Diabetes Mellitus

Diabetes is a long-term disease in which the amount of sugar in the blood is too high. Insulin is the hormone that keeps blood sugar levels within the normal range. In people with diabetes, there is either a deficiency of the hormone insulin or a reduction in its effect even though there is enough insulin. In type 1 diabetes there is insulin deficiency, while in type 2 diabetes there is a reduction in the effect of insulin. In a healthy adult, the blood sugar level measured after 8–12 hours of fasting is between 70 and 100 mg/dl. If this value is 126 mg/dl or higher on two occasions, the person has diabetes. If it is between 100 and 125 mg/dl, the person has hidden diabetes (prediabetes). In this case, the physician recommends a glucose tolerance test, which is performed after 8–12 hours of fasting. If the blood sugar measured at the 2nd hour of the test is 200 mg/dl or higher, the person again has diabetes. If this value is between 141 and 199 mg/dl, the person again has hidden diabetes. In people whose high blood sugar is detected at the hidden diabetes stage, it may be possible to stop the development of diabetes with medical nutrition therapy, exercise and certain medications.

According to research conducted in Türkiye, the proportion of the population with diabetes is approximately 15%, close to 6 million people. According to the same research, 50% of people with diabetes are not even aware of their disease yet.

Symptoms of Diabetes:

• Drinking a lot of water
• Frequent urination
• Frequent urination at night, urinary incontinence
• Eating a lot
• Weight gain or weight loss
• Blurred vision
• Itching in the genital area
• Weakness, fatigue

Major health problems caused by diabetes:

• Stroke
• Diabetic eye disease (vision loss)
• Coronary heart disease
• Kidney failure
• Nerve damage
• Foot ulcers (diabetic foot)
• Sexual problems

There are 5 golden rules of individual diabetes management:

• Diabetes education
• Medical nutrition therapy
• Exercise
• Taking medications and/or insulin regularly
• Regular check-ups with your physician

Diabetes Treatment:

Treatment is chosen according to the type of diabetes and the patient. Success is possible with diabetes education, medical nutrition therapy, regular exercise, taking medications and/or insulin regularly, and regular check-ups with the physician.

Diabetes Education:

Diabetes education is for everyone. Those who receive it gain general knowledge about diabetes and learn how to use their medications and insulin correctly, how to measure their blood sugar, and what to do if their blood sugar is low or high. Education raises awareness among people with diabetes, and as a result, health problems that diabetes can cause are diagnosed early.

Medical Nutrition Therapy:

To eat a sufficient and balanced diet, people with diabetes need to take in energy and all nutrients in the recommended amounts. Determining the energy needs of people with diabetes and having them get the appropriate amount of energy from their diet is important for achieving the desired body weight. Meals should consist of 3 main meals (breakfast, lunch, dinner) and 3 snacks (mid-morning, afternoon, bedtime). There should be 2.5–3 hours between meals. Meals should not be skipped.

Regular Exercise

In people with diabetes, regular exercise for 45 minutes at least 3 days a week improves blood sugar control. People with diabetes should start exercising when their blood sugar is between 100 and 250 mg/dl.

Medication and Insulin Therapy in Diabetes:

In patients with type 1 diabetes, oral medications have no place in treatment; only insulin is used. In type 2 diabetes, blood sugar-lowering medications can be used in treatment. In later stages, insulin may be added to treatment. Insulin therapy is replacement therapy. It is not addictive.

Regular Check-ups with Your Physician

People with diabetes should see their physician every 3 months, have tests done if recommended by the physician, and receive diabetes education again if necessary. If a change in treatment is needed, the patient should follow it. They should get information from their physician about regular eye examinations, dental and gum check-ups, and their vaccination schedule.