Endocrinology-Diabetes Questions Endocrinology-Diabetes

What are the early signs of diabetes?

My daughter is overweight and may have diabetes. I want to know what are the early signs of diabetes?

5 Answers

First signs - thirst and urinating [peeing] frequently.
If your child has diabetes, it would be Type 2 that occurs mainly in adults, but we are seeing more of in children. Early forms of this are called "metabolic Syndrome" or "Pre-diabetes". These early forms may have no or very few symptoms. Check the back of her neck & see if it is rough & has pigmentation. This is called Acanthosis Nigrecans & is associated with high insulin levels due to the insulin resistance of obesity. Look also to what kind of obesity she has. That associated with these problems is central or truncal obesity and the excess fat is intra-abdominal not just under the skin. We often illustrate this by using as an example apples & pears. Pears are small on top & bigger on the bottom. This is fat under the skin & they do not usually develop diabetes. It is the apples with central, abdominal obesity that do develop it. Other symptoms are excess urination & thirst. If it has gone this far without medical care, it has gone too far. Please see you doctor & get it evaluated. Tests can be run to confirm the physical signs & perhaps set you heart at ease. In any event see a dietician and get help for the obesity. The YMCA has a good program with dieticians & exercise specialists to help and it is relatively cheap. Please see Dr., Dietician & if available the YMCA for help as continues obesity with or without diabetes is detrimental to your childes health.
Early signs of diabetes mellitus can include fatigue, weight loss, excessive thirst, excessive urination, urinary incontinence, urinary infection, vaginal yeast infection, excessive hunger, or darkening of skin over the back of the neck and other skin folds (e.g., armpits, under the breast, the waistline, etc.). Your healthcare provider can confirm the diagnosis of diabetes mellitus by a simple, inexpensive, finger stick to check the blood sugar level.
Increase urination, and increased thirst
Diabetes is a common metabolic disorder. It is caused by either insulin deficiency or insulin resistance. Most children will have type 1 diabetes which is a state of absolute insulin deficiency. It is mainly an autoimmune process where by insulin producing cells called beta cells are destroyed in the process. It is more common in the Caucasian children. Type 2 diabetes is also becoming more common in children due to the epidemics of obesity which results in insulin resistance. The incidence of type 2 diabetes is more common in the minority population than the caucasian population. Diabetes (type 1 and type 2) can be diagnosed clinically and biochemically.

1) Any person with symptoms of excessive urination, excessive thirsty, bed wetting, nocturia, weight loss and abnormal blood sugars above 200mg/dl have diabetes unless proven otherwise.
2) Any random blood sugar greater than 200 mg/dl at more than one occasion.
3) Any fasting blood sugar (at least after 8 hrs. fasting) >126 mg/dl at more than one occasion.
4) Any blood sugar >200 mg/dl on more than one occasion using the 2 hour standard glucola test of 75 gm. ( 1.75 mg/kg up to 75 grams) performed after 8 hours of fasting on more than one occasion.
5) Hemoglobin A1c greater or equal to 6.5%
Another entity call a prediabetes state can also be established using blood sugar reference ranges if the individual is at risk for diabetes.

Biochemically, a prediabetes state can be established as follows:
1) Fasting blood sugars between 99-126mg/dl at least in more than one occasion.
2) Blood sugars between 140-200 mg/dl in the standard 2 hour glucola test on more than one occasion.
3) Hemoglobin A1c between 5.7-6.4%

The earlies signs of diabetes for both type 1 and type 2, are therefore; (biochemical markers) such as, abnormal blood sugars and abnormal hemoglobin A1c, followed by clinical signs, such as, excessive drinking, excessive urination, bed wetting, nocturia, weight loss etc. Again the first one to be abnormal are the biochemical markers before the emergence of the clinical signs and symptoms.`

If you suspect your daughter has symptoms of diabetes or if she is at high risk for diabetes, you should check her blood sugars fasting and random (if you have access to glucometer). If you get >200mg/dl persistently with or with out frank symptoms of diabetes, you may take her to her doctor promptly. If you do not get high blood sugars you may be dealing with other conditions that share similar symptoms. If you do not have an access to glucometer and you suspect diabetes you should take her to her doctor or to the emergency room.
Good luck.