys try to process the excess glucose to balance things out. Type 1 Diabetes is largely inherited. Type 2 Diabetes is by far the most common type of the disease accounting for 90-95% of all cases. The American Diabetes Association (ADA) estimates that 21 million Americans have diabetes and that only two thirds of them even know it. Type 2 starts in middle age or later. It is growing so rapidly because of the epidemic in obesity not only in the US but all over the world. There is no cure but there is plenty you can do to prevent it and then control it. Type 2 is a chronic condition that affects the way your body metabolizes sugar the main source of fuel.   People with Type 2 Diabetes have insulin resistance which prevents insulin from processing glucose properly. Soon more and more insulin is produced to overcome the resistance. During the later stages of the disease as the resistance increases, the blood glucose increases to above safe levels, but the body can't use it properly and the body actually starves for more energy. If left untreated and again most people don't know they have it, disastrous results are sure to come. It increases risk for eye, nerve, blood vessel, heart, and kidney problems.

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Diabetes Symptoms

Symtoms of adult diabetes include:

• Excessive Thirst and Urination.
• Loss of Fluids.
• Severe Hunger
• Weight Loss
• Fatigue
• Changes in Vision
• Infections
• Nerve Pain.

Excessive Thirst and Urination.

Excessive thirst (polydipsia) and frequent urination (polyuria) are the classical symptoms of diabetes. High levels of blood sugar make your blood thick and sticky and the body stimulates thirst to add fluids to dilute sugar in the blood.

When you drink plenty of water to quench thirst, the kidneys drain out excess water in the form of urine and protect the system of your body from being overloaded with fluid. But frequent urination leads to water loss in the body, which in diabetes causes sugar to concentrate again in the blood.

This process repeats the abnormal cycle of thirst and urination. These symptoms are more prominent in type 1 than type 2 diabetes and may often be absent in people with type 2 diabetes.

Loss of Fluids.

Excessive urination results in severe loss of fluids, a condition that leads to dehydration or water loss in the body.

The dehydration can cause various medical conditions, including general weakness and the more serious condition in which the blood acids become very high (ketoacidosis), especially in people with type 1 diabetes. Severe loss of water can lead to coma and even death.

Severe Hunger.

When your blood sugar is high, some sugar along with other nutrients passes in your urine. These nutrients as well as sugar are a source of energy to your body and their excretion through frequent urination causes a heavy loss of energy.

To regain energy, your body stimulates hunger. Also, when sugar accumulates in the blood and does not reach the innumerable cells and muscles that require it for energy, the cells begin to starve and you feel hungry. (Excessive hunger, however, can also be a symptom of low blood sugar, a dangerous medical condition. To be sure, test your blood sugar.)

Weight Loss.

In diabetes, you may be eating a lot and yet be losing your weight.

Reason: When sugar is high in the blood, you may spill over some sugar in the urine (noted before). Because sugar is energy (4 calories per gram), you lose a large number of calories when you excrete large amounts of sugar in the urine.

Loss of calories results in loss of weight. Rapid weight loss is a marked feature in people with type 1 diabetes; this symptom as noted earlier, may be absent in people with type 2 diabetes.

Changes in Vision.

Frequent changes in blood sugar levels make your vision blurred or clear. When blood sugar remains high, the eye lens swells and distorts the vision; when blood sugar returns to the normal level, the eye lens recovers from swelling and the vision becomes clear.

Blurred vision caused by raised blood sugar levels is a self-correcting condition, which people with diabetes may frequently experience. This condition sharply differs from the serious eye disease called retinopathy in which high levels of blood sugar damage the retina, and may lead to blindness in extreme conditions.

Fatigue.

When insulin in your body is not enough or it cannot work efficiently, sugar is not properly delivered to the cells of the body where it is required for energy. When your body does not get proper nourishment, it lacks energy and you feel fatigued.

The feeling of fatigue is common when sugar in the blood is high such as when you have eaten a heavy meal loaded with carbohydrates (because carbohydrates cause maximum rise of blood sugar). However, keep in mind that fatigue can also be a sign of low blood sugar. To be sure, test your blood sugar.

Infections.

Diabetes tends to impair your body’s infection-fighting system, resulting in an increased risk for developing infections. These infections are slow to heal and tend to resist treatment. The infections most commonly associated with diabetes include gum, urinary tract, foot, and skin infections, and various kinds of wounds and ulcers that heal very slowly.

A common infection in diabetes is a yeast infection caused by the yeast fungus called Candida. Both men and women with diabetes may develop yeast infection but the women are at increased risk.

Yeast infection causes vaginal yeast in women, a condition characterized by itching and irritation in the vagina, inflammation of the vulva, and a white coating on the vaginal walls. In men having yeast infection, the end of the penis may become red, swollen, painful, and filled with sores covered with a cheese-like white coating.

Nerve Pain.

Several years after having diabetes, people tend to develop nerve pain or numbness in their legs, feet, arms, and hands. These conditions are common symptoms of nerve damage (neuropathy) caused by diabetes. 

Raised blood sugar levels tend to damage all blood vessels in your body, including the tiny vessels that supply the blood to the nerves . When your nerves do not get enough blood, they become weak and you feel nerve pain. 

Nerve pain may diminish or disappear with improved control of blood sugar; however, it may come to stay when nerve damage has become chronic and irreversible. 

Other Symptoms.

These may include: itching, gum disease, darkening of the skin around eyes, and bad smell in breath.

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