Symptoms of Diabetes: How to Recognize the '3 Ps'

Excessive urination may be a warning sign of undiagnosed diabetes.
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Though not everyone with diabetes experiences the condition the same way, there are three main warning signs that everyone should look out for. Each begins with the letter "p" and the syllable "poly," making them easy to remember.

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Read more:Thirst and Lack of Appetite: Know What They May Be Signaling

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The 3 P’s of Diabetes

Roughly 7.3 million people in the United States have diabetes but have not been diagnosed, according to the U.S. Centers for Disease Control and Prevention (CDC). This makes it important to listen to your body and pay attention to symptoms and signs that could indicate diabetes. Only with a proper diagnosis will people with diabetes get the appropriate care, including insulin treatment when necessary.

"Three of the main warning signs of undiagnosed diabetes are excessive thirst, increased urination and increased hunger," says Matthew Petersen, vice president of medical information and professional engagement at the American Diabetes Association. These are known respectively as polydipsia, polyuria and polyphagia. The first two, Petersen notes, are particularly true for type 1 diabetes, the hereditary form of the condition in which the body does not produce insulin.

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The underlying cause of the three polys is that, without enough insulin to help glucose enter the body's cells — which is needed to convert the sugar to energy — the concentration of glucose in the blood can rise, according to the Cleveland Clinic.

More specifically:

  • Polydipsia: excessive thirst.​ The kidneys are the organs responsible for filtering out excess glucose that the body can't use, according to the Mayo Clinic. So, when someone has diabetes, the kidneys are forced to work overtime. When the kidneys cannot effectively filter out all of the excess glucose, that glucose gets excreted as urine, bringing with it many of the fluids from other areas of your body. This can dehydrate you and lead to the feeling of excessive thirst, the Mayo Clinic explains.

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  • Polyuria: excessive urination.​ Another hallmark of diabetes is an increase in urination. The reason for this symptom is that, in people with diabetes, the body is unable to effectively use glucose in the bloodstream. "It builds up, and the body tries to dilute it and excrete it through fluid intake and urination," explains Petersen.
  • Polyphagia: excessive hunger.​ A feeling of insatiable hunger can also be a sign of diabetes. "The body isn't getting the fuel it needs," Petersen says. "This occurs because insulin isn't getting the glucose into the body's cells, so there is a sense of hunger to take in more food."

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The high blood sugar, known as hyperglycemia, experienced by people with diabetes may also result in fatigue, the Cleveland Clinic notes. Similar to the factors that cause excessive hunger, this fatigue is a result of the body not being able to absorb the energy it needs from glucose. The dehydration that results from excessive urination can also add to the feeling of fatigue, according to the Mayo Clinic.

What to Do

According to the CDC, anyone who experiences the 3 P's of diabetes — possibly along with other symptoms, such as blurry vision, unintended weight loss, slow-healing sores and infections and numbness in the fingers and toes — should talk to their doctor about getting their blood sugar tested. The tests are simple, perhaps requiring fasting for a night, the CDC states, and the results tend to be available quickly.

Getting an early diagnosis can help prevent some of the longer-term effects of diabetes. These can include loss of vision, kidney failure and loss of feeling in and potential ulcers on the feet.

If you're diagnosed with diabetes, work closely with your doctor and a diabetes care team to create a routine to manage blood sugar levels, states the American Diabetes Association.

Read more:The Major Causes of Type 2 Diabetes — and Who's Most at Risk

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Is This an Emergency?

If you are experiencing serious medical symptoms, please see the National Library of Medicine’s list of signs you need emergency medical attention or call 911. If you think you may have COVID-19, use the CDC’s Coronavirus Self-Checker.
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