What is diabetes and how does it develop?

Diabetes mellitus, in which various mechanisms leads to its formation, might be described as the “deficiency or inefficiency of insulin" released from the pancreatic gland. It is often accompanied with lipid (fat) abnormalities.

Is diabetes incidence rate high?

Diabetes mellitus (commonly known as diabetes), which is a disorder of carbohydrate metabolism, is increasingly prevalent  than predicted all over the world and in Turkey as well. The incidence of diabetes in our country is reported as 14% in a recently published study.

What is insulin?

Insulin is a vital hormone to enable the absorption of glucose (sugar) molecule from the blood to be used by the cells. Therefore, insulin deficiency or inefficiency results in high blood sugar level exceeding  tolerable limits.  High blood sugar may affect all organs of the body over time.

How many types of diabetes are there? 

It is divided into two main types: Type 1 diabetes mellitus, is an insulin deficiency as a result of destruction of the pancreatic cells synthesizing insulin due to infectious diseases, radiation and exposure to certain chemical substances. It is often encountered in children and young patients. It has no family history. For treatment, decreased insulin level is to be replaced. The prevalence of Type 1 is 5-10% among overall diabetes patients. The remaining 90-95% of patients are affected by a condition called Type 2 diabetes in which insulin secretion is decreased and / or the body develops resistance to insulin. It reveals after 35-40 years of age. It is also encountered in other family members.

What are the symptoms of diabetes? 

Although the conventional symptoms of type 2 diabetes include mouth dryness, increased hunger/thirst, fatigue, and weakness, some patients may also have coma as an acute complication.

What happens if diabetes is left untreated? Diabetes leads to 2 major complications.

  1. Acute complications: Low blood sugar (hypoglycemia) and conditions that might be called as diabetic coma
  2. Long-term complications: Untreated diabetes can lead to the development of complications affecting body systems overall primarily the cardiovascular system, visual system, urinary system and nervous system (diabetic neuropathy, etc.) over time due to the hyperglycemia (high blood sugar). Moreover, diabetic individuals are more prone to developing infections than those without diabetes. The available data suggests that the incidence and mortality of cardiovascular diseases are 2-8 times higher in diabetic individuals compared to non-diabetic people. Diabetes is the most prevalent cause of kidney failure and non-traumatic foot / leg amputation (surgical removal) worldwide. It is also one of the most common causes of vision loss and blindness.

How to diagnose diabetes?

Diagnosis is made by laboratory tests. Diagnosis is enabled with fasting plasma glucose and postprandial glucose tests as well as oral glucose tolerance test.

Which tests are required to follow diabetes?

As it is a disease affecting various body systems, physical examination, eye ground examination, fasting and postprandial plasma glucose tests, tests for cholesterol and other blood markers as well as urine tests should be administered at certain intervals.

Can diabetes be cured? 

Although there are different classes of anti-diabetic medications available, we are currently trying to prevent the conditions induced by diabetes with the goal of keeping blood sugar within certain limits, because diabetes is not entirely curable.

What are the medications used for diabetes treatment?

The first and foremost treatment of diabetes is to change lifestyle. A healthy diet, regular and proper exercise, quitting smoking, restricting alcohol consumption and use of appropriate medications prescribed by your physician on recommended dose are essential points to take into account. Medications are classified in two groups:

  1. Oral medications: According to their mechanism of action, insulin sensitizing agents that make the body more sensitive to insulin, agents that decrease absorption of sugar from the intestines, inhibitors of insulin secretion by inhibiting the breakdown of certain hormones in the intestines, and inhibitors of renal insulin re-absorption are groups of oral medications.
  2. Medications with injections:  Medications acting like hormones in the intestines, insulin and synthetic insulin analogs.

In brief, diabetes can be managed by diet and exercise programs accompanied with oral medications. In some patients, insulin treatment may also be required depending on the severity or the course of the disease.  In addition, accompanying diseases and disorders, such as hypertension, blood lipid imbalance, renal / visual / neurological involvement, etc. should be treated.

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