ELDER TIP Because their thirst mechanism functions less effectively, older adults may not report polydipsia, a hallmark of diabetes in younger adults.
In ketoacidosis and hyperosmolar hyperglycemic nonketotic syndrome, dehydration may cause hypovolemia and shock. Wasting of glucose in the urine usually produces weight loss and hunger in type 1 diabetes, even if the patient eats voraciously.
Long-term effects of diabetes may include retinopathy, nephropathy, atherosclerosis, and peripheral and autonomic neuropathy. Peripheral neuropathy usually affects the hands and feet and may cause numbness or pain. Autonomic neuropathy may manifest itself in several ways, including gastroparesis (leading to delayed gastric emptying and a feeling of nausea and fullness after meals), nocturnal diarrhea, impotence, and orthostatic hypotension.
Because hyperglycemia impairs the patient’s resistance to infection, diabetes may result in skin and urinary tract infections (UTIs) and vaginitis. Glucose content of the epidermis and urine encourages bacterial growth.
» READ BOOK EXCERPT ONLINE »
Source: Professional Guide to Diseases (Eighth Edition), 2005
Intestinal obstruction:
Signs and Symptoms
(Professional Guide to Diseases (Eighth Edition))
Depending on location of obstruction: nausea, vomiting, diarrhea, abdominal pain, drowsiness, thirst, rebound tenderness, abdominal distention, dehydration, constipation
» READ BOOK EXCERPT ONLINE »
Source: Professional Guide to Diseases (Eighth Edition), 2005
Diabetes mellitus:
Signs and symptoms
(Handbook of Diseases)
Diabetes may begin dramatically with ketoacidosis in type 1 or insidiously. Its most common symptom is fatigue, from energy deficiency and a catabolic state. However, many patients with type 2 diabetes may be asymptomatic.
Insulin deficiency or resistance causes hyperglycemia, which pulls fluid from body tissues, causing osmotic diuresis, polyuria, dehydration, polydipsia, dry mucous membranes, and poor skin turgor. In ketoacidosis and hyperglycemic hyperosmolar nonketotic state, dehydration may cause hypovolemia and shock. Wasting of glucose in the urine usually produces weight loss and hunger in uncontrolled type 1 diabetes, even if the patient eats voraciously.
Long-term effects
In diabetes, long-term effects may include retinopathy, nephropathy, atherosclerosis, and peripheral and autonomic neuropathy.
Peripheral neuropathy usually affects the hands and feet and may cause numbness or pain. Autonomic neuropathy may manifest itself in several ways, including gastroparesis (leading to delayed gastric emptying and a feeling of nausea and fullness after meals), nocturnal diarrhea, impotence, and postural hypotension.
Because hyperglycemia impairs the patient’s resistance to infection, diabetes may result in skin and urinary tract infections and vaginitis. Glucose content of the epidermis and urine encourages bacterial growth.
» READ BOOK EXCERPT ONLINE »
Source: Handbook of Diseases, 2003
Intestinal obstruction:
Signs and symptoms
(Handbook of Diseases)
Signs and symptoms depend on the location and extent of the obstruction.
Partial small-bowel obstruction
Colicky pain, nausea, vomiting, constipation, abdominal distention, and signs and symptoms of dehydration characterize small-bowel obstruction.
Auscultation reveals bowel sounds, borborygmi, and rushes; occasionally, they’re loud enough to be heard without a stethoscope. Palpation elicits abdominal tenderness with moderate distention; rebound tenderness occurs when the obstruction has caused strangulation with ischemia. In late stages, signs of hypovolemic shock result from progressive dehydration and plasma loss.
Complete small-bowel obstruction
In a complete small-intestinal (small-bowel) obstruction, vigorous peristaltic waves propel bowel contents toward the mouth instead of the rectum. Spasms may occur every 3 to 5 minutes and last about 1 minute each, with persistent epigastric or periumbilical pain. Small amounts of mucus and blood may be passed. The higher the obstruction, the earlier and more severe the vomiting. Vomitus initially contains gastric juice, then bile, and finally fecal contents of the ileum. Constipation develops with complete obstruction. There’s minimal or no fever. Abdominal distention is pronounced. Mild tenderness is present. Peristaltic rushes and high-pitched tinkles occur during paroxysms of pain. Visible peristalsis may be noted.
Partial large-bowel obstruction
Symptoms of large-bowel obstruction develop more slowly because the colon can absorb fluid from its contents and distend well beyond its normal size. Constipation may be the only symptoms for days. Colicky abdominal pain may appear suddenly, producing spasms that last less than 1 minute each and recur every few minutes. Continuous hypogastric pain and nausea may develop, but vomiting is initially absent.
Large-bowel obstruction can cause dramatic abdominal distention: Loops of large bowel may become visible on the abdomen.
Complete large-bowel obstruction
Eventually, a complete large-bowel obstruction may cause fecal vomiting, continuous pain, or localized peritonitis.
Patients with a partial obstruction may display any of the above signs and symptoms in a milder form. Leakage of liquid stools around the obstruction is common with partial obstruction.
» READ BOOK EXCERPT ONLINE »
Source: Handbook of Diseases, 2003
Article Excerpts About Symptoms of Diabetic Gastroparesis:
Diabetic Neuropathy The Nerve Damage of Diabetes: NIDDK (Excerpt)
Autonomic neuropathy can affect digestion.
Nerve damage can cause the stomach to empty too slowly, a disorder called
gastric stasis. When the condition is severe (gastroparesis), a person can
have persistent nausea and vomiting, bloating, and loss of appetite. Blood
glucose levels tend to fluctuate greatly with this condition.
If nerves in the esophagus are involved, swallowing may be difficult.
Nerve damage to the bowels can cause constipation or frequent diarrhea,
especially at night. Problems with the digestive system often lead to
weight loss.
(Source: excerpt from Diabetic Neuropathy The Nerve Damage of Diabetes: NIDDK)
Gastroparesis and Diabetes: NIDDK (Excerpt)
Symptoms of gastroparesis are
- Nausea
- Vomiting
- An early feeling of fullness when eating
- Weight loss
- Abdominal bloating
- Abdominal discomfort.
These symptoms may be mild or severe,
depending on the person.
(Source: excerpt from Gastroparesis and Diabetes: NIDDK)
Diabetes is no reason to stop chasing Olympic gold. Meet Chris Jarvis, an elite Canadian rower, who continues to aggressively train despite having...
There may be another thing that people with diabetes need to take care of: their balance. Watch some balance exercises and learn what you can do to...
Almost half of all people with diabetes experience some form of nerve damage, which can develop into a complication known as peripheral neuropathy....
Controlling blood sugar levels are crucial for people with diabetes. But equally important is blood pressure control. High blood pressure and...