Understanding the Classic Symptoms of 4P and the Dangers of Diabetes Mellitus Complications
Diabetes mellitus is often referred to as the “mother of all diseases” because of its destructive impact on various organs if not managed properly.
Dr Wirawan Hambali, a specialist in internal medicine from the Faculty of Medicine at the University of Indonesia, outlined the characteristic symptoms experienced by patients and the serious complications that threaten them, both in the short and long term.
According to Wirawan, diabetes patients generally display four primary symptoms that are interconnected, commonly referred to as the classic symptoms of 4P. These include elevated blood sugar levels accompanied by weight loss, increased appetite (polyphagia), frequent urination (polyuria), and excessive thirst (polydipsia).
The phenomenon of drastic weight loss in diabetes patients occurs because the body experiences an energy crisis. Despite high blood sugar levels, the sugar cannot enter the body’s cells due to insufficient insulin production.
“We can observe that in advanced diabetic patients who are not treated, those who were previously overweight gradually lose weight. Why? Because glucose cannot be utilised by the cells,” Wirawan explained.
This condition of “starving” cells triggers polyphagia, an urge to eat continuously because the body feels it is constantly lacking energy intake. The other very common symptom is a dramatic increase in urination frequency. Wirawan explained that diabetic patients’ urine often contains very high sugar levels, which naturally draws fluid out of body tissues. This medical phenomenon is known as osmotic diuresis.
“Diabetic patients’ urine contains sugar, so its osmotic pressure is high, which actually draws fluid from inside the body. That’s why diabetic people urinate frequently,” he added.
The knock-on effect of losing large amounts of body fluid through urine then triggers polydipsia, or constant thirst as the body attempts to replace the lost fluid.
Furthermore, Wirawan divided diabetes complications into two major categories:
Short-term (acute) complications: Result from extremely extreme fluctuations in blood sugar levels over a short period. If blood sugar spikes too high or drops too low, patients risk experiencing medical emergencies such as diabetic coma.
Long-term (chronic) complications: Caused by uncontrolled high blood sugar levels over an extended duration, damaging the blood vessel system.
Understanding the 4P symptoms and the risk of complications is expected to increase public awareness to undertake early detection and regular treatment to prevent more severe organ damage.