RECALL OF METFORMIN EXTENDED RELEASE
In May 2020, the
Food and Drug Administration (FDA)recommended that some makers of metformin extended release remove some of their tablets from the U.S. market. This is because an unacceptable level of a probable carcinogen (cancer-causing agent) was found in some extended-release metformin tablets. If you currently take this drug, call your healthcare provider. They will advise whether you should continue to take your medication or if you need a new prescription.
The three P’s of diabetes are polydipsia, polyuria, and polyphagia. These mean increases in thirst, urination, and appetite. They are the most common diabetes symptoms and often happen at the same time.
Have you heard of the three P’s of diabetes? They often occur together and are three of the most common diabetes symptoms.
Simply defined, the three P’s are:
- polydipsia: an increase in thirst
- polyuria: frequent urination
- polyphagia: a rise in appetite
We’ll discuss the three P’s in more detail, explaining how they’re diagnosed and treated as well as when you should see your doctor.
Polydipsia is the word used to describe excessive thirst. If you’re experiencing polydipsia, you may feel thirsty all of the time or have persistent dry mouth.
In people with diabetes, polydipsia is caused by increased blood glucose levels. When blood glucose levels get high, your kidneys produce more urine in an effort to remove the extra glucose from your body.
Meanwhile, because your body is losing fluids, your brain tells you to drink more in order to replace them. This leads to the feeling of intense thirst associated with diabetes.
Persistent feelings of thirst can also be caused by:
- osmotic diuresis, an increase in urination due to excess glucose entering the kidney tubules which can’t be reabsorbed, leading to increased water in the tubules
- mental health issues, such as psychogenic polydipsia
Polyuria is the term that’s used when you’re passing more urine than normal. Most people produce about 1–2 liters of urine per day (1 liter equals about 4 cups). People with polyuria produce more than 3 liters of urine in a day.
When blood glucose levels are too high, your body will try to remove some of the excess glucose via urination. This also leads to your kidneys filtering out more water, which leads to an increased need to urinate.
Passing abnormal amounts of urine can also be associated with other things besides diabetes, including:
- diabetes insipidus
- kidney disease
- high calcium levels, or hypercalcemia
- mental health issues, such as psychogenic polydipsia
- taking medications such as diuretics
Polyphagia describes excessive hunger. Although we may all feel an increase in appetite in certain situations — such as after exercise or if we haven’t eaten in awhile — sometimes it can be a sign of an underlying condition.
In people with diabetes, glucose can’t enter cells to be used for energy. This can be due to either low insulin levels or insulin resistance. Because your body can’t convert this glucose to energy, you’ll begin to feel very hungry.
The hunger associated with polyphagia doesn’t go away after consuming food. In fact, in people with unmanaged diabetes, eating more will just contribute to already high blood glucose levels.
Like polydipsia and polyuria, other things can cause polyphagia as well. Some examples include:
- an overactive thyroid, or hyperthyroidism
- premenstrual syndrome (PMS)
- taking certain medications, such as corticosteroids
The three P’s of diabetes often, but not always, occur together. Additionally, they often develop more quickly in type 1 diabetes and more slowly in type 2 diabetes.
Since the three P’s are a good indicator that your blood glucose levels may be higher than normal, your doctor can use them to help diagnose diabetes. However, other symptoms can also occur along with the three P’s.
These symptoms include:
- feeling tired or fatigued
- blurry vision
- unexplained weight loss
- sensations of tingling or numbness in the hands and feet
- slow healing of cuts and bruises
- recurring infections
If you’re experiencing any of the three P’s with or without other diabetes symptoms, your doctor can perform tests to make a diagnosis.
- A1C blood test
- fasting plasma glucose (FPG) test
- random plasma glucose (RPG) test
- oral glucose tolerance test
It’s always important to remember that other conditions besides diabetes may also cause one or more of the three P’s. If you’re experiencing one or more of these symptoms, you should see your doctor.
A note about prediabetes
What about the three P’s and prediabetes? Prediabetes is when your blood glucose levels are higher than they should be, but not high enough to diagnose type 2 diabetes.
If you have prediabetes, you likely won’t experience clear signs or symptoms like the three P’s. Because prediabetes can go undetected, it’s important to get your blood glucose levels tested regularly if you’re at risk for type 2 diabetes.
In diabetes, the cause of the three P’s is higher than normal blood glucose. As such, keeping blood glucose levels managed can help to stop the three P’s.
Some examples of ways to do this include:
- taking medications for diabetes, such as insulin or metformin
- regular monitoring of things like blood glucose levels, blood pressure, and cholesterol
- following a healthy eating plan
- being more physically active
Following a diagnosis, your doctor will work with you to develop a treatment plan that’s appropriate for your condition. In order to keep your diabetes symptoms managed, stick to this plan as much as possible.
So when should you make an appointment with your doctor to discuss one or more of the three P’s?
If you’re experiencing an abnormal increase in thirst, urination, or appetite that lasts over a period of several days, you should see your doctor. This is particularly important if you’re experiencing more than one of the three P’s.
Also keep in mind that each of the three P’s can occur individually as a symptom of conditions other than diabetes. If you’re experiencing symptoms that are new, persistent, or concerning, you should always make an appointment with your doctor so that they can evaluate you.
The three P’s of diabetes are polydipsia, polyuria, and polyphagia. These terms correspond to increases in thirst, urination, and appetite, respectively.
The three P’s often — but not always — occur together. They’re an indicator of higher than normal blood glucose levels and are some of the most common symptoms of diabetes.
If you’re experiencing one or more of the three P’s, you should make an appointment with your doctor to discuss your symptoms.