August 15, 2005
Diagnosis and Symptoms
Question from Egypt:
I am a 21 year old medical student. I weigh 76 kg (167 pounds) and am 165 cm (5 feet, 5 inches) tall. Four the last four and a half months, I have had a transient increase in my urine output at fixed times, from 7 p.m. to 10 p.m. I urinate every hour, then the output decreases gradually over time. This does not occur every day, but for one to three days a week. During menstruation, my urine output is always small as I urinate only four times a day. I have no nocturia and no thirst. I don’t drink a lot and I haven’t lost any weight. I have actually gained about 3 kg (6.5 pounds) during this time.
Throughout these months, I have had no infections, no pruritus, no acetone odor in my breath, no nausea, vomiting, or abdominal colic. When I excrete large amounts of sweat, my urine output is small. This transient increase in my urine output does not occur after eating large amounts of sugars.
My parents do not have diabetes and there is no history of type 1 diabetes in my family. If I have type 1 diabetes, can the symptoms be so mild and sporadic like this? Do the classic symptoms of diabetes always occur together? Does the urine of diabetics tastes sweet? Are the symptoms of diabetes continuous throughout the days of the week?
Answer:
It does not sound like the kind of symptoms you would see with diabetes. For instance, the polyuria you describe is not typical. Generally, with diabetes, the increased urination occurs throughout the night. It is accompanied by increased hunger and weight loss with a decrease in visual acuity. I would recommend having a fasting glucose at some point to make sure it is not a problem, but I do not think that will be the answer. I would recommend you plot your oral fluid intake against your urine output and see if they are always in agreement. I bet you may find that they are.
JTL
