Diabetes Care, Vol 21, Issue 1 111-115, Copyright © 1998 by American Diabetes Association
Association of symptoms of type 2 diabetic patients with severity of disease, obesity, and blood pressure
CJ Bulpitt, AJ Palmer, C Battersby and AE Fletcher
Division of Geriatric Medicine, Royal Postgraduate Medical School, Hammersmith Hospital, London, U.K.
OBJECTIVE: The symptoms of 430 type 2 diabetic patients were determined by
a self-administered questionnaire before entry into the U.K. Prospective
Diabetes Study. RESEARCH DESIGN AND METHODS: Entry into the trial followed
2 months of dietary treatment for newly diagnosed patients with type 2
diabetes. Forty symptoms with five levels of severity were included in the
questionnaire. A complaint rate was computed as the sum of symptom scores
divided by the number of symptom questions answered. RESULTS: The complaint
rate was independently and positively related to BMI, fasting plasma
glucose (FPG), and being a woman. Three symptoms--presence of dry mouth (P
< 0.001), thirst (P < 0.01), and stomach pain (P = 0.02)--were
related to FPG independent of sex, age, BMI, or blood pressure. Only dry
mouth was related to HbA1c (P = 0.05). Complaints of shortness of breath,
swollen ankles, headaches, heartburn, sweating, wheezing, nocturia, thirst,
and diarrhea increased with BMI independently of other variables. A
complaint of cold extremities decreased with BMI. Heartburn, weakness of
limbs, and hot flushes were positively related to blood pressure, and
unsteadiness was negatively related. CONCLUSIONS: The symptoms reported by
patients with type 2 diabetes increased with FPG and markedly with BMI. The
symptoms associated with obesity have been underestimated in the past.