10 Alarming Signs Your Blood Sugar Is Too High

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10 Alarming Signs Your Blood Sugar Is Too High
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In a span of three decades, the number of people in the world diagnosed with diabetes went from 108 to 422 million. That’s almost a fourfold increase – and these numbers are just from 1980 to 2014. The WHO reports that diabetes was the leading cause of death worldwide in 2019; an estimated 1.5 million deaths were attributed to the disease. In the United States, the CDC estimates that over 88 million Americans are already pre-diabetic (1 in 3 Americans!), meaning that without proper lifestyle changes, they had a high risk of becoming diabetic within the next few years, if not months. [1][2][3]


In a popular Youtube video, Dr. Sten Ekberg talks about 10 alarming signs of high blood sugar to watch out for. Here is the list of 10, with our own research added:

1. Weight Gain

Weight gain, or specifically, central obesity (which is weight gain in the abdomen), is one of the key risk factors for diabetes. Studies have firmly linked abdominal or central obesity with the prevalence of diabetes, showing a positive association between weight gain and insulin resistance – a major risk factor in developing type 2 diabetes. Type 2 diabetes is characterized by (1) your body’s inability to produce enough insulin to meet the needs of your dietary intake and (2) your cells insensitivity to insulin. Insulin helps our cells absorb glucose or sugar from food, and without enough of it, our blood glucose levels remain high (hyperglycemia), which can lead to weight gain. [4][5][6]

2. Frequent Urination, Thirst, Headaches, Hunger, And Weight Loss

Unlike weight gain, which is primarily a risk factor for diabetes, frequent urination can be a sign that your blood sugar is already high. This happens because our kidneys are trying to keep up with the elevated levels of sugar by trying to filter out the glucose through our urine. Because the kidneys cannot just filter out glucose alone, additional fluid is also excreted, causing increased thirst and dehydration due to the frequent urination. Dehydration causes our blood vessels to constrict, which can also lead to frequent headaches. [7]


You are probably wondering how hunger and weight loss can be signs of diabetes: The pathophysiology of the disease tells us that because of insulin resistance and the resulting hyperglycemia, our cells are not getting the glucose they need to produce energy and perform life-sustaining processes (which includes the repair and development of tissues in the body). With your cells being starved of glucose, diabetics often lose weight and feel that they are always hungry, also known as polyphagia. [8]

3. Blurry Vision

Another alarming sign of diabetes is blurry vision. For some, this is already a late sign of diabetes, because blurry vision often occurs after persistent or extended periods of high blood sugar. Shih, et. al. in 2017 published a study in the Nutrition and Diabetes Journal, highlighting the effects of diabetes mellitus on the eyes. The researchers discussed how diabetes affects the eyes in three major ways: (1) impaired wound healing, (2) corneal swelling, and (3) nerve damage. All three are caused by the persistently high levels of glucose in the blood, which damages the delicate tissues of the eyes – causing ocular dysfunction. Aside from blurry vision, recurrent eye infections are also warning signs that you might have diabetes. [9]

Diabetic retinopathy is one of the major complications of diabetes. The prevalence of diabetic retinopathy varies with each study but they all approximate the numbers at around 100 million people, which is about a quarter of the current prevalence rates of diabetes worldwide. Diabetic retinopathy or DR is characterized by damage to the retina, or the soft tissue at the back of the eye. The retina is responsible for converting light into signals to be interpreted by the brain. When the retina is damaged due high blood sugar, it can develop lesions, scarring, and edema or swelling, which can cause the retina to detach (called retinal detachment). This is characterized by a shadow-like object or swarm of black specks sweeping in front of your vision, requiring rapid eye surgery in order to avoid total vision loss. Of course, not all diabetics with DR develop retinal detachment, but the risk is pretty high if your blood sugar remains uncontrolled. [10][11]

4. Nausea, Vomiting, Confusion, DKA

Nausea, vomiting, and confusion are all linked to a life-threatening condition called DKA – or Diabetic Ketoacidosis. DKA happens when (1) your blood sugar is persistently high and (2) you do not have enough insulin to bring glucose into your cells, (3) causing your body to start breaking down fat stores for energy. The breakdown of fat causes a build up of acids or ketones in your blood. The ketones can cause systemic inflammation, including swelling of the brain, which manifests as nausea, vomiting, and confusion. [12]

5. Recurrent / Frequent Infections


Various studies have shown that persistently high blood sugar affects your body’s immune system, making you prone to recurrent infections. Berbudi, et. al. reported in 2020 that an increased risk for various infections like pulmonary tuberculosis, pneumonia, skin and soft tissue infections, and even urinary tract infections can be linked to hyperglycemia. Dr. Ekberg also mentions an increased risk for yeast infections because high blood sugar feeds these kinds of opportunistic bacteria. [13]

6. Fatigue / Poor Focus

Kalra and Sahay in 2018 published a study on what they called the “Diabetes Fatigue Syndrome” or DFS. Based on the clinical practice of the researchers, they defined DFS as a syndrome that involves easy fatiguability of people with diabetes. They propose that the fatigue is caused by the energy the body expends to turn the excess glucose from carbohydrates into fat. Dr. Ekberg mentions that this typically occurs after eating, which fits with Kalra and Sahay’s hypothesis, because this is the time when the body is trying to bring your sugar levels down. However, because of insulin resistance, the body converts your glucose intake into triglycerides or fat, which takes a lot of energy and can cause you to feel tired. [14]

7. Slow Healing

We previously mentioned that diabetes can cause an altered immune response in the body – you will notice this sign if even small wounds such as minor cuts or scrapes take a longer time to heal than usual. This is because high blood sugar causes chronic inflammation in our tissues, which can slow wound healing. This can also be linked to recurrent skin and soft tissue infections – because prolonged wound healing also increases the risk for infection. One major complication is the development diabetic foot ulcers, which are dangerous wounds in the feet that do not heal, causing infection and even tissue death or necrosis. [15]

8. Swollen / Bleeding Gums + Oral Infections

In connection to the above we have slowed healing in the gums and teeth, causing swelling and bleeding, and even recurrent oral infections. These oral infections are largely caused by Streptococcus mutans, a kind of bacteria that lives in our mouth and feeds on sugar and carbohydrates. This microorganism is responsible for the plaque on our teeth and the eventual formation of cavities. According to Dr. Ekberg, if you switch to a low carb or ketogenic diet, you will actually notice less plaque formation on your teeth because the Streptococcus mutans has no carbohydrates to feed from. [16][17]

9. Skin Changes (Dry, Itchy Skin; Blisters;, Skin tags; Acanthosis nigricans)

A study published in the Journal of Drugs and Dermatology highlighted that 30 to 70 percent of diabetics have skin problems. Diabetic skin changes like dry, itchy skin, development of blisters and skin tags, and even the previously mentioned poor wound healing, can be the very first warning signs of high blood sugar or diabetes. Dr. Ekberg specifically mentions Acanthosis nigricans as a diabetic skin change, which is the darkening of the skin, typically in skin folds of the neck, armpits, groin, and under the breasts. Abraham, et. al. in 2011 found direct associations between Acanthosis nigricans and hyperinsulinemia and hyperglycemia, both of which are risk factors for diabetes. [18][19]

10. Neuropathy – Tingling, Numbness, Gastroparesis

Last on the list is neuropathy and is possibly the scariest out of all these signs. Diabetic neuropathy is caused by nerve damage due to high levels of blood sugar. This is often described as “pins and needles” in the hands and feet, which can even develop into neuropathic pain. Another kind of neuropathy is neuropathic arthropathy or Charcot joint. This affects the bones, joints, and soft tissues in the foot or ankle – which can cause your ankle to dislocate. [20] According to Dr. Ekberg, neuropathy can affect the vagus nerve and cause gastroparesis. With a damaged vagus nerve, your intestinal tract is not receiving adequate signals to digest food which can lead to constipation, indigestion, and bowel changes.

This list of warning signs can be quite overwhelming and more often than not, these warning signs are no longer signs, but rather complications of persistently high blood sugar. If we stay vigilant with our health and learn to notice these signs early on, we can stop diabetes in its tracks.

References:

[1] World Health Organization. https://www.who.int/news-room/fact-sheets/detail/diabetes

[2] US Department of Health and Human Services. National Diabetes Statistics Report 2020. https://www.cdc.gov/diabetes/pdfs/data/statistics/national-diabetes-statistics-report.pdf

[3] Centers for Disease Control and Prevention. Prediabetes – Your Chance to Prevent Type 2 Diabetes. https://www.cdc.gov/diabetes/basics/prediabetes.html

[4] Straznicky, N., et. al. (2009). Autonomic Nervous System: Metabolic Function. https://www.sciencedirect.com/topics/psychology/abdominal-obesity/

[5] Wan, H., et. al. (2020). Associations between abdominal obesity indices and diabetic complications: Chinese visceral adiposity index and neck circumference. https://pubmed.ncbi.nlm.nih.gov/32736628/

[6] McCracken, E., et. al. (2018). Pathophysiology of the metabolic syndrome. https://pubmed.ncbi.nlm.nih.gov/29241747/

[7] Mayo Clinic. Diabetes symptoms: When diabetes symptoms are a concern. https://www.mayoclinic.org/diseases-conditions/diabetes/in-depth/diabetes-symptoms/art-20044248/

[8] Melmed, S. (2020). Type 1 Diabetes Mellitus. https://www.sciencedirect.com/topics/neuroscience/polyphagia/

[9] Shih, K., et. al. (2017). A systematic review on the impact of diabetes mellitus on the ocular surface. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5380897/

[10] Jenkins, et. al. (2015). Biomarkers in Diabetic Retinopathy. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5397989/

[11] National Eye Institute. Retinal Detachment. https://www.nei.nih.gov/learn-about-eye-health/eye-conditions-and-diseases/retinal-detachment/

[12] Gosmanov, A. & Kitabchi, A. (2018). Diabetic Ketoacidosis. https://www.ncbi.nlm.nih.gov/books/NBK279146/

[13] Berbudi, A., et. al. (2020). Type 2 Diabetes and its Impact on the Immune System. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7475801/

[14] Kalra, S. & Sahay, R. (2018). Diabetes Fatigue Syndrome. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6064586/

[15] Baltzis, D., et. al. (2014). Pathogenesis and treatment of impaired wound healing in diabetes mellitus: new insights. https://pubmed.ncbi.nlm.nih.gov/25069580/

[16] Kudiyirickal, M., et. al. (2015). Diabetes mellitus and oral health. https://pubmed.ncbi.nlm.nih.gov/25487035/

[17] Matsumoto-Nakano, M. (2014). Dental caries. https://www.sciencedirect.com/topics/medicine-and-dentistry/streptococcus-mutans

[18] Kirsener, R., et. al. (2019). Diabetic Skin Changes Can Benefit from Moisturizer and Cleanser Use: A Review. https://jddonline.com/articles/diabetic-skin-changes-can-benefit-from-moisturizer-and-cleanser-use-a-review-S1545961619P1211X/

[19] Abraham, C. & Rozmus, C. (2011). Is Acanthosis Nigricans a Reliable Indicator for Risk of Type 2 Diabetes in Obese Children and Adolescents?: A Systematic Review. https://journals.sagepub.com/doi/10.1177/1059840511430952

[20] Zakin, et. al. (2019). Diabetic Neuropathy. https://pubmed.ncbi.nlm.nih.gov/31639839/

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