By: Phyllis Edgerly
Like many people with diabetes, Gayle Hoover Thorne of Sacramento, California, was led to her type 2 diagnosis by water—or rather, the feeling that she couldn’t get enough of it.
Thorne sought her doctor’s help because she was “sleeping all the time and thirsty.”
When a person with diabetes overindulges in carbohydrates, they will soon experience a terrific thirst.
“I can only assume that the water taken for that thirst helps dilute the sugars and flush them out,” says Thorne.
Actually, thirst arises because the body is already drawing on its existing supply of water to flush out those sugars, which cannot pass out on their own. Instead, they siphon water out of the body.
“When blood sugar goes up, it starts a diuretic effect, resulting in excessive water loss,” the reason frequent urination is another common diabetes symptom, says Robert Meloni, MD, and fellow of the American College of Endocrinology. “This leads to dehydration and excessive thirst, which is unrelieved until the blood sugar is lowered—then water replenishment will help.”
With water estimated to make up 70 percent of our body weight (and 85 percent of our brain), everyone needs to drink adequate amounts to avoid dehydration. For those with diabetes, it’s especially essential, with water at the root of almost every preventive lifestyle measure.
Going with the Flow
As Thorne learned more about her diabetes, she also learned more about the benefits of water.
“We know it’s important to get enough, but the VHL Family Alliance described in its March 2001 Forum Research Report that 75 percent of Americans are chronically dehydrated, and in 37 percent, the thirst mechanism is so weak that it is often mistaken for hunger,” says Thorne. “Even mild dehydration will slow down the body’s metabolism as much as three percent, and lack of water is the number-one trigger of daytime fatigue.”
Thorne says she found this out herself.
The body loses about 10 to 12 cups of water daily—even during sleep—through breathing, perspiration and in body wastes. The best way to replace these cups of water is to simply drink more. Water enters the blood stream more rapidly than other drinks. Foods high in water content, such as fresh fruits and vegetables, also help, but beverages such as tea, coffee and certain soft drinks are actually detrimental if they contain caffeine, which leaches water from the body.
Experts say you should not wait until you are thirsty to replenish your body’s water supply, as dehydration may have already set in by the time you notice. Instead, begin drinking water early in the day, when it helps your body get moving.
People with diabetes should strive for at least eight glasses, or up to 12 or more (as much as a quart an hour) if you are physically active or exercising. If you need a reminder, drink a glass after every trip you make to the bathroom. You can detect whether you’re consuming enough water, as your urine color should be pale, almost clear. A dark yellow color means you need more fluids.
What About Urination?
Those with diabetes have often experienced urinary frequency and may feel apprehensive about increasing their fluid intake. Nobody wants to be stuck in traffic in a situation like this without rest-room facilities at hand.
Obviously, there’s a lot to be said for timing, and those who know they’ll be away from a bathroom for a period of time may want to curtail their fluid intake an hour or two beforehand. Additionally, when summer really pours on its heat, much of the fluid consumed may be eliminated as perspiration rather than urine.
It’s also important to remember that certain kinds of beverages actually cause urinary frequency, with caffeine and alcohol the biggest offenders, as these have diuretic properties.
“When blood sugar is well-controlled, urinary frequency is not usually an issue,” notes Meloni. “It therefore wouldn’t be advisable for a [person with diabetes] to restrict fluid intake. It would be better to sip smaller quantities over time from a water bottle; and taking water along in this way in something many can fit into their lives.”
This consistent intake in smaller amounts reduces the need for bathroom stops while keeping you well-hydrated, says Meloni.
Water is essential to many body functions, a major component of blood and body fluids, and an important part of the digestive process. It aids digestion and promotes nutrient absorption by carrying these fluids, along with oxygen, to cells, thereby facilitating body-tissue repair.
Water helps filter waste and remove it from the body, promoting regularity and preventing kidney stones. A recent study published in the New England Journal of Medicine suggests that people with type 2 diabetes can lower their blood sugar significantly by increasing the amount of water-soluble fiber in their diets, which also helps with eliminating waste. To do this, they’ll also need to drink plenty of water to keep things moving through their system.
Water helps maintain the electrolyte balance in our bodies as it prevents dehydration. Without enough water, blood thickens and can’t reach small blood vessels, causing depletion of sodium and other minerals, which threatens the body’s chemical and electrical systems.
By preventing dehydration, water also guards against such symptoms as headache, fatigue, weakness and muscle cramps. Athletes know that even mild dehydration can produce cramps, and that water helps prevent injury by cushioning joints and protecting organs and tissues.
As an added summer bonus, increased water intake also helps regulate body temperature to keep things cooler. As the single most important aspect of cellular integrity, water also helps keep our skin moist and improves its elasticity, tone and smoothness. A person with diabetes’s tendency toward frequent urination and dehydration is a major reason why they often experience dry skin.
In Sickness and in Health
The Centers for Disease Control (CDC) advises people with diabetes to continue taking some insulin even if illness makes them unable to eat—but take an adjusted dose recommended by a healthcare provider. This is where fluids can really make a difference.
During illness, doctors often instruct people with diabetes to drink liquids that have sugar in them to maintain blood-sugar levels, and to really pour on the water when their temperature rises above normal, says Meloni. It is extra important at times like this to try to drink up to 12 eight-ounce glasses of liquid per day, and to write down how much you drink, in case you suffer fluid loss due to vomiting or other symptoms.
“Water consumption is also an excellent foil for hunger for those trying to avoid weight gain or maintain a healthy weight,” says Meloni says.
University of Washington research found that one glass of water shut down midnight hunger pangs for almost 100 percent of the dieters in its study.
Because those with diabetes may experience other complications, Meloni counsels moderation, noting, “In the presence of heart disease, vascular disease, lung disease or renal disease, profuse fluid intake shouldn’t be attempted.”
It is important, however, to drink more fluid whenever you increase physical activity, as well as during hot weather, at high altitudes or in low humidity. It is recommended that you drink at least two glasses of water 30 minutes to an hour before exercising, and again 10 minutes beforehand. It’s also important to carry water with you and rehydrate both while and after you exercise. Weight loss during exercise indicates inadequate fluid consumption. A one-pound loss should be replaced with two cups of water or other calorie- and caffeine-free beverage.
For optimal health, people with diabetes find that water benefits a body all year round, but summer is the time to really pour on the benefits with plenty of glasses of this ultimate thirst-quencher. If you want variety, add some lemon or lime and you’ll get a boost of health-enhancing vitamin C, too.