What is Diabetes?

Diabetes is a disease that develops when the secretion gland called the pancreas fails to produce a sufficient amount of insulin hormone or when the insulin it produces cannot be effectively used. As a result, an individual cannot use the sugar, glucose, from the food consumed, leading to an increase in blood sugar levels, which can cause serious complications.

In a healthy individual, the blood sugar level is less than 100 mg/dL after a 10-hour fast and does not exceed 140 mg/dL after a meal (two hours later). Diabetes can be diagnosed through Fasting Blood Sugar (FBS) measurement, Postprandial Blood Sugar (PPBS) measurement, or an Oral Glucose Tolerance Test (OGTT). FBS measurement between 100-125 mg/dL indicates impaired fasting glucose (pre-diabetes), while FBS measurement ≥ 126 mg/dL or PPBS measurement ≥ 200 mg/dL indicates the presence of diabetes. A diagnosis of diabetes is also confirmed if FBS is ≥ 126 mg/dL or PPBS is ≥ 200 mg/dL on two separate occasions.

HbA1c is valuable in monitoring diabetic patients, providing insight into a three-month average of blood sugar levels. An ideal level for HbA1c in diabetic patients is considered to be < 6.5%.

What is Insulin?

In healthy individuals, most of the food, especially carbohydrates, is converted into glucose for energy use in the body. The pancreas, an organ located on the back surface of the stomach, produces a hormone called “insulin,” which allows muscles and other tissues to take glucose from the blood and use it as energy. Glucose passing into the blood from the food enters cells through insulin. Insulin opens the “door” of the cell to allow glucose to enter and plays a crucial role in ensuring that blood sugar levels are maintained within desired limits. Insufficient or lack of insulin leads to an increase in blood sugar levels.

What is Insulin Resistance?

Insulin resistance occurs when tissues do not respond to the normal signals of insulin. Tissues such as the liver, muscles, and fat tissue do not follow the commands of insulin. In individuals with insulin resistance, the entry of blood sugar into muscle, fat, and liver cells becomes difficult, leading to an accumulation of sugar in the blood. The pancreas may respond by producing more insulin to allow cells to take in more sugar. However, over time, the pancreas may tire, lose its ability to provide sufficient insulin, and diabetes may develop.

Factors such as being overweight, polycystic ovary syndrome (PCOS), corticosteroid treatments, increased waist circumference (above 80 cm in women, above 94 cm in men), aging, and a sedentary lifestyle can contribute to the development of insulin resistance.

Types of Diabetes:

1. Type 1 Diabetes: Develops more rarely, affecting young individuals. It occurs due to the absence of insulin in the body, leading to a rapid increase in blood sugar. The individual starts using fats instead of glucose for energy, resulting in significant weight loss.
2. Type 2 Diabetes: More common, affecting older individuals. Type 2 diabetes involves two primary problems: insulin resistance and insufficient insulin secretion. Early diagnosis of Type 2 diabetes allows prevention through lifestyle changes (diet and exercise) and, if necessary, medication.
3. Gestational Diabetes: Occurs during pregnancy.
4. Other Specific Types of Diabetes.

Who is at Risk for Type 2 Diabetes?

• Individuals with a body mass index (BMI) above 25 and a waist circumference greater than 80 cm in women or 94 cm in men.
• Those with a family history of diabetes (parents, siblings, etc.).
• Those with high total, LDL cholesterol, and triglyceride levels, or low HDL cholesterol levels.
• Individuals with existing cardiovascular disease.
• Those with polycystic ovary syndrome (PCOS).
• Individuals with high blood pressure.
• Those diagnosed with gestational diabetes during pregnancy or those giving birth to a child weighing over 4 kg.
• Individuals previously diagnosed with impaired fasting glucose are considered at high risk.

Symptoms of Diabetes:

Common symptoms include excessive thirst, frequent urination, fatigue, and unexplained weight loss. However, some individuals may not exhibit any obvious symptoms. If any of the mentioned symptoms are present, it is crucial to seek medical advice promptly.

Why is Diabetes a Serious Disease?

The consequences of diabetes can be severe, leading to blindness, kidney failure, nerve damage, heart attacks, strokes, and foot problems. These complications can be prevented with timely treatment and good blood sugar control.

Preventive Measures:

• Blood sugar measurement
• Blood pressure measurement
• Body measurements
• Foot examination
• Urine test for protein presence
• Cholesterol test
• Eye examination
• Dental check-ups
• Regular EKG (Electrocardiogram) testing

Treatment of Diabetes:

Treatment varies depending on the type of diabetes and the patient. It may include education, a healthy diet plan, regular exercise, appropriate medication, and regular health check-ups.

Nutritional Tips:

• Consume small, regular meals and healthy snacks.
• Choose skimmed milk and vegetable oils.
• Change cooking methods to boiling, grilling, and steaming.
• Avoid excessive consumption of solid fats, margarine, butter, fried foods, fatty meats, refined sugar, honey, jam, cakes, and chocolate.

Exercise:

Exercise has numerous benefits, including weight loss, improved blood circulation, increased self-confidence, muscle development, strengthening the heart, better sleep, stress reduction, appetite control, and extending life.

Medication for Diabetes:

• Type 1 diabetes requires insulin use.
• Type 2 diabetes often starts with oral medications, progressing to insulin in advanced stages if necessary.

Consequences of Uncontrolled Blood Sugar:

Serious consequences of diabetes may include eye problems, kidney problems (leading to kidney failure, requiring dialysis or kidney transplantation), sensory/nerve problems, heart/circulatory system problems (heart attack), stroke, and foot problems (gangrene, limb loss).

Preventive Measures:

• Blood sugar measurement
• Blood pressure measurement
• Body measurements
• Foot examination
• Urine test for protein presence
• Cholesterol test
• Eye examination
• Dental check-ups
• Regular EKG (Electrocardiogram) testing