DIABETES
What is diabetes and how does it develop?
Believed to be playing a role in the development of many mechanisms, diabetes can be described as the "deficiency or inactivity of the insulin hormone" secreted by the pancreatic gland. It usually brings with it lipid (fat) metabolism disorders.
Is diabetes frequent?
Characterized as a disorder of carbohydrates metabolism, diabetes is prevalent far beyond expectations both in Turkey and globally and is increasing by the day. In a recently published study, prevalence ratio of diabetes has been found to be around 14%.
What is insulin?
Insulin is an indispensable hormone necessary for the glucose (sugar) molecules in the blood to be used properly by the cells. Therefore, its deficiency or inactivity results in blood sugar levels rising above accepted limits. This excess of blood sugar may affect all the organs in the body with time.
How many types of diabetes are there?
Diabetes is divided into two. Type 1 diabetes occurs when there is a deficit of insulin caused by a destruction of pancreatic cells which synthesize insulin hormone. The destruction may be caused by infectious diseases, radiation and exposure to some chemical substances etc. It is mostly seen in children and adolescents. There is no family history of the disease. Treatment consists in replacing the insulin that is deficient. Approximately 5-10% of diabetes patients have this type of diabetes. The remaining 90-95% suffer from Type 2 diabetes characterized by a decrease of insulin and / or a change in the body's response to insulin. This second type usually presents after ages 35-40. It may also be seen in other members of the family.
What are the symptoms of diabetes?
Although standard symptoms of Type 2 diabetes include dryness of the mouth, overeating / excessive drinking of water, fatigue and listlessness, some patients may enter a coma as first symptom.
What happens if diabetes is not taken under control?
Diabetes results in two significant phenomena.
Suddenly developing cases
These are cases that we can describe as hypoglycemia and diabetic coma.
Problems developing in the long term
Diabetes that goes uncontrolled may cause hyperglycemia (high levels of blood sugar) and may subsequently cause complications that affect all the systems of the body including first and foremost the cardiovascular system, the eyes, the kidneys, the nervous system (cases such as diabetic neuropathy, etc.). Furthermore, individuals with diabetes are more likely to develop infections compared with individuals who do not suffer from diabetes. Existing data indicate that the incidence and mortality of cardiovascular diseases in individuals with diabetes is 2-8 times higher than in individuals who do not suffer from it. Globally, the most prevalent cause of renal failure and of non-traumatic foot/leg amputation (surgical removal) cases is diabetes. Particularly in developed countries, diabetes is one of the causes of vision loss and blindness.
How is diabetes diagnosed?
Diagnosis is made with laboratory methods. It is made possible through preprandial and postprandial blood tests and glucose tolerance tests.
Which tests are necessary?
When taking into consideration that diabetes is a disease that involves many systems in the body, aside from physical examination, both preprandial and postprandial blood tests for determining blood sugar levels, blood lipids and other blood parameters, eye ground examination, urine test etc. should also be conducted in the appropriate time intervals.
Can diabetes be treated?
Although there are many different drug classes, it is not possible to cure the disease completely yet, thus doctors try to prevent possible results that diabetes might have by trying to keep blood sugar levels between specific limits.
Which medications are used in the treatment of diabetes?
The primary and indispensable treatment of diabetes is lifestyle changes. Adjusting diet, working out regularly with the right exercises, quitting smoking, limiting alcohol consumption and of course, using medications at the right doses and time intervals as prescribed by the doctor are among the most important points to take into account. Medications can be divided into two groups:
Medications administered orally
Based on their impact mechanism, these are insulin sensitizing agents, insulin secretagogue drugs, medications that reduce glucose absorption in the intestines, medications that prevent certain hormones from breaking in the intestines thus adjusting insulin secretion, and medications that prevent reabsorption of insulin from the kidneys.
Medications administered through injections
These are medications that act like certain hormones in the intestines, insulin and insulin-likes.
In short, diabetes can be treated with specific dietary and exercise programs, with additional oral medications if needed; however, some patients may require the administration of insulin based on the stage and severity of the disease. Moreover, comorbidities and accompanying disorders (high blood pressure, blood lipids imbalance, renal / eye / nerve involvement etc.) should also be treated.
