July 30, 2003
Complications
Question from Florida, USA:
For the last year and a half, my spouse, who has had type 1 diabetes for 20 years, has had very low and high blood sugar levels along with occasional blackouts. It is harder and harder for him to recognize them coming on. He has problems in remembering birthdays, simple directions, etc. For the last six months, he has had weight loss, constant fatigue, severe night sweats, headaches, nausea every single day, and his feet are always swollen. When I ask him to describe his “pain”, he says “it’s really not hurting pain but more discomfort nauseating pain”. He has had to leave his job and is now on disability.
His endocrinologist (whom he trust totally 100% and sees extremely often) says that all this is due to his diabetes causing the onset of secondary complications, and his prognosis is always the same. I asked my spouse to go to another doctor in case his diabetes doctor is missing something, but he just says that the doctor knows best, we should trust him fully, and he would never disagree with him.
Could this not be a sign of something else (like cancer)? In my opinion, his doctor doesn’t bother to look any further other than saying “it’s his diabetes”. I feel like my spouse has always managed and controlled his diabetes better than the average person. I’ve threatened to call his doctor and have a few choice words with him, but my spouse defends him and his knowledge. They blame it all on his diabetes, but I don’t totally agree.
Answer:
It is common to blame all medical abnormalities on diabetes complications in someone with long standing type 1 diabetes. However, people with diabetes can develop other medical problems too. You are correct in that your spouse should be evaluated for other disorders that could cause these symptoms in people without diabetes before saying that these are due to complications of diabetes.
If he is having unexplained weight loss and night sweats, you want to make sure his thyroid function has been recently tested. An overactive thyroid can cause some of these symptoms. If he is having night sweats, you want to make sure he has had a PPD test to make sure he hasn’t been exposed to tuberculosis.
Yes, cancer can cause some of these symptoms, but unless he has some specific abnormalities, you wouldn’t know where to start look. He should have a complete chemistry evaluation and CBC. Certain nutritional deficiencies and anemias can give some of these symptoms. I assume he has had an EKG and doesn’t have any cardiac abnormalities.
If it turns out that nothing else is found, and his symptoms are still felt to be due to complications from his diabetes, there are some treatments which sometimes bring relief. His endocrinologist would be more helpful than I in recommending more specific treatments.
TGL
