Blood sugar signs you may ignore: My patient felt thirsty even in cool environs, felt itchy at night

Indian Express

2 days ago

A young man came to me saying he wasn't quite feeling himself lately, that he was just feeling 'a bit off.' So I asked him to list what was 'off.' He said that he was low on energy, feeling thirstier than usual even in cool environs and had broken sleep because he had to go to the washroom to urinate twice or thrice. His skin would itch at night, too. I also noticed that there were dark patches in the folds of his neck and a cut on his hand that had not healed even after 10 days. He was displaying signs of high blood sugar.
The reason we tend to miss these signs is because they are subtle and easily explainable to other health conditions. If you're tired, you tell yourself, it's probably work. If you are urinating frequently at night, then you think it's because of all the fluid you had during the day or the extra tea and coffee. If you feel all too sleepy after eating, then you attribute that to the heaviness of the meal. If you have blurry vision, you think it is an eye problem, if it is dry mouth, you think you have not had enough water. Sometimes, you may have repeated urinary tract infections or darkening skin patches and rashes which you treat in isolation.
But fact is that these are all signs of high blood sugar which can go unnoticed for years.
Understanding red flags
Itchy skin: This especially happens around the groin or underarms. Diabetes can disrupt the skin's ability to retain moisture, leading to dryness and itching. This is often due to impaired sweat and sebaceous gland function, which hydrates the skin. Dry skin can be exacerbated by poor circulation, a common complication of diabetes.
Unexplained weight loss: If your body can't get enough fuel from your food, it goes to burn muscle and fat stores instead. So, the patient may lose weight.
Extreme fatigue: This usually stems from being dehydrated because of constant urination.
Poor vision: High blood sugar can damage blood vessels in your eyes and you may experience blurry vision. If left untreated, permanent damage can occur and lead to more complications.
Delayed healing of wounds: High blood sugar can damage nerves and blood vessels, impairing blood circulation. So nutrients and oxygen do not reach the wounded area for proper healing. The same can cause tingling, numbness or pain in your hands and feet.
Dizzy spells: Sometimes people may feel light-headed and dizzy, which passes off quite quickly. High blood sugar may result in dehydration, which affects concentration and memory.
Irritability: Bouts of irritation and changing moods are indicative of rapid shifts in blood sugar.
Unusual smelling breath: Low insulin levels lead to ketosis because the body, lacking sufficient insulin to utilise glucose for energy, turns to fat for fuel, producing ketones as a byproduct. This may further be broken down to acetones that smell like nail polish.
At what age should one ideally get their first blood sugar test done?
For most healthy adults, age 30 is a good time to begin routine blood sugar screening. However, if someone has risk factors, like a family history of diabetes, is overweight, has a sedentary lifestyle or has conditions like PCOS (polycystic ovary syndrome), high blood pressure or high cholesterol, it's advisable to start even earlier — possibly in the mid-20s.
What tests to take?
A simple fasting blood sugar test, along with an HbA1c test (average blood sugar count of three months) are enough to start with. If needed, we may also do a postprandial (after-meal) test.
In many cases, if the tests are done in the prediabetes stage, then its progression to full-blown diabetes can be avoided. That stage can often be reversed with lifestyle changes like diet, exercise and weight management. That's why early detection is so important.
(Dr Mohan is chairman, Dr Mohan's Diabetes Specialities Centre, Chennai)