Diabetes

What Is Diabetes (Sugar Disease)?

The human body's energy needs are met by the carbohydrates, proteins and fats in the foods we eat. As these nutrients are digested, simple sugars called glucose are released. Glucose is the most important source of nutrition for all the organs of the body. For cells to use the energy in glucose, glucose has to be taken into the cell. It is the hormone insulin, secreted by the pancreas, that allows glucose to enter the cell and be stored as glycogen.

Sugar disease, or diabetes (Diabetes Mellitus), is a disease with high blood sugar that occurs when the pancreas cannot produce enough insulin for the body, or when the insulin it produces cannot be used effectively by the body.

Diabetes is diagnosed when the fasting glucose (the amount of sugar in a person's blood after 8 hours of fasting) is 126 mg/dL or above, when the level 2 hours after a sugar load (oral glucose tolerance test/OGTT) is 200 mg/dL or above, when the blood hemoglobin A1c (hemoglobin A1c; a protein formed by the interaction of blood sugar with the hemoglobin in red blood cells) is 6.5% or above, or when a random blood glucose of 200 mg/dL or above is found in a person with symptoms of diabetes. In a person without symptoms, a single high result is not enough; the diagnosis is confirmed by elevation in two different tests or by repeating the same test. Click here to view our diabetes diagnosis package.

What Are the Types of Diabetes?

Diabetes can occur in several different forms, and there are 3 main types: Type 1 diabetes, Type 2 diabetes and gestational diabetes. In diabetes, the body cannot produce or use the insulin it needs, so the glucose level in the blood rises. In Type 1 diabetes, the body's natural insulin production decreases. In Type 2 diabetes and gestational diabetes, the body develops resistance to the effect of insulin. As a result of these two conditions, blood sugar rises (hyperglycemia). The form of diabetes that has not yet fully developed is called latent diabetes or pre-diabetes.

What Is Type 2 Diabetes?

Type 2 diabetes is a very common condition that causes the sugar (glucose) level in the blood to become very high. It is a condition in which the body's cells become resistant to the insulin that is normally produced and therefore cannot make use of the sugar in the blood. Excess weight, a sedentary lifestyle, stress, a family history of diabetes and advancing age are among the causes of Type 2 diabetes. However, because the symptoms of Type 2 diabetes do not always make people feel unwell, it may not be noticed easily.

In addition to the usual symptoms such as excessive thirst, frequent urination and fatigue, it increases the likelihood of serious problems involving the heart and nerves. Type 2 diabetes is a condition that will affect a person's daily life for a lifetime. Bringing it under control may require dietary changes, medication and regular medical check-ups.

What Is Type 1 Diabetes?

Type 1 diabetes is a condition in which the body cannot produce enough of the hormone insulin to control blood sugar. As a result, the sugar (glucose) level in the blood reaches very high values. Daily insulin injections are needed to keep the excessively elevated blood glucose under control. Type 1 diabetes usually appears at a young age. It results from the body's own immune system attacking the insulin-producing cells of the pancreas.

Type 1 diabetes can cause diabetic ketoacidosis, that is, DKA. DKA occurs when there is a severe insulin deficiency in the body. The body, unable to use sugar for energy, starts to use the fat stored in the body instead. When stored fat is used by the body, chemicals called ketones are left behind. If this is not brought under control, ketones accumulate in the blood and raise the acidity of the blood. Individuals who are unaware that they have Type 1 diabetes, especially children, may not be diagnosed until they deteriorate because of DKA. For this reason, it is important to recognize the signs and symptoms of DKA so that it can be treated quickly.

Among the symptoms of Type 1 diabetes, unplanned weight loss comes first. If the body cannot obtain energy from food, it will start burning existing muscle and fat for energy instead. This is the reason for starting to lose weight without changing your diet and activity. The ketones produced by the body while burning fat can cause nausea and a feeling of vomiting. Ketones can rise in the blood to dangerous, potentially life-threatening levels.

What Is Gestational (Pregnancy) Diabetes?

Gestational diabetes, that is, diabetes in pregnancy (pregnancy sugar), results from pancreatic cells that were able to secrete sufficient insulin before pregnancy becoming unable to secrete enough insulin as the pregnancy progresses.

Because of gestational diabetes, blood sugar can rise during pregnancy even if there were no signs of diabetes in the past. This condition usually resolves on its own after the pregnancy ends. Those with diabetes in the family, those over 30 years of age and those who are overweight are at risk of diabetes in pregnancy.

What Is Latent Diabetes?

If, under normal conditions, a person's blood sugar level is higher than normal but not high enough to diagnose diabetes, this condition is defined as latent diabetes or pre-diabetes.

Research has found that people with latent diabetes generally develop Type 2 diabetes within 10 years. Eating healthily and adopting a more active lifestyle appear to be effective ways to prevent or delay latent diabetes from turning into Type 2 diabetes.

What Are the Risk Factors for Diabetes (Sugar Disease)?

1. Genetic factors and family history: Family history is important for all types of diabetes. In particular, if a first-degree relative has Type 1 diabetes, a blood test should be done under a physician's supervision without waiting for any symptoms.
2. Pancreatic diseases: Because the hormone insulin is secreted by the pancreas, any disease occurring in the pancreas can cause a risk of diabetes. Some rare diseases can damage the pancreas and therefore cause diabetes.
3. Obesity: Obesity is one of the most important risk factors for Type 2 diabetes and gestational diabetes.
4. Insulin resistance: In Type 2 diabetes, the cells' development of resistance to insulin causes the glucose level in the blood to rise.
5. Sedentary lifestyle: A sedentary lifestyle can make weight control difficult and creates a risk of Type 2 diabetes.
6. Polycystic ovary syndrome: Polycystic ovary syndrome increases the risk of Type 2 diabetes in women.
7. Age: In Type 2 diabetes, age is also important, as are lifestyle and the patient's weight. Because metabolism begins to slow with advancing age, the risk of Type 2 diabetes increases indirectly.
8. Gestational diabetes: Women who have had diabetes in pregnancy have an increased risk of becoming Type 2 diabetes patients in later years.

Is There a Relationship Between Obesity and Diabetes?

There is a direct relationship between Type 2 diabetes and obesity. 80% of patients with Type 2 diabetes are overweight. Insulin resistance, which causes abdominal fat accumulation, can also cause Type 2 diabetes. In this case, controlling weight with an appropriate diet reduces symptoms and can improve the patient's general health.

Diseases Caused by Diabetes

The main diseases caused by diabetes are as follows:

1. Heart and vascular diseases
2. Strokes
3. Damage to the blood vessels of the eye and the retina
4. Kidney failure
5. Erectile dysfunction in men
6. Diabetic foot
7. Diseases of the nervous system

Diabetes can cause the diseases listed above, and when the complications of these diseases are added, it can impair the patient's quality of life and physical integrity. With treatment carried out under a physician's supervision, complications related to diabetes and the diseases it causes can be prevented or their effects reduced.

Diabetes Treatment

Diabetes is a chronic disease and has no definitive cure. Treatment of the disease aims to prevent its adverse effects and to keep the patient's quality of life from declining. Keeping the blood sugar level within normal limits is important in order to minimize the effects of the disease.
It is of great importance for the patient to learn about diabetes, monitor their own blood sugar, eat properly and exercise sufficiently in order to reduce the risk of long-term complications. In addition, in order to reduce the high cardiovascular disease risk caused by diabetes, it is essential not to smoke and to keep blood pressure and cholesterol levels under control.
Antidiabetic medication for Type 2 diabetes and insulin therapy for Type 1 diabetes are the methods used to bring diabetes under control with medication.
Although it has been seen that blood sugar levels can be returned to normal in 80% to 100% of diabetic patients with obesity as a result of gastric bypass surgery, it is not a commonly used solution.

How Should One Eat with Diabetes?

The diets of diabetic patients can be prepared under their physicians' supervision, depending on the patient's general health and weight. There are foods that should be avoided and foods that should be preferred in diabetes.

Carbohydrates

Because diabetes is also called sugar disease, there is often a misunderstanding that diabetic patients should not eat sugar, that is, carbohydrates. However, there is nothing wrong with eating the right carbohydrates. Products such as whole grains, brown rice, oats, quinoa and sweet potatoes are suitable for the diet of diabetic patients. What should be avoided in a diabetic diet are refined grains, white flour and products made with this flour, packaged products and fried carbohydrates.

Vegetables

All vegetables rich in fiber are suitable for a diabetic diet. When cooking vegetables, it is necessary to avoid frying and to use methods such as steaming and grilling. Vegetables that are low in sodium and cooked without salt or with little salt are suitable for the diet. Green leafy vegetables in particular are recommended. Products containing a lot of salt such as pickles, certain cheeses, and vegetables cooked with saturated fats such as butter and margarine should be avoided.

Fruits

Most fresh fruits are suitable for diabetic patients as long as they are consumed in the recommended portions. Fruit jams sweetened with sugar and canned fruits are not recommended for diabetic patients. Freshly squeezed fruit juices are recommended more than packaged ones.

Proteins

Contrary to popular belief, protein-rich foods are not only animal products. Plant-based protein sources such as beans, lentils, chickpeas, soy, seeds, nuts and tofu are suitable for the diet of diabetic patients. In addition, fish, eggs and chicken are suitable for the diet of diabetic patients. What matters is that animal products are unprocessed and not fried. Processed red meats, chicken and fish may contain high amounts of sodium and fat. Animal products that are fried, salt-cured or high in saturated fat are not recommended for diabetic patients. Fat-free or low-fat milk and dairy products, or plant-based milks, should be preferred.

Fats

Trans fats and animal fats are harmful not only for diabetic patients but for general body health. Vegetable oils such as olive oil, hazelnut oil and sunflower oil should be preferred, and these oils should be consumed without frying. Fat-rich plant products such as avocado and nuts are healthy and suitable for the diet. A physician should be consulted about the fats in processed and packaged products, even if they are vegetable-based.

Beverages

All kinds of carbonated drinks, coffee and tea mixes, energy drinks and alcohol with added sugar and sweeteners are products that should be avoided not only by diabetic patients but by everyone who wants to protect their body health. Instead, water, soda water, freshly squeezed fruit juices, unsweetened teas and coffee can be consumed.

Diabetes in Children

Insulin is one of the leading hormones in balancing sugar, the body's source of nourishment. Sugar disease, that is diabetes, occurs due to disturbances in this hormone. Although diabetes is generally known as an adult disease, in recent times, with increasing awareness of the subject, it can also be detected in children.
Diabetes in children is divided into Type 1 and Type 2. In Type 1 diabetes, formerly called "insulin-dependent diabetes," there is damage to the pancreatic cells that produce the hormone insulin, which allows sugar in the bloodstream to enter the tissues. Type 2 diabetes, on the other hand, results from the tissues becoming insensitive to the hormone insulin, so that sugar in the bloodstream cannot enter the tissues.

Causes of Diabetes in Children

What causes diabetes in children is not exactly known. Even if there are people with diabetes in the family, children may be predisposed to diabetes. However, this genetic inheritance does not lead to diabetes in every child.
Type 1 diabetes can arise from destruction caused by immune-system problems in the pancreatic cells that help produce insulin.
Although Type 2 diabetes is seen more often in adulthood, it can rarely occur in children as well. In children predisposed to Type 2 diabetes, in particular being overweight (obesity) and insufficient physical activity can cause diabetes to develop.

Symptoms of Diabetes in Children

Diabetes, which results from a disturbance in the processes involving the hormone insulin, presents in children with a number of symptoms. Some of these are:

1. Increased urine output, bedwetting
2. Excessive thirst and water consumption
3. Dry mouth
4. Excessive hunger
5. Fatigue
6. Weight loss
7. Irritability and depression

In addition, in children with diabetes that is untreated or poorly treated, it is also possible to see signs of a condition called diabetic ketoacidosis, caused by excessively high blood sugar:

1. Clouding or loss of consciousness
2. Deep and rapid breathing
3. Dry skin
4. Abdominal pain
5. Vomiting
6. Fruity or acetone odor on the breath

If the symptoms of diabetic ketoacidosis appear, a health institution should be contacted.

Diagnostic Methods for Diabetes in Children

Diabetes is not a disease that is easily diagnosed. Generally, because families do not suspect diabetes in their children, they consult a doctor for other health problems.
In a child with symptoms, a random blood glucose of 200 mg/dL or above establishes the diagnosis; in a child without symptoms, a fasting glucose of 126 mg/dL or above, a 2-hour OGTT value of 200 mg/dL or above, or an HbA1c of 6.5% or above must be confirmed by repeat testing. These tests may sometimes be repeated more than once.
If the tests requested by the physician are not sufficient to make a diagnosis, then a test called the glucose tolerance test is performed. This test is done by giving the child a specially prepared liquid to drink. Measurements are repeated 2 hours after drinking the liquid, and a clear diagnosis can be made for the child.

Treatment Methods for Diabetes in Children

Diabetes in children, seen in many countries around the world, has recently become one of the most common childhood diseases in our country as well. Diabetes that develops in children is not a disease that can be cured. It is important to accept that it is a chronic disease and to live a life compatible with the disease.
Insulin therapy is generally planned for children with Type 1 diabetes. However, in addition, a medication treatment deemed appropriate by the physician may also be started. Along with treatment, dietary changes and regular exercise, in line with the child's living standards, are recommended.
Treatment of Type 2 diabetes can also follow the same methods as that of Type 1. Changing the eating pattern and regular exercise are recommended in order to bring the child's insulin resistance under control.
It is very important for diabetic patients, especially those using insulin, to monitor their blood sugar at home in the manner and frequency recommended by their physicians and to attend examinations at certain periodic intervals in order to bring the disease under control. Periodic follow-up is also of great importance for carrying out routine checks for kidney and eye diseases, which are seen more often in diabetic patients than in the rest of the population.