Identify six atypical symptoms of diabetes to aid in early blood sugar management.

Medication Use and Dosage Considerations for Hyperglycemic Patients

It is advisable to understand the six unusual symptoms of diabetes:

For a long time, the typical symptoms of diabetes in people's minds have been "three highs and one low," namely, polydipsia, polyuria, polyphagia, and weight loss. However, with the further development of diabetes treatment, a large amount of clinical experience shows that diabetes also has many previously unnoticed signs, which are becoming increasingly prominent. In summary, there are six main types of these signs:

(1) Pupil constriction
Clinically, the area of ​​the pupil is precisely measured using an infrared electronic pupillometer. The average area of ​​a normal person is 15.4±6.8 square millimeters, while that of a diabetic patient is 12.5±5.8 square millimeters, with the same average for male and female patients. At the same time, pupil dilation is often required to examine the fundus, but diabetic patients are not sensitive to mydriatic drugs, and the effect of pupil dilation is lower than that of normal people. This abnormal reaction is related to the sympathetic and parasympathetic autonomic neuropathy caused by diabetes.

(2) Hand and foot contractures
Manifested as the inability to extend the palm, which is arched when laid flat, also known as "hand contracture." Cord-like indurations can be felt on the palms, which are painful to the touch. The skin is rough, and in severe cases, the fingers retract towards the palm. This phenomenon, seen on the soles of the feet, is called "foot contracture." It is related to thrombosis of small arteries in the palms and soles, leading to malnutrition of the aponeurosis and fibromatosis. It is a manifestation of systemic vascular complications of diabetes.

(3) Weakened Achilles tendon reflex
The Achilles tendon reflex is a method for examining nerve function. Specifically, it involves tapping the Achilles tendon at the back with a hammer. The normal response is contraction of the gastrocnemius muscle and flexion of the foot towards the plantar surface. More than 50% of those with abnormal glucose tolerance tests have absent Achilles tendon reflexes, compared to only about 4% of normal individuals. Furthermore, the longer the course of the disease, the higher the incidence of diminished or absent Achilles tendon reflexes. However, this examination has become an important means of early detection of diabetes.

(4) Upper body obesity in women
Obesity increases the risk of diabetes. Women with upper body obesity and a waist-to-hip ratio greater than 0.7, regardless of their weight, have a higher incidence of abnormal glucose tolerance tests than 60%. Experts advise that a glucose tolerance test must be performed when the waist-to-hip ratio is greater than 0.85, as this is highly likely a symptom of diabetes.

(5) Difficulty urinating: Main symptoms include decreased urination awareness, prolonged intervals between urination, difficulty urinating, increased residual urine in the bladder, and bladder distension. Severe cases can lead to complications such as urinary tract infections, urinary reflux, and renal failure, and may even cause bacteremia, which is difficult to treat and has a poor prognosis. Therefore, when middle-aged and elderly men experience difficulty urinating, they should not only consider benign prostatic hyperplasia but also whether they have diabetes.

(6) Erectile dysfunction: According to relevant statistics, approximately 40% to 60% of male diabetic patients also experience erectile dysfunction. However, more than half of these cases are functional rather than organic, and with appropriate treatment, penile erectile function can be improved and gradually restored.

In conclusion, understanding these six unusual symptoms of diabetes is crucial for the prevention, diagnosis, and treatment of diabetes, and diabetic patients should pay particular attention to them in their daily lives.