Confusion in diagnosis

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Some diabetic patients present chiefly with weight loss, but even then the diagnosis is sometimes missed, and I have seen two teenagers referred for psychiatric management of anorexia nervosa before admission with ketoacidosis. Perhaps weakness, tiredness, and lethargy, which may be the dominant symptoms, are the most commonly misinterpreted; "tonics" and iron are sometimes given as the symptoms worsen.

Deteriorating vision is not uncommon as a presentation, due either to change of refraction causing myopia (mainly in Type 1 diabetes) or to the early development of retinopathy (mainly in Type 2 diabetes). Foot ulceration or sepsis in older patients brings them to accident and emergency departments and is nearly always due to diabetes. Occasionally painful neuropathy is the presenting symptom, causing extreme pain in the feet, thighs, or trunk.

Glycosuria itself is responsible for the monilial overgrowth which causes pruritus vulvae or balanitis; some older men are first aware of diabetes when they notice white spots on their trousers. In hot climates drops of sugary urine attract an interested population of ants, and at least one patient now attending the clinic at King's College Hospital presented in this way before he came to England.

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Diabetes 2

Diabetes 2

Diabetes is a disease that affects the way your body uses food. Normally, your body converts sugars, starches and other foods into a form of sugar called glucose. Your body uses glucose for fuel. The cells receive the glucose through the bloodstream. They then use insulin a hormone made by the pancreas to absorb the glucose, convert it into energy, and either use it or store it for later use. Learn more...

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