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Diabetes: No risk factors, so why do I have symptoms?

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!

— Thirsty

Dear Thirsty,

You’re 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 other risk factors you mention are predictors, meaning that they can increase the possibility of developing diabetes. However, it's possible to still develop the condition without some of the associated risk factors. In the same vein, showing some symptoms of diabetes doesn’t necessarily mean that you have diabetes. Additionally, it's key to note that risk factors can vary based on the type of diabetes. But, if you’re concerned about certain symptoms, such as your constant need for water, it's a good idea to see a health care provider. Getting tested will help you find out if your water drinking if associated with diabetes, and if it is, allow you to manage the condition and avoid any complications. In terms of your question about insurance coverage for this type of testing, generally speaking, public and private insurance plans often cover the cost of diabetes tests for people with certain risk factors.

Given that there is more than one type of diabetes, explaining the risk factors for the different types can be helpful in explaining a person's general risk. Type I diabetes is usually diagnosed in children and young adults who exhibit symptoms such as increased thirst or frequent urination and are associated with risk factors such as genetics and geography. Type II diabetes, on the other hand, is most common in adults aged 19 to 44 who are overweight or obese and have additional diabetes risk factors (such as physical activity levels, family history, high blood pressure, abnormal cholesterol levels), adults 45 years and older, and women who had gestational diabetes while pregnant. However, children can also develop Type II diabetes, so individuals between the ages of 10 and 18 who are overweight and have at least two other risk factors for developing diabetes might want to consider getting tested. Additional considerations for children include low birthweight and maternal gestational diabetes.

It’s recommended that anyone exhibiting symptoms of any type of diabetes get tested sooner rather than later. Diagnosing diabetes typically involves one of the following blood tests: fasting plasma glucose (FPG), oral glucose tolerance test (OGTT), A1C (which measures blood glucose), and random plasma glucose (RPG). Your results will indicate whether you're prediabetic, diabetic, or neither. Prediabetes is diagnosed when blood glucose levels are higher than normal but not high enough to be diagnosed as diabetes. It’s recommended that those who are diagnosed as prediabetic get checked for Type II diabetes every year. The good news is that a prediabetes diagnosis doesn’t guarantee that it will develop into diabetes — early treatments can return blood glucose levels to the normal range. However, if you're diagnosed with prediabetes, it's good to pay attention to any changes in symptoms, as increased urination, thirst, and fatigue are all potential signs that prediabetes may be shifting to Type II diabetes.

Talking with your health care provider about your symptoms can help them determine any risk factors you have. If they do find that it's appropriate based on the risk factors, they may recommend that you get tested, which may allow for the test to be covered by insurance. You can also speak with your health care provider in advance to make sure the test is covered by your specific insurance plan. Testing early will also help you accurately determine the cause of your constant thirst and may alleviate any potential concerns. And in the meantime, enjoy spending time with your caring friends and family! 

Here's hoping that this response quenched your curiosity,

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Last updated Jan 07, 2022
Originally published Oct 16, 2009

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