Diabetes

WHAT IS DIABETES?

Diabetes is a chronic, broad-spectrum metabolic disorder that requires continuous medical care, in which the body cannot make adequate use of carbohydrates, fats and proteins due to insulin deficiency or defects in insulin action. The body cannot control the amount of glucose in the blood. Diabetes is a lifelong disease characterized by elevated blood sugar. To carry out daily activities, the body needs a type of sugar called "glucose". The hormone that allows glucose to enter the cells is insulin, which is secreted by the pancreas. Without insulin, glucose (sugar) cannot enter the cells. The cells will starve.

Continuous education of healthcare professionals and patients is essential to reduce the risk of acute complications of the disease and to prevent its long-term chronic complications (retinal, renal, neural, cardiac and vascular), which also increase the cost of treatment.

SYMPTOMS OF DIABETES

• Frequent urination and drinking a lot of water,
• Eating a lot or loss of appetite,
• Weakness and tiring easily,
• Dry mouth,
• Blurred vision,
• Unexplained weight loss,
• Persistent infections, recurrent fungal infections and itching.

CLASSIFICATION OF DIABETES

Type 1 Diabetes

If the hormone insulin is completely lacking, this type of diabetes is called "type 1 diabetes". There is usually an absolute insulin deficiency. It usually begins before the age of 30.

• Three peaks are seen: before school age (around 6 years),
• at puberty (around 13 years) and
• in late adolescence (around 20 years).

Patients with type 1 diabetes must use insulin for life.

Type 2 Diabetes

If the hormone insulin is present but in insufficient amounts, or if there is resistance to insulin in the tissues, this type of diabetes is called "type 2 diabetes".

• It mostly appears after the age of 30; however, as a result of rising obesity, it has begun to appear in childhood or adolescence as well, especially in recent years.
• Type 2 diabetes can be controlled with diet, exercise and medications.
• There is a strong genetic predisposition. As the genetic load increases, the risk of diabetes rises in later generations and the disease begins to appear at earlier ages.
• Patients are often obese or overweight.
• The disease usually has an insidious onset and may go unnoticed. Many patients have no symptoms at first, and it may be discovered by chance.
• Some patients may seek medical care because of blurred vision, numbness and tingling in the hands and feet, foot pain, recurrent fungal infections or delayed wound healing.

WHO IS MOST LIKELY TO DEVELOP TYPE 2 DIABETES?

• People who have first-degree relatives with diabetes,
• People with cardiovascular disease,
• People who are overweight,
• People with high blood pressure,
• Women who have given birth to a large baby or were diagnosed with gestational diabetes during pregnancy,
• People with low physical activity,
• It may be more common in people with a triglyceride level of 250 mg/dL or higher and/or an HDL cholesterol level of 35 mg/dL or lower.

Gestational Diabetes Mellitus (GDM):

It is a form of diabetes that appears during pregnancy and usually resolves after delivery. Pregnancy-related insulin resistance and genetic predisposition play a role. It often resolves after delivery but recurs in later pregnancies. It is also considered an important risk factor for type 2 diabetes.

THE GOAL OF DIABETES TREATMENT is to prevent rises and drops in blood sugar, prevent complications that may develop due to diabetes, and slow the progression of problems that have already developed.

MEDICATION TREATMENT INCLUDES:

1- Blood Sugar-Lowering Medications:

• Insulin secretagogues
• Insulin sensitizers
• Medications that slow carbohydrate absorption
• Incretin-enhancing agents
• Non-insulin injectable agents

2- Insulin Therapy: It is a replacement therapy. It is not habit-forming or addictive.

DIABETES AND CHRONIC COMPLICATIONS

Failure to control blood sugar leads to health problems in the short and long term.

• Diabetic Retinopathy- Damage to the blood vessels in the retina.

Have a fundus (retinal) eye examination at least once a year to check for diabetic retinopathy!

• Diabetic Nephropathy- Develops due to damage to the small blood vessels in the kidneys.

Have your microalbuminuria measured at least once a year to check for diabetic nephropathy!

• Diabetic Neuropathy- Damage to the nerve cells. It causes complaints such as pain, tingling, numbness, aching, throbbing and burning in the feet and lower legs.

PREVENTIVE FOOT CARE

As a result of nerve damage, loss of sensation in the feet, loss of muscle strength, clawing of the toes, deformities, dry skin, calluses and cracks may develop. With preventive foot care, the development of a "diabetic foot ulcer" can be prevented. It is very important and necessary to receive training from a diabetes education nurse on how foot care should be done and how the feet should be protected.