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Diabetes Mellitus : Symptoms
Western Medicine Chinese Medicine
1. Type 1 Diabetes:
The most typical symptoms of diabetes or high blood glucose include frequent urination, frequent thirst, and frequent hunger or eating. These are usually more common in type 1 patients. Other characteristics that are more typical of type 1 patients include:
younger age of onset
human leukocyte antigen (HLA) or genetic predisposition
presence of islet-cell antibody
thin appearance
prone to ketosis (an acute situation when the body starts to break down fat and produces ketone bodies due to an absolute lack of insulin and extremely high level of glucose)
high glucose levels (hyperglycemia) or low glucose levels (hypoglycemia)
absolute dependence on insulin that must be injected into the body

2. Type 2 Diabetes
Because type 2 patients only have a relative deficiency of insulin, most symptoms are not as pronounced, and usually occur later in life. Type 2 patients are less likely to be ketotic (see above), with only a third of them needing insulin injections. In addition, they are often overweight, have abnormal blood pressure and fat levels measured as cholesterol / triglycerides and have frequent vascular or neurologic complications. See below.

3. When diabetes is uncontrolled
Uncontrolled diabetes occurs when glucose levels remain persistently high and is typically associated with long-term complications. It is proposed that the persistent hyperglycemia (high glucose levels) and the formation of glycated proteins (including glycosylated hemoglobin, HbA1c) are responsible for weakening the capillary walls and clogging the small blood vessels. As a result, the microvascular complications such as retinopathy (damage to the eyes), nephropathy (damage to the kidney), and neuropathy (damage to the nerves) occur.

Diabetic retinopathy is the leading cause of blindness in the United States, and is preceded by microaneurisms (focal dilation of retinal capillaries occurring in diabetes), hemorrhages, edema (swelling), fibrosis (scarring), and retinal detachment.
Diabetic nephropathy is the leading cause of end stage kidney disease (ESRD) in the United States. It is preceded by presence of protein in the urine, abnormal kidney function and increased blood pressure.
Neuropathy can present itself in two forms: peripheral or autonomic neuropathy. Symptoms of peripheral neuropathy include tingling, numbness, or burning of extremities as well as abnormal vibratory, sensory, and reflexes mostly in the lower extremities. Diabetic neuropathy is the most common cause of non-traumatic amputations in the United States. The other form of neuropathy is autonomic, in which patients may have problems with digestion and, impotence or suffer from improper cardiovascular reflexes.

Furthermore, uncontrolled diabetes can also lead to macrovascular complications such as coronary heart diseases and peripheral artery disease that presents with heart problems, pain upon walking and inability to walk far. In summary, diabetes can be a devastating disease causing harmful effects to the eyes, kidney, nerves, genitals, and heart.

TCM practitioners recognize symptoms of diabetes from both a western and eastern point of view.

Clinical distinction in western medicine: Type I diabetes occurs in individuals who do not produce any insulin. The onset of Type I diabetes begins at a young age. Clinical symptoms change quickly and become increasingly more serious. Typical signs include excessive and constant thirst, excessive drinking and eating, excreting an excessive amount of urine with sugar in it, and weight loss.

Type II diabetes occurs in individuals who do not have enough insulin or whose insulin does not work properly. The onset of Type II diabetes usually begins in middle or old age. However, the disease may be present in a sub clinical form for years before diagnosis. The main symptoms are extreme fatigue, dry mouth and excessive thirst. Other symptoms like excessive urination, and excessive eating may not be as obvious with this type.

According to Traditional Chinese Medicine diagnosis, the disease can be divided into four types of disharmony patterns:

1. Yin Deficiency and Excessive Heat Type
Symptoms related to this type include thirst for cold drinks, an increased appetite, and dislike of heat and emotional imbalances. Other symptoms include dark urine, constipation, an appearance of a red tongue with a yellow coating and a pulse that feels rapid and taut or slippery.
2. Deficiency of Qi and Yin Type
Symptoms include shortness of breath, heart palpitations, fatigue and weakness that can lead to reluctance to speak. Additional symptoms include: constant thirst, spontaneous sweating, sweating during sleep, being easily irritable, having trouble sleeping, feeling heat in the palms of the hands and soles of the feet, dark urine and constipation. The tongue appears dry, red and swollen, while the coating is scaled off. The pulse is weak and uneven.
3. Blood Stasis and Internal Obstructed Type
Symptoms include darkened skin, weight loss and malaise, fullness and blurred pain in the chest, numbness or stabbing pain in limbs, which worsens at night. People who suffer from this form of diabetes will also have purple-colored lips, and a tongue that is dark in color or appears bruised. The tongue will also be covered with a thin white or yellow colored coating, or appear dark and bruised. The pulse feels taut or uneven.
4. Deficiency of Yin and Yang Type Symptoms include a below normal body temperature, aversion to coldness with cold feeling limbs, a pale face, ringing in the ears, weakness in the lower back, occasional fever, sweating at night, impotence or premature ejaculation of sperm. The stool is loose and excessive clear urine is passed. The bulging tongue appears light pink, and is blanketed with a thin white coating or a white greasy fur. The pulse is faint or rapid and uneven.

Other related patterns:
Accumulated Internal Wet Heat Type: The body appears fat and bloated. The mouth is dry and has a bitter taste with foul smelling burps. Other symptoms include itchy skin, yellow and cloudy urine, and loose stool. The tongue appears swollen and is covered with a yellow greasy or turbid yellow greasy fur coating. The pulse feels weak and slippery.