Are 'Three Excesses and One Deficiency' (polydipsia, polyuria, polyphagia, weight loss) typical symptoms for all diabetic patients?

"Three Polys and One Loss" Are Not Universal Symptoms for All Diabetics

Hello! Many people have similar questions about the "three polys and one loss" symptoms.

Short answer: No. While "three polys and one loss" (polydipsia, polyuria, polyphagia, and weight loss) are classic symptoms of diabetes, absolutely not all diabetic patients experience them. Relying solely on these symptoms as diagnostic criteria would miss many "hidden" cases.

Let's break it down:

Why Do "Three Polys and One Loss" Occur?

These are essentially the body’s "distress signals" triggered by severely elevated blood sugar levels.

• Polyuria (excessive urination): When blood sugar rises beyond a certain threshold, the kidneys can’t handle it. Excess sugar spills into the urine, dragging large amounts of water with it—similar to needing extra water to rinse sugar out of sand. This leads to frequent urination.
• Polydipsia (excessive thirst): The body loses significant fluids through urination, triggering intense thirst. The brain signals "Drink water now!"—a self-preservation instinct.
• Polyphagia (excessive hunger): Diabetes stems from insulin dysfunction. Insulin acts like a key, shuttling blood sugar (energy) into cells. If the "key" (insulin) is insufficient or ineffective, cells starve despite high blood sugar. They then scream "I’m hungry!" to the brain, causing constant cravings.
• Weight loss: When cells can’t access blood sugar for energy, the body "robs Peter to pay Paul"—breaking down fat and muscle for fuel. Imagine having money in the bank but forgetting the password, forcing you to sell furniture for cash. Result: weight drops despite eating more.

Why Do Many Lack These Classic Symptoms?

1. Most have type 2 diabetes in early stages

   • The vast majority of diabetics in China have type 2 diabetes, which develops slowly and "sneaks in." Early-stage blood sugar is only mildly elevated, so the body copes without triggering distress signals.
   • Many type 2 patients—especially early on—feel no symptoms at all. High blood sugar is often discovered incidentally during check-ups or while investigating other issues (e.g., hypertension, heart disease, blurred vision, slow-healing wounds).

2. Weight increases instead of decreasing

   • Many type 2 diabetics start with overweight/obesity. Early insulin resistance promotes fat storage, so weight loss rarely occurs. Weight may even rise.

3. Type 1 diabetes shows more classic symptoms

   • "Three polys and one loss" are far more common and pronounced in type 1 diabetes. This type strikes abruptly—with zero insulin production—causing blood sugar to skyrocket rapidly, leading to severe, acute symptoms.

To Summarize

• "Three polys and one loss" reflect critically high blood sugar—a "severe alarm" from the body.
• Many diabetics, especially early-stage type 2, have subtle symptoms: mild fatigue, blurred vision, itchy skin, or even none at all.
• Don’t wait for "three polys and one loss" to test blood sugar. If you have diabetes in your family, are overweight/obese, over 40, or have hypertension/high cholesterol, regular blood sugar checks are essential.

Hope this clarifies things!