ONE of the most frequently asked questions in my practice is: How can I tell if I am diabetic? And it is not surprising that people ask this question because some of the symptoms are not visible or are so mild you might think there is no reason to be concerned.

The following is a list of some of the main symptoms of diabetes. When you have finished reading the list, ask yourself if you have any of them. I would recommend that if you do, you should play it safe and see a doctor. This is certainly one situation in which it is better to be safe than sorry.

• Passing your urine frequently: This happens because your body is trying to get rid of the extra blood sugar by passing it out in the urine. This is called polyuria.

• Constant thirst: Your body is trying to rehydrate itself and make up for all the excess urination. The medical term for this is polydipsia.

• Hunger: This is because your body is literally starving for the energy it cannot get from sugar, which is just floating around in the blood and not being taken to the cells. This is known as polyphagia.

• Fatigue: Since the glucose is not getting into your body, it has no fuel.

• Weight loss without any effort on your part: This is because your hungry body has started to use fat and muscle for fuel because it cannot use sugar normally.

• Frequent infections: For example, in the urinary tract and vaginal yeast infections

• Slow-healing sores

• Dry, itchy skin

• Numbness andor tingling in the feet

• Blurred vision

Remember that, although these symptoms give a good indication of the disease, some diabetics may have only a few or even none of these symptoms.

In addition to these symptoms there are also other health problems that can be caused by diabetes. There are many severe long-term complications that are caused by unnoticed and/or untreated diabetes. These include:

• Hardening of the arteries, atherosclerosis: This can cause heart disease, peripheral arterial disease (what we call poor circulation), a stroke, or a heart attack.

• Diabetic retinopathy: A type of eye disease that leads to loss of vision. Unfortunately, some diabetics may have this complication and not know it.

• Diabetic nephropathy: A disease of the kidney that has no early symptoms and can lead to kidney failure.

• Diabetic neuropathy: A family of nerve disorders caused by diabetes. While some persons with nerve damage may have no symptoms, others may experience pain, tingling, or numbness in the feet, legs, hands, and arms. These nerve problems may occur in every organ in the body, including the heart, digestive tract, and sex organs.

• Poor healing of wounds: Particularly of the feet, which can lead to gangrene and limb amputation.

Testing for diabetes

Diabetics need to learn all they can about the disease, and very importantly, about how it is tested and what the measurements mean. This knowledge can literally mean the difference between life and death.

A blood glucose test measures the amount of sugar (glucose) in the blood. Blood glucose is measured in units called milligrams per decilitre (mg/dl) and millimoles per litre (mmol/l). Measurements give an indication of the sugar level in the blood at the time the test is done.

Our blood glucose levels need to be maintained within a certain range to help us keep healthy. Normal glucose levels fall between 3.8 and 7.8 mmol/l (that’s the same as 70 and 140 mg/dl ). Generally, blood glucose levels are lower in the mornings and rise after meals are eaten.

Blood sugar levels measuring above 7.8 mmol/l are indicative of high blood sugar or hyperglycemia. Levels that fall below 3.8 mmol/l indicate low blood sugar or hypoglycemia.

Blood tests must be performed to determine whether someone has pre-diabetes or diabetes. Persons who already know they are diabetic need to have regular blood tests performed to check on how well the sugar is being controlled.

There are four main types of blood tests for diabetes:

1. Random blood glucose: This measures your blood sugar regardless of when you had your last meal. A blood glucose level higher than 11 mm/l indicates the possibility of diabetes (11 mm/l means 11 millimoles per litre; this is the same as 200 milligrams per decilitre (200 mg/dl).

2. Fasting blood glucose: This measures your blood sugar when it is at its lowest, that is, at least eight hours after you ate your last meal. If your blood sugar measures more than 6.1 mm/l or 110 mg/dl it indicates the possibility of diabetes or pre-diabetes.

3. Two-hour postprandial blood glucose: Postprandial means “after meal”. The blood sugar is tested exactly two hours after drinking a glucose-rich drink. If your two-hour blood glucose level is more than 7.8 mm/l or 140 mg/dl and your fasting blood glucose is normal, it means you have pre-diabetes. If your fasting and 2-hour blood glucose levels are above normal, it means you are diabetic. Yes, it’s that simple to diagnose.

4. Oral glucose tolerance test: This requires that you fast for at least eight hours before doing the test and for a specific period while the test is being done. After blood is first taken, you are given a glucose-rich drink and asked to wait. Your blood will be taken at hourly intervals after you have this glucose drink. This can be done for up to three hours after you have had the drink. The reason this is done is to chart how your body handles a load of glucose over a specific period. A version of this, the O’Sullivan test, is used to test for gestational diabetes.

5. HbA1c or glycosylated haemoglobin test: This gives your doctor an overall picture of how your diabetes is being controlled. The test measures the amount of sugar that is attached to the red blood cells. The results are given as a percentage. Red blood cells live in the bloodstream for about four months and so the HbA1c test shows the average blood sugar for the past three to four months.

Having diabetes is not a death sentence. Get to know your body, how your body responds to food, exercise, and stress. Live your best life!

Excerpts taken from the book A patient’s guide to the treatment of diabetes mellitus. ©Jacqueline Elaine Campbell

Dr Jacqueline E Campbell is a family physician and radio show host. She is the author of the book