Diabetes paranoia - in desperate need of guidance

[mbta23015]

My pinky toe has been sensitive to temperature for a few months now (among several other symptoms; see below) and I’m paranoid about diabetes. I currently hold a CAT 1 medical which I got renewed about a month ago and am just starting on my CPL (I need about 100 more hours). I cannot describe the amount of stress this has put me through, but I’m looking for guidance on what my next steps should be.

Do I wait it out and see if TC contacts me about my urine test? Even if they don’t, that still doesn’t necessarily rule out diabetes as the urine test only detects higher blood sugar levels from my understanding. Should I see my family doctor ASAP to get a blood test referral? Should I try improving my diet first to see if the symptoms improve first? The TC CAME handbook says: https://tc.canada.ca/en/aviation/public ... 2#diabetes

“Those who already hold a professional pilot licence (ATPL, CPL) may be considered for a Category 1 medical certificate, restricted to flying with an accompanying pilot, as well as for a Category 3 or 4 medical certificate
All other pilots will only be considered for a Category 3 or 4 medical certificate.
Date modified: 2015-02-20”

Should I get my CPL before consulting my doctor then? However, I’m reading in other (more recent than 2015) forum posts that you can apply for a CAT 1 even if you hadn’t held one before, like this one viewtopic.php?t=132302 (although I’m not sure where they got their information from). I don’t really understand why it would matter what licence you had once at the time of diagnosis, but if someone could clarify whether or not this standard has been changed in recent years, that would be appreciated.
Another of my thoughts is that my symptoms are largely nocebo/psychosomatic due to the immense amount of stress I’ve put myself through over this. I genuinely don’t know what I’d do with my life if I can’t fly for a living. There’s no other job remotely like it and the thought of my medical being taken away scares the living shit out of me. My paranoia over this has honestly consumed the better part of my life for the past ~5 months.+


More detailed symptoms: It started out in mid-April as a very slight discomfort around the joint connecting my “ring toe” to my foot, which honestly just felt like a very mild strain of the toe and I wasn’t able to curl it as much as the other toes. I wasn’t really sure how I got it, but I didn’t think much of it because I exercise fairly regularly and tend to pull muscles and the like every so often. A few weeks later I started noticing that the toe next to it, my pinky toe, was sensitive to the cold in the sense that it would get more cold than the rest of my toes would. This wasn’t debilitating by any stretch of the imagination, but due to my neuroticism it was something I started focusing on. This went on until it started getting warmer around June. It would still get a bit cold on cooler evenings or in strong A/C, but not nearly as much as before. Over the summer, it largely went away (I’m assuming because it was hot), however I did notice that if it was really hot, that toe would feel hotter than the rest. Additionally, I take hot showers, and if I leave the water running on my foot, when I get out, that toe and my other pinky toe are visibly more red than the rest, along with a small area on the outside edge of my foot. I then noticed later that my original “sore toe” (the “ring” toe) appears to possibly have a very slight hammertoe, or the beginnings of a hammertoe. Then, a few weeks ago I started noticing that my kneecaps would get cold. The more I would focus on it, the less it would seem to go away. This was until about two weeks ago when, despite promising myself to stop Googling symptoms, I did. When I saw that most results said that you shouldn’t be worried about cold kneecaps, the symptoms almost went away completely. I sometimes now still feel that my kneecaps are slightly colder than the rest of my leg, usually during cardio. This makes sense, to me at least, because blood flow in the kneecaps is obviously less than other parts of the leg, plus I’m a relatively skinny guy (~19.4 BMI). This made me think that maybe my symptoms are indeed psychosomatic. However, very recently I’ve started feeling that my other pinky toe (the one that was asymptomatic aside from redness after hot showers) is also starting to have the same symptoms as the other one. This now reignited my slight dip in stress levels over this whole possible diabetes idea I’ve had. These symptoms, along with the others, mainly occur while sitting. Aside from these symptoms, I’ve had nothing else of note; no numbness, abnormal hunger, thirst, increased urination frequency, fatigue, etc. I’m also fairly active, I play soccer, run, and lift weights and my performance in those has not changed in the slightest. I will say that, as I mentioned, I’m fairly skinny and I know I don’t usually eat enough in terms of calories (I’ve always been this way my whole life) and I’ve gone through periods of weight gain for muscle-building purposes, but then I would get caught up in university and lose the weight again. I’ve started to try to improve that recently, hopefully to ameliorate these symptoms if they are dietary related.

[North Shore]

Not a Dr., but you sound a little ‘paranoid/hypochondriac’. My sense of it is that if you’re fairly healthy, good BMI, regular exercise, no other symptoms, then you’re probably over-thinking things.. Perhaps go and see your family doc, mention your concerns, and then go from there. Don’t bring Transport into it unless you have to (that is, if you are diabetic, then you have a duty to notify.)

Good Luck..

[7ECA]

Yeah, sounds like you've really gone hard over into the paranoid hypochondriac side of self-diagnosis via WebMD...

Your CAME would have told you right off the bat if there was something amiss with your urine dip stick - as it's a simple test that is read off like a pool/spa test with the key right on the side of the bottle. Having said that, if you've concerned about your risk for diabetes (especially if there is a family history) go see your family doctor and ask them about the situation. If they feel it is necessary, they'll send you off for blood tests and you go from there.

Diabetes is a highly manageable condition, for those whom seek to actively work at maintaining a healthy lifestyle; it's not a death sentence by any means.

[Inverted2]

Wait till you get in to your 40’s. You’ll get out of bed with a new ache or pain every day.

Relax. Live life and don’t worry so much.

[C-GKNT]

Of course you should go to you family doctor but it is not hard to do a preliminary check of your blood glucose levels yourself. Any pharmacy will sell you a lancet, a blood glucose meter and some test strips.

Diabetes is not something to guess about and is normally quite manageable. If you are in fact diabetic, the consequences of not dealing with it properly can be MUCH more severe than losing your aviation medical. Did I mention you should go see your family doctor?

[NotDirty!]

From my understanding, loss of sensation in your feet is more of a long-term symptom… you are more likely to experience some of the short term symptoms like frequent urination and insatiable thirst.
Nonetheless, a quick fingerstick will give you a current blood glucose reading. Your doctor can order blood tests, and is hopefully more qualified than the collected wisdom of Dr. AvCanada.

[Old fella]

Well…. Discuss with your family doctor or health care provider, request an A1C and Glucose fasting blood test as that will settle it. My Glucose is on the higher end of normal however no medical intervention is required and I do a lancet test at Pharmacy every couple of months. Also consult a dietitian for advice on sugar levels related to your diet, you would be quite surprised what he/she will come up with.

Best of luck

[BigQ]

Would it be type 2 diabetes?

Go on the carnivore diet. It reverses type 2 after a few months of being pure carnivore.

[JungleRiot]

My pinky toe has been sensitive to temperature for a few months now (among several other symptoms; see below) and I’m paranoid about diabetes. I currently hold a CAT 1 medical which I got renewed about a month ago and am just starting on my CPL (I need about 100 more hours). I cannot describe the amount of stress this has put me through, but I’m looking for guidance on what my next steps should be.

Do I wait it out and see if TC contacts me about my urine test? Even if they don’t, that still doesn’t necessarily rule out diabetes as the urine test only detects higher blood sugar levels from my understanding. Should I see my family doctor ASAP to get a blood test referral? Should I try improving my diet first to see if the symptoms improve first? The TC CAME handbook says: https://tc.canada.ca/en/aviation/public ... 2#diabetes

“Those who already hold a professional pilot licence (ATPL, CPL) may be considered for a Category 1 medical certificate, restricted to flying with an accompanying pilot, as well as for a Category 3 or 4 medical certificate
All other pilots will only be considered for a Category 3 or 4 medical certificate.
Date modified: 2015-02-20”

Should I get my CPL before consulting my doctor then? However, I’m reading in other (more recent than 2015) forum posts that you can apply for a CAT 1 even if you hadn’t held one before, like this one viewtopic.php?t=132302 (although I’m not sure where they got their information from). I don’t really understand why it would matter what licence you had once at the time of diagnosis, but if someone could clarify whether or not this standard has been changed in recent years, that would be appreciated.
Another of my thoughts is that my symptoms are largely nocebo/psychosomatic due to the immense amount of stress I’ve put myself through over this. I genuinely don’t know what I’d do with my life if I can’t fly for a living. There’s no other job remotely like it and the thought of my medical being taken away scares the living shit out of me. My paranoia over this has honestly consumed the better part of my life for the past ~5 months.+


More detailed symptoms: It started out in mid-April as a very slight discomfort around the joint connecting my “ring toe” to my foot, which honestly just felt like a very mild strain of the toe and I wasn’t able to curl it as much as the other toes. I wasn’t really sure how I got it, but I didn’t think much of it because I exercise fairly regularly and tend to pull muscles and the like every so often. A few weeks later I started noticing that the toe next to it, my pinky toe, was sensitive to the cold in the sense that it would get more cold than the rest of my toes would. This wasn’t debilitating by any stretch of the imagination, but due to my neuroticism it was something I started focusing on. This went on until it started getting warmer around June. It would still get a bit cold on cooler evenings or in strong A/C, but not nearly as much as before. Over the summer, it largely went away (I’m assuming because it was hot), however I did notice that if it was really hot, that toe would feel hotter than the rest. Additionally, I take hot showers, and if I leave the water running on my foot, when I get out, that toe and my other pinky toe are visibly more red than the rest, along with a small area on the outside edge of my foot. I then noticed later that my original “sore toe” (the “ring” toe) appears to possibly have a very slight hammertoe, or the beginnings of a hammertoe. Then, a few weeks ago I started noticing that my kneecaps would get cold. The more I would focus on it, the less it would seem to go away. This was until about two weeks ago when, despite promising myself to stop Googling symptoms, I did. When I saw that most results said that you shouldn’t be worried about cold kneecaps, the symptoms almost went away completely. I sometimes now still feel that my kneecaps are slightly colder than the rest of my leg, usually during cardio. This makes sense, to me at least, because blood flow in the kneecaps is obviously less than other parts of the leg, plus I’m a relatively skinny guy (~19.4 BMI). This made me think that maybe my symptoms are indeed psychosomatic. However, very recently I’ve started feeling that my other pinky toe (the one that was asymptomatic aside from redness after hot showers) is also starting to have the same symptoms as the other one. This now reignited my slight dip in stress levels over this whole possible diabetes idea I’ve had. These symptoms, along with the others, mainly occur while sitting. Aside from these symptoms, I’ve had nothing else of note; no numbness, abnormal hunger, thirst, increased urination frequency, fatigue, etc. I’m also fairly active, I play soccer, run, and lift weights and my performance in those has not changed in the slightest. I will say that, as I mentioned, I’m fairly skinny and I know I don’t usually eat enough in terms of calories (I’ve always been this way my whole life) and I’ve gone through periods of weight gain for muscle-building purposes, but then I would get caught up in university and lose the weight again. I’ve started to try to improve that recently, hopefully to ameliorate these symptoms if they are dietary related.

To be honest, as long as you havent been jabbed, youve got nothing to worry about.

[BacktrackRWY]

Thought to copy/paste your symptoms into CHATGPT.. It's useful advice..

I'm not a doctor, but there are a few things to consider when you're trying to understand these symptoms:

1. **Referred Pain**: Pain or symptoms in one part of the body can sometimes originate from a different part. For example, discomfort in one toe might come from an issue elsewhere in the foot or even further up the leg.

2. **Neuroticism and Psychosomatic Symptoms**: As you mentioned, it's possible for heightened stress or anxiety to cause or amplify physical symptoms. Psychosomatic symptoms are physical symptoms that might not have a clear physical cause but are related to psychological factors. Since the coldness in your kneecaps seemed to mostly resolve when you read that it wasn't usually a cause for concern, this might indicate that at least some of your symptoms could be influenced by anxiety or focus.

3. **Peripheral Circulation**: Coldness in extremities can sometimes be related to peripheral circulation. Conditions that affect blood flow to the extremities, like Raynaud's phenomenon, can cause fingers or toes to feel unusually cold or even change color. However, this doesn't usually involve only one toe or kneecap.

4. **Hammertoe**: A hammertoe is a deformity where the toe bends or curls downward instead of pointing forward. This can be caused by various factors, including shoes that don't fit properly, muscle imbalances, or trauma.

5. **Dietary or Nutritional Issues**: It's important to ensure you're getting a balanced diet, especially if you're very active. Nutritional deficiencies can cause a range of symptoms.

6. **Diabetes**: You mentioned a concern about diabetes. Diabetes can cause a condition known as peripheral neuropathy, which affects the nerves in the extremities. However, it's usually associated with other symptoms such as numbness or tingling. From what you've described, your symptoms don't seem to match the typical symptoms of diabetes, and you haven't mentioned experiencing the more common symptoms like excessive thirst, frequent urination, or unexplained weight loss.

7. **Activity Level**: Since you're active and involved in sports like soccer, it's possible that you might have sustained minor injuries or strains that you weren't immediately aware of, which could be causing some of the discomfort.

Regardless of the potential causes mentioned, it's essential to see a healthcare professional to get a proper evaluation. They can provide a definitive diagnosis and recommend any necessary treatment.

When I asked "What tests to run?"

I'm not a doctor, but if you're experiencing persistent or concerning symptoms, it's crucial to consult with a medical professional who can give a proper evaluation. That said, some potential evaluations or tests that might be relevant based on the symptoms you described could include:

1. **Physical Examination**: A healthcare provider will typically start with a thorough physical examination of your foot, toes, legs, and any other relevant areas. This can help to identify visible abnormalities like a hammertoe, signs of inflammation, or other potential issues.

2. **X-ray**: This can be used to evaluate the bones in your foot and identify any potential fractures, deformities, or other structural problems.

3. **Blood Tests**:
- **Complete Blood Count (CBC)**: To check for signs of infection, anemia, or other blood-related issues.
- **Blood Glucose Test**: To check for diabetes.
- **Other Nutritional and Metabolic Tests**: These might include checking for levels of certain vitamins, minerals, or other nutrients to see if you might have any deficiencies.

4. **Nerve Conduction Study**: If neuropathy is suspected, this test measures how quickly nerves in your arms and legs transmit electrical signals. It's a common test used to diagnose carpal tunnel syndrome and peripheral neuropathy.

5. **Thermography**: This uses infrared imaging to show patterns of heat and blood flow on or near the surface of the body. It could potentially be used to identify areas of reduced blood flow or increased inflammation.

6. **Doppler Ultrasound**: If there's a suspicion of circulatory issues, a Doppler ultrasound can be used to measure and assess the flow of blood in the veins and arteries of your legs.

7. **Referral to a Specialist**: Depending on the initial findings, you might be referred to a specialist, such as:
- **Podiatrist**: A doctor specializing in feet and lower extremities.
- **Rheumatologist**: If there's a suspicion of a rheumatic or autoimmune condition.
- **Neurologist**: If there's a suspicion of nerve-related issues.

8. **Psychological Evaluation**: If there's a strong belief that some of your symptoms might be psychosomatic or related to anxiety, you could be referred to a psychologist or psychiatrist for an assessment.

Ultimately, the specific tests or referrals you might need will depend on your initial evaluation and the professional judgement of your primary care provider. It's essential to be open and honest about all of your symptoms and any potential concerns so they can provide the best recommendations.

[NotDirty!]

Yes, because obviously nobody had diabetes prior to the COVID jab!

[RatherBeFlying]

If there's any family history of diabetes, you really want to stop it before it happens. Your family doctor will want to test fasting blood sugar and A1C (Dr Google can tell you what levels are good or concerning). If you don't have to go on meds, you have nothing to report to TC.

Weight control and diet can prevent and even reverse type 2 diabetes.

Pasta, potatoes, rice, corn and even bread can elevate blood sugar. Intake has to be limited. Forget chips and soft drinks.

Book: The Diabetes Code
YT: KenBerryMD talks up paleo diet.

[Sidebar]

Untreated diabetes can cause permanent damage to organs. It would be better to know your diagnosis, especially if you do have diabetes. Testing is very simple. Go see your doctor and talk to them about your problems.

[Bede]

If you don't have to go on meds, you have nothing to report to TC.

Not quite. The question on the medical is "have you ever been investigated for..."

[lostaviator]

Diabetes runs in my family too. A few years ago I had a numb toe and started to worry. Though, not to the extent you are by the sounds of it. So different concerns (numb vs temp sensitivity), but similar concerns.

It’s good that you’re worried, but the internet can make things much worse.

Turns out… I had bought a new pair of running shoes that were not meant for me. The support/arch was causing me to run awkwardly. New shoes, numb toe went away.

You’ll be fine. Take care of yourself.

['CauseTheCaravanCan]

Well a couple of tips from my own experience.
1) buy shoes with a wider toe box (cross trainers instead of runners) until we've figured this out
2) read Deep Nutrition by Dr Catherine Shanahan. If she can't convince you to follow a more traditional diet that will arrest prediabetes and insulin resistance and reverse the sympstoms fast, no one can.
Keep in mind you had to have been running with consistently elevated blood sugar (pre-diabetes) for a decade or more for your pancreas to finally say 'ope, i'm not doing this anymore" and now you're a full-blownType 2 Diabetic.
Get off the added sugar (flavored yogurt, kraft peanut butter, granola bars). Get off the fried foods. Get off things that combine sugar and oils (cookies, breakfast cereals/buns, donuts, muffins, iced coffee milkshakes.)
According to several studies, our body can only process the glycemic load of about a teaspoon of sugar at any given time before our pancreas starts pumping out major insulin and that process takes hours.
When you consider most of us begin our day with jammy toast or a donut plus a sweetened coffee. Have a granola bar a couple hours later, Red Bulls, hit the vending machine for "a little something sweet" around 3, grab a coke with dinner and finish the day with ice cream or lucky charms then get up and do it all again, you can see how our bodies develop insulin resistance and a pot belly by 30.
Eat starches (think small servings of pasta, real sourdough bread, root vegetables) with a good helping of usable fats instead of a bigger plate of starch (butter, bacon fat, olive oil) to slow absorption, make you satisfied and feel fuller longer and to prevent insulin spikes.
For god sakes eat veggies. Breakfast lunch and dinner.
At least one fermented food every day (plain 10 percent fat yogurt, kombucha, lacto-fermented pickle, kimchi)
With these changes, your systemic inflammation will subside, your circulation will improve and your foot and leg pain/issues will vanish. Along with many other chronic ailments. (Back pain, arthritis, headaches etc)
You said you're slim, but even slender people's organs can be suffocating in visceral fat. If you're a sugar lover, I'd start there.
No meds required, just use food as medicine and then monitor for results.

[Airbrake]

Talk to your Dr and then talk to a registered nutritionist or dietitian.
They will be the ones who have the most up to date info about how to best approach it to maintain your medical.

[-42]

Please let us all know what if any flying job you get in the end as I would like to drive that day. See a Doctor man. Or ask for advice on a forum. Decision making is part of your career man.

[NotDirty!]

“Those who already hold a professional pilot licence (ATPL, CPL) may be considered for a Category 1 medical certificate, restricted to flying with an accompanying pilot, as well as for a Category 3 or 4 medical certificate
All other pilots will only be considered for a Category 3 or 4 medical certificate.
Date modified: 2015-02-20”

This section you quoted only applies to restrictions for insulin treated diabetes (ITDM). Typically insulin is not the initial treatment used for type 2 diabetes, your doctor my prescribe oral medications with minimal risk of hypoglycaemia. This would not affect your ability to fly, you can hold an unrestricted medical! Please see a doctor as soon as possible! Long term effects of untreated diabetes, on the other hand, could lead to you being ineligible to hold a medical, not to mention the stress of the unknown.

[PropDog]

My pinky toe has been sensitive to temperature for a few months now (among several other symptoms; see below) and I’m paranoid about diabetes. I currently hold a CAT 1 medical which I got renewed about a month ago and am just starting on my CPL (I need about 100 more hours). I cannot describe the amount of stress this has put me through, but I’m looking for guidance on what my next steps should be.

Do I wait it out and see if TC contacts me about my urine test? Even if they don’t, that still doesn’t necessarily rule out diabetes as the urine test only detects higher blood sugar levels from my understanding. Should I see my family doctor ASAP to get a blood test referral? Should I try improving my diet first to see if the symptoms improve first? The TC CAME handbook says: https://tc.canada.ca/en/aviation/public ... 2#diabetes

“Those who already hold a professional pilot licence (ATPL, CPL) may be considered for a Category 1 medical certificate, restricted to flying with an accompanying pilot, as well as for a Category 3 or 4 medical certificate
All other pilots will only be considered for a Category 3 or 4 medical certificate.
Date modified: 2015-02-20”

Should I get my CPL before consulting my doctor then? However, I’m reading in other (more recent than 2015) forum posts that you can apply for a CAT 1 even if you hadn’t held one before, like this one viewtopic.php?t=132302 (although I’m not sure where they got their information from). I don’t really understand why it would matter what licence you had once at the time of diagnosis, but if someone could clarify whether or not this standard has been changed in recent years, that would be appreciated.
Another of my thoughts is that my symptoms are largely nocebo/psychosomatic due to the immense amount of stress I’ve put myself through over this. I genuinely don’t know what I’d do with my life if I can’t fly for a living. There’s no other job remotely like it and the thought of my medical being taken away scares the living shit out of me. My paranoia over this has honestly consumed the better part of my life for the past ~5 months.+


More detailed symptoms: It started out in mid-April as a very slight discomfort around the joint connecting my “ring toe” to my foot, which honestly just felt like a very mild strain of the toe and I wasn’t able to curl it as much as the other toes. I wasn’t really sure how I got it, but I didn’t think much of it because I exercise fairly regularly and tend to pull muscles and the like every so often. A few weeks later I started noticing that the toe next to it, my pinky toe, was sensitive to the cold in the sense that it would get more cold than the rest of my toes would. This wasn’t debilitating by any stretch of the imagination, but due to my neuroticism it was something I started focusing on. This went on until it started getting warmer around June. It would still get a bit cold on cooler evenings or in strong A/C, but not nearly as much as before. Over the summer, it largely went away (I’m assuming because it was hot), however I did notice that if it was really hot, that toe would feel hotter than the rest. Additionally, I take hot showers, and if I leave the water running on my foot, when I get out, that toe and my other pinky toe are visibly more red than the rest, along with a small area on the outside edge of my foot. I then noticed later that my original “sore toe” (the “ring” toe) appears to possibly have a very slight hammertoe, or the beginnings of a hammertoe. Then, a few weeks ago I started noticing that my kneecaps would get cold. The more I would focus on it, the less it would seem to go away. This was until about two weeks ago when, despite promising myself to stop Googling symptoms, I did. When I saw that most results said that you shouldn’t be worried about cold kneecaps, the symptoms almost went away completely. I sometimes now still feel that my kneecaps are slightly colder than the rest of my leg, usually during cardio. This makes sense, to me at least, because blood flow in the kneecaps is obviously less than other parts of the leg, plus I’m a relatively skinny guy (~19.4 BMI). This made me think that maybe my symptoms are indeed psychosomatic. However, very recently I’ve started feeling that my other pinky toe (the one that was asymptomatic aside from redness after hot showers) is also starting to have the same symptoms as the other one. This now reignited my slight dip in stress levels over this whole possible diabetes idea I’ve had. These symptoms, along with the others, mainly occur while sitting. Aside from these symptoms, I’ve had nothing else of note; no numbness, abnormal hunger, thirst, increased urination frequency, fatigue, etc. I’m also fairly active, I play soccer, run, and lift weights and my performance in those has not changed in the slightest. I will say that, as I mentioned, I’m fairly skinny and I know I don’t usually eat enough in terms of calories (I’ve always been this way my whole life) and I’ve gone through periods of weight gain for muscle-building purposes, but then I would get caught up in university and lose the weight again. I’ve started to try to improve that recently, hopefully to ameliorate these symptoms if they are dietary related.

I’m not a doctor, you should see a doctor if you’re worried.

That said I did go to paramedic school. The word diabetes means to siphon in Greek and refers to the excess urine output in diabetics. The biggest indicators for diabetes Mellitus (Insipidus is caused by a gland problem in your brain) are polydispsia, polyphagia and polyuria. (Fancy way of saying excess thirst, hunger and urine). Diabetes Mellitus which is the diabetes you are concerned about manifests this way because as your blood sugar becomes excessively high due to either a lack of insulin or insulin insensitivity your kidneys are unable to reabsorb the glucose that passes into the urine. That’s how your kidneys work; small molecules and electrolytes are filtered into your urine and are then reabsorbed into your blood in order to maintain electrolyte and pH levels. Large proteins such as albumin, blood cells and the like do not pass into the urine unless you have damage to your kidneys hence why the CAME dips your urine for sugar and protein. It uses a mechanism called countercurrent multiplication to do this which I won’t get into because that is an entire lesson into itself. As you pass these large amounts of urine you become extremely thirsty due to the fluid losses. This large fluid loss can also cause electrolyte imbalances (sodium and potassium which are important to muscle and heart function). The hunger response is because with the exception of your brain and kidneys every organ in your body requires insulin to transfer glucose into the cell and since they are unable to, they are effectively “starving in a land of plenty” as it was put to me in pathophysiology class.

If some temperature sensitivity in your pinky toe is your main concern my first thought wouldn’t be diabetes. Your urine test at your medical is literally a stick the doctor swishes in your pee that looks for proteins and glucose. I would see a family doctor if you have serious concerns about it. There are atypical cases and presentations to every disease however if you are not experiencing excessive thirst, urination and hunger I wouldn’t jump to diabetes. That said often but not always, type II diabetes is associated with excess body fat. The link is not fully understood yet.

Again, I would consult a trained physician if I were you and you really are concerned.