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Diabetes Symptoms Even When T2 Controlled

Grateful

Well-Known Member
Messages
1,399
Location
Kent, United Kingdom
Type of diabetes
Type 2
Treatment type
Diet only
Prior to diagnosis the only consistent T2 symptom I had was frequent urination. This has been going on for a number of years, and unfortunately I just ascribed it to "getting old" and did not mention it to my doctor. The T2 diagnosis came out of the blue, as the result of a routine medical. Fortunately, after diagnosis I managed to bring T2 BG levels under full control (see signature below).

There has been no change in the frequent urination. I still need to "go" frequently, including at least once in the middle of the night. Now, it is true that since the diagnosis, I have been hydrating much more (2 liters of water per day, in addition to drinks with meals). But even so....

So I wanted to ask: When BG is fully controlled, should the frequent urination symptom disappear? Should I be concerned? (Yes, I will mention it to my doctor, I'm seeing him next week.)
 
I've had the same problem. I wake up at least twice during night 1:30 AM and 5:30 AM normally.
Seems that I have a bit of prostate adenome, that is normal for my age..
 
There are other reasons for frequent urination apart from diabetes, and getting older is one of them. How do you define "frequent"? It is not at all unusual to have to get up during the night, especially if we drink a lot during the evenings.

It is also possible to train your bladder to empty less often by holding yourself in for 10 minutes.

I have had to get up in the night for as long as I can remember .... many years, and I also need to urinate more frequently in the mornings than the afternoons for some reason. I am used to it, so it doesn't worry me. There is never any sugar or protein in it when I'm checked.
 
I'm afraid our experience is that there was a huge improvement, but not what I would describe as full normality. Pre diagnosis and normalising blood sugars, every shopping trip, motorway journey or whatever involved loo stops, sometimes several. Also up to four times in the night!!
My definition of "normal" is, of course, what I do (!!) and I am a female in my 60's. James (mid 60's) is nearly normal during the day, but still gets up twice in the night. He's had his prostate checked, so it's not that. The doctor (and, unusually I'm inclined to agree with him) said it is just habit and, as @Bluetit1802 has said above, self training and a bit of bladder stretching, by holding on a bit longer could do the trick.
Sally
 
Bluetit1802 said:
How do you define "frequent"?
Click to expand...

So, I'm male, and 60 years old. Mostly I am a good sleeper, usually going to bed around 9pm. I wake up usually between midnight and 4 to have a pee, then go back to bed. Sometimes I wake up again around 5 to 6 feeling, again, like I want to wee. Usually I "hold it in" and just go back to sleep, then get up around 7.

Daytime: I use the lavatory every couple of hours. This is easy for me because I run my own business and work from home. If I were working in a conventional office it would probably be noticed and commented upon!!

Prior to my diagnosis, the frequent-peeing was a minor social issue sometimes, although I don't know if anyone noticed. For instance, if I went to a play or a concert, I would inevitably end up in the queue at the men's lavatory during the interval. I suspect this might not longer be as bad, now, post-diagnosis.

Edited to add: Both pre- and post-diagnosis, I have had no problem with a regular two-hour drive that I do every couple of weeks or so (no need for "pit stops"). I am a passenger in that car, not the driver. I also travel on planes every few months, including multi-hour flights, and seldom need to use the plane lavatory (although my first stop upon arrival at the destination airport is usually the airport toilets).

It isn't really a big deal and I am not keen to be medicated for it, unless there is something dangerous about it or unless it indicates something about my T2 status. Hence, this thread.

Responding to some commenters: I am not at all keen to train myself to "hold it in" because of my hunch that this is a bad idea, health-wise, in the long run. Besides, it's uncomfortable and lavatories are easy to find, most of the time.
 
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I agree with @sally and james in that it can be just a habit. Before I leave the house, every time I leave the house, I have a wee. This is habit. I am not really needing to go but have this phobia that I might a bit later when there is no available loo. When on holiday in the UK (several times a year) we visit 2 or 3 different places a day, and make sure the first one has toilets. Again, this is habit. Like you, when in theatres or similar, we both go during the interval - and it very noticeable that most of the rest of the audience is doing the same judging by the queues for the Ladies.

Apparently it is quite normal to empty the bladder up to 10 times in 24 hours. I have never kept count, but I doubt I exceed that. It doesn't sound like you do, either, from what you say.

I believe the reason for frequent urination with high blood sugars is because the kidneys are in overdrive disposing of as much glucose as they can - if there aren't very high BS then there isn't any excess glucose to dispose of so the kidneys don't go in overdrive.

As for "training the bladder" it was a doctor that suggested that to me many years ago when I mentioned it was difficult for me with the job I had at the time (on the road and visiting people in their homes, which weren't always hygienic places)
 

The way I understand it is that with uncontrolled T2, the body is desperately trying to shed glucose, including dumping it in the urine and stimulating the body to pee. This is why it is called "diabetes mellitus," an ancient term denoting that the urine tastes like honey (yes, that's gross, but they obviously had no other way to analyze it).

So I had jumped to the conclusion that, if the body is no longer over-glucosed, then the frequent urination would go away.

OTOH, with the approach of old age it seems like we all need to "go" more frequently anyway, including people without diabetes. Those queues during the intervals at plays and concerts here in the USA consist mainly of middle-aged people (at least so far as the men's toilets are concerned, I don't know about the women's).
 
Metformin affects the kidneys and made me get up in the middle of the nigh to pee. Since stopping metformin I no longer have this problem.
 

@Grateful, Congratulations on your success thus far! Your numbers are fantastic! Yes, it is always the best course of action to address specific concerns with your doctor as I see you plan to do next week!

The following is a review of the underlying physiology of frequent urination, or polyuria, in diabetes as polyuria can have several causes. Take a look at the following information from Diabetes.co.uk:

Polyuria - Frequent Urination
https://www.diabetes.co.uk/symptoms/polyuria.html
“In diabetes, the level of sugar in the blood is abnormally high. Not all of the sugar can be reabsorbed and some of this excess glucose from the blood ends up in the urine where it draws more water.”

Diabetes Mellitus and Polyuria
https://courses.washington.edu/conj/bess/polyuria/polyuria.htm
“In a diabetic that has hyperglycemia, the filtered load of glucose (amount of glucose filtered) can exceed the capacity of the kidney tubules to reabsorb glucose, because the transport proteins become saturated. The result is glucose in the urine. Glucose is a solute that draws water into the urine by osmosis. Thus, hyperglycemia causes a diabetic to produce a high volume of glucose-containing urine.”​

So, in diabetes, the underlying physiology for polyuria is hyperglycemia. As your blood glucose is in good control then hyperglycemia unlikely to be the cause. However, it is always important to see if you are spilling glucose in your urine and the routine urinalysis you will have next week will give you and your doctor the information you need .
 
Biggles2 said:
However, it is always important to see if you are spilling glucose in your urine and the routine urinalysis you will have next week will give you and your doctor the information you need.
Click to expand...

Actually, he usually only does the blood test (this is not a full medical checkup, it is just a three-monthly diabetes follow-up). I will mention the frequent urination issue and we'll see if he orders a urinalysis.

I think it is just possible that my frequent urination has little to do with T2 (otherwise I should have noticed an improvement when I brought the T2 under control). I say that, because I've had the frequent-peeing issue for quite a long time, five years at least. If that turns out to be the case (i.e. not due to T2) I will actually be quite relieved (ugh! sorry for the pun).

Why relieved? Because I've been worrying that my T2 could have been there, but undiagnosed, for the past five years during which I've had the frequent-peeing issue. Maybe, just maybe, that was not the case and it was something other than T2, perhaps just "getting old." In which case perhaps the T2 is recent-onset.

Diagnosis was in February 2017. Prior to that, my last A1C test was in November 2009 when it was 5.5% (36) and no concern was expressed at the time.
 
I seem to have "slow kidneys" - that is it takes quite a while for fluid intake to make it through to my bladder.

Others I know can drink a glass of water and need to pee almost straight away.

I think prostate issues tend to make you go little and often.

I often have to get up in the early hours of the morning - between 4 and 5 - but this is for a substantial pee. I assume this is the result of my body processing the food and drink from the previous evening whilst I am asleep. Having a pee just before I fall asleep (which is tricky to organise because I tend to think about having a last pee then wake up early morning to do it) might help.

One answer is to not eat or drink after, say, 4 pm which gives your body time to clear everything through. This doesn't suit all lifestyles though.

So as others have said if your urine test at review doesn't show sugars then it is probably not the diabetes making you pee.

I am on Metformin so that may explain the pee in the night thing. However although I can see via a search that there are posts on a lot of fora about this, I can't at the moment locate increased urination in the list of known side effects on any of the "medical" sites. Anyone know why Metformin would increase urination?
 
I was in a queue for a supermarket loo with a group of ladies aged middle to oaps with a young lady at the front ,she looked at us and said that she would come back later because she could wait ! The rest of us agreed that it would be nice to have a " young " bladder again !
CAROL
 
@Grateful - Whilst others have suggested holding a full feeling bladder, that wouldn't be something I'd favour for myself.

I wee a lot. In fact when I recently had a couple of 24 hours urine collection tests (nothing diabetes related), the first attempt had to be aborted by mid afternoon as I had already filled the provided container, with almost half the day to go. The two that I completed both required additional containers. My Doc was surprised, but unconcerned.

I feel unconcerned with the situation. OK, I almost always make one trip to the loo during the night, but it's only a couple of paces away and doesn't overly impact my sleep.

When the results of my 24-hour tests were back, my GP commented again, and asked me how often I visited the loo. I'm afraid my response was an unhelpful "as often as I need to". To be honest, I had never thought anything of it.

When I mentioned my through the night trip she suggested if it was unwanted, then to try training myself to ensure I actually properly emptied my bladder each time I went, and particularly before bed. Applying her suggested technique, I haven't noticed any difference.

If you're concerned, mention it to your Doc.
 
Grateful said:
Actually, he usually only does the blood test (this is not a full medical checkup, it is just a three-monthly diabetes follow-up). I will mention the frequent urination issue and we'll see if he orders a urinalysis.
Click to expand...

Take a urine sample with you, just in case it comes in useful during discussions. At my surgery we have to use special containers they give us beforehand, with different coloured lids for different types of tests.
 
Bluetit1802 said:
Take a urine sample with you, just in case it comes in useful during discussions. At my surgery we have to use special containers they give us beforehand, with different coloured lids for different types of tests.
Click to expand...
Right ask before if you have to take a "STERILE" urine sample so is possible to check if there's an infection. You have to ask before because you''l have to get a gamma-ray sterilized plastic container at the pharmacy and ask the pharmacist the correc t procedure, ie. wash the hands before, like you were have just changed the oil to your car ;-)
 
@Grateful my experience pre-diagnosis was that I had frequent urination to the point of incontinence and bed wetting.

But all these symptoms clear when my glucose level normalized.

The key remaining symptoms is a dull backache midway on the right side of the spine.
 
Grateful said:
So I wanted to ask: When BG is fully controlled, should the frequent urination symptom disappear? Should I be concerned? (Yes, I will mention it to my doctor, I'm seeing him next week.)
Click to expand...
Before diagnosis I was slowly having to get up more and more times in the night.. got up to 4 or 5 times.
These days with reasonable control I rarely get up in the night however I still pee quite a lot during the day and try not to have anything to drink after 8 pm apart from a glass of water with my magnesium supplement just before bed. I then get up and pee on waking usually between 7 and 7.30 a.m. I'm 55 by the way.
 

Interesting. After reading all the responses to my question, I am reassured. My hunch is that what I have is a result of "growing old." If so, the frequent peeing (which I have had for about five years) was not caused by diabetes at all -- the evidence being that it has not changed even though BG is now under control.

Quite a few of the responders on this thread seem to be peeing about as often as I am, even with their T2 under control. Also, I am hydrating a lot, all the time, including in the middle of the night after peeing. This is mainly to avoid kidney stones -- I passed a kidney stone in May and believe me, that is not something you ever want to happen again! (The pain has been described as "worse than childbirth" but I have no direct method of comparison, being male....)

Other than the urination thing, I do not appear to have had any obvious symptoms of T2, at diagnosis. I was not thirsty or hungry, I had not recently lost or gained weight, I had no vision problems, there was no tingling in the hands or feet. I did have a mild headache (which I had had for about a month and mentioned to my doctor) and that disappeared a few weeks after I started the low-carb diet. Headache is (sometimes) listed as a T2 symptom.

I do not consider my "frequent peeing" to be a big deal. Therefore I would very much like to avoid "medicalizing" it, taking drugs for it, whatever. American commercial television is chock-full of rather nauseating drug ads aimed at middle-aged men who have to "go" a lot, and pushing drugs such as Flomax.

That (the contents of the paragraph above) is what I will tell my doctor during my routine consultation next week. We'll take it from there.
 

Sounds like a good idea.. the only symptom I had was once waking in the middle of the night experiencing an all over body tingling.. As I was severely overweight (and peeing a lot in the night) and having been diagnosed as prediabetic a year before, I toddled off to the surgery and got tested.. with the expected results.. since then have lost weight and am now about the healthiest I have been in my adult life.
 
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