What is diabetes mellitus? How does it develop?

Diabetes mellitus is a metabolic disorder associated with the metabolism of proteins and fats, especially carbohydrates, and manifested by elevated blood sugar levels. The main cause of metabolic disorders in diabetes is the inability of glucose (sugar) transported by the blood to enter the cells. Normally, glucose obtained from food and entering the blood from the liver depot enters the cell with the help of the hormone insulin, secreted by the pancreas, where it is burned and converted into energy. Cells have doors (receptors) through which various substances enter the cell. Normally, these doors are closed and only open when the right key is present. In diabetes, the hormone insulin acts as the key. Based on this example, diabetes is caused by a lack of insulin and/or a disorder of the receptors affected by insulin.

What are the different types of diabetes?

Type 1 Diabetes (insulin-dependent diabetes): Type 1 diabetes mellitus (insulin-dependent diabetes): a type of diabetes that mainly manifests itself in childhood and results from insufficient or absent insulin secretion in the pancreas, requiring insulin to be supplied from external sources.

Type 2 Diabetes: A type of diabetes that occurs when cells become insensitive to the hormone insulin, which regulates blood sugar levels.

Latent Autoimmune Diabetes: It is a type of diabetes similar to Type 1 diabetes that occurs as a result of the body’s immune system attacking itself during a pathology.

Commonly known as latent diabetes, prediabetes is the period before the onset of type 2 diabetes, when blood sugar levels are slightly above normal, and the onset of the disease can be prevented or delayed with proper treatment and diet.

Gestational diabetes: occurs during pregnancy and is only seen in pregnant women. It usually goes away after giving birth. However, it increases the risk of developing type 2 diabetes in both the mother and child in the future. It is very important to treat gestational diabetes and control blood sugar levels during pregnancy.

Type 1 Diabetes

It is more common in children, adolescents, and young adults. Type 1 Diabetes is caused by an autoimmune process (the body’s immune system cannot recognize its own cells), which destroys the beta cells of the pancreas that produce insulin. With this type, patients have to take insulin injections for life due to the relative or complete absence of insulin in the blood. For this reason, Type 1 Diabetes is also called Insulin-Dependent Diabetes Mellitus (IDDM). Overall, 10% of diabetes cases in our society are caused by type 1 diabetes. The incidence of Type 1 Diabetes in children varies between countries (regions), and 1-42 out of 100,000 children under the age of 15 develop diabetes each year. Type 1 Diabetes is generally more common in northern countries.

 Type 2 Diabetes

It is more common in adults and obese people. In patients with Type 2 Diabetes, carbohydrate metabolism is disrupted as a result of resistance in insulin receptors in tissues rather than a deficiency in insulin secretion. It is known that Type 2 Diabetes develops on the basis of genetic predisposition, but the genetic mechanisms have not been fully understood. People with Type 2 Diabetes can continue their lives without the need for insulin at the beginning of their disease and for a very long time. Therefore, Type 2 Diabetes is also called non-insulin-dependent diabetes (Non-Insulin-Dependent Diabetes Mellitus = NIDDM). Type 2 Diabetes is one of the most common diseases among the adult population in the world and in our country.

What are the symptoms of Diabetes Mellitus?

The clinical signs (symptoms) of diabetes are caused by disturbances in carbohydrate, protein, and fat metabolism in the body. Glucose, which cannot enter cells due to insulin deficiency and/or insulin resistance, begins to be excreted in the urine if its level in the blood exceeds a certain threshold (180 mg/dL). Glucose excreted by the kidneys also increases fluid loss, resulting in frequent urination — polyuria. To restore the fluid loss caused by polyuria, the body drinks a lot of water, which is also called polydipsia. Since the body cannot absorb glucose as a source of energy, frequent hunger pangs occur and appetite increases — polyphagia. On the other hand, fats and proteins, which are reserve energy stores, begin to break down, and as a result, despite increased appetite, the patient experiences weight loss — emaciation.

In addition to these classic symptoms, diabetic patients may also experience symptoms such as fatigue, blurred vision, skin infections, and vaginal yeast infections in women.

Causes of Diabetes

The causes of diabetes vary depending on the type. Although the exact causes of Type 1 Diabetes are not fully known, it is believed to be primarily an autoimmune disease. The body’s immune system attacks the insulin-producing cells of the pancreas, causing them to be destroyed. Type 2 Diabetes is largely related to lifestyle and genetic factors.

A sedentary lifestyle, an unbalanced diet, and excess weight play a major role in the development of this type of diabetes. In addition, people with a family history of diabetes are at a higher risk of developing the disease.

Gestational diabetes is caused by hormonal changes and a decrease in the body’s sensitivity to insulin during pregnancy. During pregnancy, the body needs extra insulin. However, in some cases, the pancreas cannot produce enough insulin to meet this need. As a result, blood sugar levels rise and gestational diabetes develops.

How is diabetes diagnosed?

The diagnosis of diabetes mellitus is made based on criteria set by various international organizations (WHO: World Health Organization, IDF: International Diabetes Federation):

✔ A plasma glucose level of 200 mg/dl or higher measured at any time of the day in a person with classic diabetes symptoms,

✔ Plasma sugar equal to or above 126 mg/dl after fasting for at least 8 hours,

✔ Plasma glucose level at 2 hours in the oral glucose tolerance test (OGTT) is equal to or above 200 mg/dl,

✔ Having HbA1C (Glycosylated haemoglobin A1c) ≥ 6.5% (≥48 mmol/mol).

Based on these indicators, the diagnosis of Diabetes Mellitus is confirmed and the endocrinologist prescribes a diet and comprehensive treatment, taking into account the type of Diabetes, the patient’s age, complaints, concomitant diseases, and complications.

Diabetes Treatment Methods

There are different approaches to treating diabetes, and these approaches vary depending on the type of disease. The main treatment for Type 1 Diabetes is insulin injections. Insulin regulates the blood sugar levels in the body, improving the patient’s quality of life.

In Type 2 Diabetes, proper nutrition, physical activity, and medication are the main treatment methods.

Diabetes medications prescribed by a doctor help the body use insulin more effectively. Regular exercise and a balanced diet are very important for patients. Treatment for gestational diabetes is aimed at protecting the health of both the mother and the baby. Treatment is usually carried out with proper nutrition and blood sugar control. In severe cases, insulin treatment may be used. Blood sugar levels are regularly monitored under the supervision of a doctor until the end of pregnancy.

The Role of a Healthy Lifestyle in Diabetes

A healthy lifestyle is essential for managing diabetes. A balanced diet helps diabetics control their blood sugar levels. Eating the right amount of carbohydrates, proteins, and fats helps maintain their energy levels. Regular physical activity is recommended as it should be an integral part of a diabetic’s lifestyle. Daily walks, swimming, or light exercise can help stabilize blood sugar levels by increasing insulin sensitivity. It is important to consult a doctor before starting any exercise program.

Stress management is also an important factor in diabetes. Stress hormones can cause blood sugar levels to rise. Meditation, breathing exercises, and other relaxation techniques can be helpful for patients as well…

 Complications of Diabetes

Diabetes can lead to serious complications if not managed properly. Cardiovascular disease is one of the most common complications of diabetes. High blood sugar can damage arteries and clog them, increasing the risk of heart attack and stroke. Kidney problems are also common in people with diabetes.

Prolonged high blood sugar levels can impair kidney function, causing nephropathy, a condition that can lead to kidney failure if left untreated.

Another complication is diabetic retinopathy. It occurs as a result of damage to the blood vessels in the retina of the eye and can lead to vision loss. Early diagnosis and treatment play an important role in preventing these complications.

Diet and Nutrition Principles in Diabetics

A healthy diet is vital for people with diabetes. Foods with a low glycemic index, such as whole grains, green leafy vegetables, and legumes, help keep blood sugar levels stable. Foods help maintain the body’s energy levels and prevent sudden sugar spikes.

It is also important to regularly include protein sources, such as lean meat, fish, and eggs, in your diet. Protein helps to keep blood sugar levels more stable and increases feelings of fullness. Low-fat dairy products can also be added to your diet.

It is important for diabetics to stay away from sugar and processed carbohydrates. Sweet drinks, white bread, and desserts cause a rapid rise in blood sugar levels. Instead, natural sources of sugar, such as fruit, should be preferred. However, fruit should also be consumed in moderation.

The Importance of Regular Medical Supervision in Diabetes

Regular check-ups are essential to effectively manage diabetes. Regular blood sugar monitoring is essential to monitor the patient’s condition. The doctor can adjust the treatment plan based on this information.

For more detailed monitoring, an HbA1c test should be performed every three months. The test plays an important role in the long-term management of diabetes. The HbA1c level allows you to assess the effectiveness of treatment and the impact of lifestyle on the disease.

Diabetics should also have regular tests for kidney function, eye health, and cardiovascular health. This helps detect complications early and intervene in a timely manner. Being under the care of a doctor makes it easier to manage the disease and improves quality of life.

The Importance of Physical Activity in Diabetes

Regular physical activity plays an important role in managing diabetes. Daily exercise increases the body’s sensitivity to insulin and stabilizes blood sugar levels. Walking, swimming, or light exercise are particularly suitable for diabetics.

Exercise not only regulates blood sugar levels but also supports cardiovascular health. Physical activity improves blood circulation, helps combat excess weight, and increases energy levels. It also allows diabetics to lead a healthier and more active lifestyle.

It is important to consult a doctor before starting a physical activity program, as certain types of exercise may be risky for some people with diabetes. It is recommended to monitor blood sugar levels and pay attention to body signals during exercise.

The Importance of Water Consumption in Diabetics

Drinking enough water is very important for maintaining good health in diabetes. Water helps stabilize blood sugar levels and speeds up the body’s elimination of toxins. This is especially important in cases where blood sugar levels are high.

Drinking water also supports kidney function. During diabetes, the kidneys work hard to remove excess sugar, which can cause the kidneys to become overloaded. Drinking enough water facilitates this function and protects their function. It is recommended that diabetics drink enough fluids daily to properly meet their water needs. It is better to avoid sugary or carbonated drinks and prefer pure water.

The Role of Drug Treatment in Diabetes

Medications play an important role in managing diabetes. Insulin injections are the main treatment for people with Type 1 Diabetes. Insulin helps the body control blood sugar levels and allows patients to lead a normal lifestyle.

For people with Type 2 Diabetes, medications help the body use insulin more effectively or increase insulin production. The medications can be taken in tablet form. They are usually used in conjunction with a healthy diet and physical activity. Your doctor will prescribe the appropriate dose and treatment plan.

Patients should monitor their blood sugar levels regularly during drug treatment. It is important to see your doctor regularly to evaluate your treatment plan and make changes if necessary. Medications are only a tool to manage symptoms and are most effective when combined with a healthy lifestyle.

Ways to Prevent Diabetes Complications

Diabetes can lead to serious complications if not managed properly. However, these complications can be prevented by taking appropriate measures. First and foremost, keeping your blood sugar under control is essential. Maintaining stable blood sugar levels through diet, exercise, and medication can reduce the risk of complications.

Regular medical check-ups help detect complications early. Special tests are performed to detect problems in the eyes, kidneys, and nervous system early. Problems that are detected early can be treated more easily.

Maintaining a healthy lifestyle, physical activity, and stress management play an important role in preventing complications. Also, avoiding smoking and alcohol consumption significantly reduce the risk of cardiovascular disease.

What Should Proper Nutrition Be Like in Diabetes?

Therapeutic nutrition for diabetes is very important for patients’ quality of life. The healthy eating program used is aimed at maintaining blood sugar levels at the desired level and preventing an increase in blood fat levels. Patients who consume the right foods also reduce the risk of developing other health problems that diabetes can cause.

The diet of diabetic patients should be determined individually by dietitians, because the diabetic patient’s height, weight, blood sugar level, and medications they use constitute the basic information for the nutrition program to be designed.

Thanks to the 6-times-a-day meal program aimed at diabetics, insulin is used in a balanced way, the body’s need for insulin is reduced, and the patient is protected from sudden sugar rises and falls. Meal breaks should not exceed 2-2.5 hours, and daily calorie intake should be distributed in a balanced way.

Diabetics are recommended to eat “complex carbohydrate” foods, such as legumes, vegetables, and whole grain bread, which take longer to digest than simple carbohydrates. A diet designed for diabetics should not be temporary, but should be a lifelong dietary habit.

The main nutritional recommendations for diabetics are as follows:

• Margarines should be avoided, only olive oil and a small amount of butter should be used. Grilled and lean red meat and white meat should be preferred.
• Diabetics should avoid all types of sugar, fried and roasted foods, and ready-made products.
• The patients’ nutritional program should consist of foods rich in vitamins B, C, and E.
• The fiber content in the diet should be increased. Too much fiber slows down the absorption of carbohydrates.
• Fruits should be consumed without peeling.
• Foods with a high glycemic index, such as carrots and rice, which quickly raise blood sugar levels, should be avoided.
• Water consumption should be increased. Aim to drink at least 2-2.5 litres of water per day.
• Foods should be prepared by grilling, boiling, or baking.
• Sweeteners should be avoided as much as possible.
• You should avoid very salty foods such as canned goods, homemade tomato paste, and pickles.