Dear Alice,

A few friends have asked me to get tested for diabetes after seeing how much water I drink. I pretty much drink water constantly; my boyfriend actually jokes that I am more of a fish than a human because of how much water I drink (I don't count, but it must be 20-30 glasses a day, at least, and it's been this way for about five years. Sometimes the waiter has to refill my glass a dozen times just in the course of one meal). I urinate often... probably as a result of that. But when I was looking around the Internet I came across symptoms for diabetes, and I connected with more than just the thirst issue — I also have strong bouts of fatigue for seemingly no reason, irritability and headaches (sometimes alleviated by drinking water, actually), and when I get cuts or bruises they often take a long time to heal.

The thing is, I have NO risk factors of diabetes. I have no family members with diabetes, I'm a distance runner, I'm on a really well balanced vegetarian diet, I don't have high blood pressure, I'm not overweight, I'm under 25.

So, could 20 to 30 glasses of water or more a day be just by coincidence how much my body needs, or is this worth getting checked out for? I don't know if insurance will cover it so it's important to know beforehand that it is even worth it before I toss my money towards it. Thanks for the help!


Dear Thirsty,

You are fortunate to have friends who are so concerned about your health. They seem to have noticed one of the more visible symptoms of diabetes — drinking lots of water. The risk factors you mention are predictors, but they aren't definitive clues as to who will and won't develop a given condition, such as diabetes. Likewise, showing some symptoms of diabetes does not necessarily mean that you have diabetes. However, whenever you have symptoms that are concerning, it's a good idea to see your health care provider.

There are two main types of Diabetes mellitus, Type I or juvenile-onset diabetes, and Type II or adult-onset diabetes. (FYI — a third type, gestational diabetes, may occur during pregnancy.) Type II diabetes is the type associated with the risk factors you mention of having a poor diet, little exercise, and being overweight. However, Type I and gestational diabetes are not necessarily associated with diet, weight, exercise levels, or family history. No matter the type, diabetes may lead to serious complications if not diagnosed and managed early on. Diabetes can affect individuals who have no risk factors, including those who generally eat healthy food and get plenty of exercise.

You mention that you have been holding off on testing for diabetes unless you know that it's worth getting checked. Getting tested for diabetes may be a decision that has personal as well as clinical factors. But keep in mind that if you do decide to be tested for diabetes, earlier is better than later. Testing typically involves the following blood tests:

  • Fasting blood glucose level (if higher than 126 mg/dL on two separate occasions, diabetes is likely)
  • Oral glucose tolerance test (if higher than 200 mg/dL after two hours, diabetes is likely)
  • Random (non fasting) blood glucose level (if higher than 200 mg/dL along with diabetes symptoms, diabetes is likely)
    List adapted from the article Type 2 diabetes from Medline Plus.

If you think that your symptoms may be signs of diabetes, you may want to consider discussing this with a health care provider, who will be able to recommend next steps, whether they include diabetes testing or not. If you are a student at Columbia, you can make an appointment to see a health care provider by either calling x4-2284 or visiting Open Communicator. You can also check out the resources that are mentioned in Meal planning for people with diabetes in the Go Ask Alice! fitness and nutrition archives.

Here's hoping that this response quenched your curiosity,


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