What is the biological reasoning behind why Type II diabetics need to urinate more frequently? Do their bladders shrink? Does the diabetes cause more liquids to get sent to the bladder than would in a non-diabetic? Some other reason? Do we know?
Diabetes results in the inability to control sugar levels in the bloodstream. When sugar levels get too high, the kidneys attempt to get rid of the excess sugar by excreting it in urine.
In fact, before more modern tests were developed, doctors would check for diabetes by testing if bees and ants were attracted to a patient’s (potentially sugary) urine, or even (erk!) tasting it.
Incidentally, this is the reason why excessive thirst is also a symptom of diabetes - the kidneys take a lot of water out of the rest of the system in order to remove the excess sugar.
A high blood sugar level means a lot more particles in the blood making it hypertonic relative to the intercellular fluid, so water will be pulled out of the cells into the blood stream. Once it’s there it will seem like excess fluid and the body will excrete it. Hypertonic blood is one of the ways that the body assesses hydration balance since normally your blood is only concentrated when you’re dehydrated, so it will trigger thirst. There are many systems designed to regulate the body, and they don’t always communicate with each other, sometimes they work at cross purposes. Sugar normally passes with water and some other things at the first step of the urine process, but is reabsorbed before it leaves the kidney. However there is a limit to how much it can reabsorb, and when the blood sugar level exceeds that it will spill into the urine.
I knew I was diabetic when mine smelled like cotton candy. Seriously.
“kidneys attempt to get rid of the excess sugar by excreting it in urine” is not true. outlierrn got it right.
The “mellitus” in “diabetes mellitus,” being discussed here, means “sweet.” That gives you an idea of how early physicians diagnosed diabetes and for how long the diagnosis has been known. (Another condition, in which the kidneys produce copious amounts of dilute urine, is call “diabetes insipidus.”)
A sort of related tidbit has to do with the role of kidneys in cotrolling sugar (regardless of whether you choose to be anthropomorphic and say “the kidneys attempt to get rid of excess sugar”, or whether you view it as a chemical phenomenon).
In the presence of normally functioning kidneys, even in the total absence of insulin, the blood sugar will not climb above 400 mg% or so (22 mMol/L).
It is only when kidney function is compromised that sugar levels of over 400 (22) are seen. With poor kidney function, levels of 1000 (55) are not too rare.
The bottom line is that with normal kidneys, you will pee out sugar faster than your body can make it once the blood sugar level is around 400 (22). So, there’s a limit to how high your blood sugar can go if you’ve got normal kidneys.
By the way, re: the OP, the thirst and frequent urination occur in all forms of diabetes (type I, type II, and type II and 1/2)
Type II and 1/2? What’s that?
Let’s see
Type 1 is your basic auto-immune destruction of the pancreatic cells which produce insulin.
Type 2 is your basic insulin resistance knackering the pancreas so that eventually it can no longer produce enough insulin to satisfy the needs of the body. Commonly found in larger people over 40 with high sugar intakes, although increasingly seen in obese youngsters.
The third type of common diabetes is gestational diabetes, or diabetes of pregnancy, which is similar to Type 2, and women with gestational diabetes are statistically more likely to develop type 2 diabetes in later life.
Type 1.5 is similar to type one, but presents in later life. It is also known as Latent Autoimmune Diabetes in Adults, it is often misdiagnosed as type 2, but the patients do not have insulin resistance and are usually of normal weight.
MODY- Maturity Onset Diabetes of the Young, is rare genetic cause of diabetes, it is usually a single gene defect, but there are several genotypes, often autosomal dominant, and can be teated with either medications or insulin, depending on type or severity.
There are other conditions such as Haemochromatosis and Cystic fibrosis which can also cause diabetes. Polycystic Ovary Syndrome (PCOS) is closely linked to impaired glucose tolerance, but it’s not fully known whether it is a cause or an effect, or simply a co-incidental occurrence in genetically susceptible individuals.
Type 2 diabetes is strongly linked to genetics- if you have a family history the best thing to do is to keep your weight and BP down, exercise frequently, eat lots of fruit, vegetables and fibre and get checked out by a doctor on a regular basis.
It’s actually a typo combined with a silly point.
The typo is that I meant to say 'Type I and 1/2" (not II and 1/2)
The silly point was that are people whose diabetes is somewhere in between classic Type I and Type II (in addition to people who have diabetes due to secondary causes such as irishgirl has mentioned).
Don’t forget one that I see a lot: “burning out your pancreas via repeated episodes of alcoholic (or other) pancreatitis and ending up insulin dependent along with needing to take digestive enzymes like lipase” diabetes.