The Three P’s of Diabetes

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Diabetes is a chronic condition characterized by high blood sugar. It occurs when the body’s ability to turn glucose from the food you eat into energy is hindered. Insulin, a hormone made by the pancreas, helps manage blood sugar levels in the bloodstream by helping blood sugar get into cells where it is used for energy. When the pancreas does not produce enough insulin, or any at all, or if the body becomes resistant to insulin, sugar in the blood cannot enter cells and remains in the blood, resulting in high blood glucose.

There are two types of diabetes, type 1 and type 2 diabetes. Type 1 diabetes occurs when a person doesn’t produce enough insulin, while type 2 occurs when a person doesn’t respond to insulin or is insulin-resistant. Roughly 34.2 million American adults have at least one of these two types of diabetes, which is about one in 10 people.

Three specific ailments are most common in people with diabetes: polydipsia, polyuria, and polyphagia, which are known as the three P's of diabetes.

A blood glucose measurement is being performed on July 28, 2020 in Pfullendorf, Germany.

DeFodi Images / Getty Images

Polydipsia

Polydipsia is the medical term used to describe extreme and excessive thirst. Often polydipsia is linked to conditions that affect the renal system and can cause a person to urinate more frequently than they should. This increase in urination leads the body to feel as though it needs to replace the liquid lost during urination. It has also been linked to conditions that lead to excessive fluid loss such as excessive sweating, high-salt diets, and the use of diuretics.

When it comes to diabetes, polydipsia is one of the most common symptoms. Since diabetes leads to an excessive amount of glucose in the blood, the body must do something to try to balance those levels. The kidneys create more urine so that the glucose can be excreted quickly, thus restoring glucose levels to normal. This can lead to a rapid loss of fluid and, in turn, thirstiness.

Polyuria 

Polyuria means urinating a lot, and it often goes hand in hand with polydipsia. It is one of the most common symptoms of diabetes. It is so typical in people who have diabetes because when glucose builds up, it can enter tubules within the kidneys. If the glucose goes into those tubules but is unable to be reabsorbed back into the bloodstream, it leads to an increase in urination. While the kidneys attempt to filter out the glucose, they also filter out more water from other parts of the body. This leads to the overproduction of urine that then needs to be secreted.  

It can be difficult to diagnose the cause of polyuria without taking into consideration polydipsia as they are typically both present at the same time. When one is extremely thirsty, they tend to urinate more from drinking more liquids. When one urinates more, they become more dehydrated and experience an increase in thirst.

Central Diabetes Insipidus and the Three P's

Although people with both type 1 and type 2 diabetes can present with polydipsia and polyuria, another type of rare disorder known as central diabetes insipidus (CDI) can also lead to both excessive thirst and urination. The cause of CDI, however, is not related to common diabetes and can be attributed to a specific deficiency in the protein arginine vasopressin.

Polyphagia 

Polyphagia is the medical term used to describe excessive hunger. There are times when an increase in appetite is expected, such as after an increase in physical activity or during hormonal changes, but eating will typically satisfy the hunger and appetite levels will normalize following food consumption. In the case of polyphagia, eating will not stop the hunger.

In those with diabetes, since glucose is not easily transferred into cells to be used for energy, the body will continue to send signals to the brain that it is hungry because it isn’t getting the energy it needs from the food already eaten.

Diagnosis: Are the Three P’s Enough?

All three P's are found in most diabetics, but for those with type 2 diabetes, they may be less noticeable than in those with type 1 diabetes. In some cases, those with diabetes may not experience these symptoms at all and could still have the condition.

For a doctor to diagnose diabetes, they will take note of all the symptoms and perform some tests. Some tests a doctor will conduct include:

  • A1C test: This test looks at a blood marker that gives an estimate of the average blood glucose over the past two to three months. If a person has diabetes, their percentage will be 6.5% or higher.
  • Fasting blood sugar test: This test requires a person to avoid all food consumption for a period of time, typically overnight. It measures blood sugar levels after not eating to determine if they are still high without any food being put into the body. If a person has a level of 126 mg/dL or higher after a fasting test, they have diabetes.
  • Glucose tolerance test: This test also requires an overnight fast, but it is done differently than the fasting blood sugar test. Doctors will measure your blood sugar levels before you drink a liquid that has glucose and then again after you do. The blood sugar levels could be checked anywhere from one to three hours after you drink this liquid. If after two hours blood sugar levels are 200 mg/dL or higher, that indicates that you have diabetes.
  • Random blood sugar test: Unlike the fasting and glucose tolerance test, this one is done randomly without any fasting. If blood sugar levels are shown to be 200 mg/dL or higher, it indicates that someone has diabetes.

Treatment

Even if a person doesn’t have diabetes, the presence of polydipsia, polyuria, and polyphagia indicates that blood glucose levels in the body are high. It’s vital to control blood glucose levels to avoid any health complications that can arise from it. High blood sugar can lead to various health issues because it can cause blood vessel damage. When this happens, the risk for developing heart disease, kidney disease, vision or nerve problems, and stroke are all increased.

Managing blood sugar levels can be easy to do if a person is aware of the symptoms to watch out for. In the case of low blood sugar, also known as hypoglycemia, keeping certain supplies handy such as fruit juice, regular soda, hard candy, or glucose tablets can help restore levels. To manage high blood sugar, also known as hyperglycemia, it’s recommended that a person becomes more active on a regular basis and eats foods that have a low glycemic index.

Consumption of carbohydrates should also be kept in check. Choose to eat fewer carbs or by choosing carbs that are slowly digested. This can help decrease the risk of a blood sugar spike. It’s also important to eat regularly and avoid skipping meals, limit alcohol and junk food consumption, and practice portion control.

Exercise and Blood Sugar Levels

Exercise is a vital component of managing blood sugar levels. Studies have shown that brief high-intensity workouts can help keep blood sugar in check for one to three days following the exercise session.

A Word From Verywell

In the event that you are suffering from the three P’s, you should seek medical attention from your doctor. They will help confirm or rule out diabetes. Other symptoms that aren’t included in the three P’s should also be monitored. Getting blood work regularly, even if you don’t have symptoms that are typically present for those with undiagnosed diabetes, can help identify whether you have high blood sugar or prediabetes. Early detection can help prevent the development of type 2 diabetes by simply making a few lifestyle changes.

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  1. Centers for Disease Control and Prevention. National diabetes statistics report 2020. Updated February 11, 2020.

  2. Kids Health. Hyperglycemia and diabetic ketoacidosis. Updated October 2016.

  3. Fathollahi A, Daneshgari F, Hanna-Mitchell AT. Effect of polyuria on bladder function in diabetics versus non-diabetics: an article review. Curr Urol. 2015 Sep;8(3):119-125. doi:10.1159/000365702

  4. Nigro N, Grossmann M, Chiang C, Inder WJ. Polyuria-polydipsia syndrome: a diagnostic challenge. Intern Med J. 2018 Mar;48(3):244-253. doi:10.1111/imj.13627

  5. National Organization for Rare Disorders. Central diabetes insipidus. Updated 2015.

  6. Centers for Disease Control and Prevention. Diabetes tests. Updated May 15, 2019.

  7. Wang WT, Lee P, Yeh HW, Smirnova IV, Choi IY. Effects of acute and chronic hyperglycemia on the neurochemical profiles in the rat brain with streptozotocin-induced diabetes detected using in vivo ¹H MR spectroscopy at 9.4 T. J Neurochem. 2012 May;121(3):407-417. doi:10.1111/j.1471-4159.2012.07698.x

  8. Centers for Disease Control and Prevention. Manage blood sugar. Updated June 2, 2020.

  9. Adams OP. The impact of brief high-intensity exercise on blood glucose levels. Diabetes Metab Syndr Obes. 2013;6:113-122. doi:10.2147/DMSO.S29222