Diabetes, the incidence of which is gradually increasing, negatively affects organs such as the heart, eyes, kidneys, as well as the immune system, nervous and vascular systems if left uncontrolled. In diabetes, blood glucose levels need to be carefully monitored. According to experts, lifestyle changes and weight control can be effective in preventing Type 2 diabetes that occurs in advanced ages.
November 14 is commemorated as World Diabetes Day every year in memory of the birth anniversary of Fredrick Bantig, who made it possible to treat millions of patients with diabetes by discovering insulin in 1921.
Dr. Güzin Oğuz Yıldırım, Internal Medicine Specialist at Üsküdar University NPISTANBUL Hospital, defined diabetes as "a chronic, comprehensive metabolic disorder in which the organism cannot adequately utilize carbohydrates, fats and proteins due to insulin deficiency or problems in insulin action, requiring continuous medical care".
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Diabetes can cause damage to many organs
"It would not be wrong to say that diabetes = a disease in all nerves and vessels," said Dr. Güzin Oğuz Yıldırım, stating that diabetes can cause damage in many organs:
"With accelerated arteriosclerosis, cardiovascular diseases trigger and cause the progression of the disease groups with the highest mortality rate in the world.
It causes vision loss, which we call diabetic retinopathy, in which the eye vessels deteriorate and is specific to the disease.
It poses a great risk to our quality of life with the development of numbness and false sensation starting from the fingertips of the feet and hands. (peripheral neuropathy)
It impairs our quality of life, from digestive problems to our sexual life (autonomic neuropathy).
Diabetes is again the number 1 cause of kidney diseases that progress to dialysis (diabetic nephropathy).
It disrupts our immune system, making it easier for many opportunistic microorganisms to cause infections in our body.
It makes it difficult for our wounds to heal, makes the surgeries we need to undergo risky and increases the risk in the postoperative period and prolongs the recovery period."
Urinating a lot and drinking a lot of water can be a sign of diabetes
Stating that diabetes has classical and less common symptoms, Dr. Güzin Oğuz Yıldırım said, "Classical symptoms include polyuria (excessive urination), polydipsia (drinking too much water), polyphagia (eating too much) or loss of appetite, weakness, fatigue, dry mouth and nocturia (nocturnal urination). Less common symptoms include blurred vision, unexplained weight loss, persistent infections, recurrent fungal infections and itching."
Type 1 Diabetes is seen in children and young people
Stating that there are various forms of diabetes, also called "diabetes mellitus", Yıldırım said, "Type 1 diabetes, which we call Type 1 diabetes, is usually caused by the absence of insulin detected in childhood and youth or deformed by the secretions developed by the body's defense cells against pancreatic cells, but we can keep the metabolism in balance by providing the insulin that the body cannot make from outside to the body."
Type 2 diabetes can be prevented with proper nutrition and weight control
Dr. Güzin Oğuz Yıldırım said that in the case called Type 2 Diabetes, problems arise in the use of insulin produced by the organism due to a disorder in cell wall receptors called insulin resistance. Dr. Yıldırım said that for Type 2 Diabetes patients, tablets, subcutaneous injections, insulins, insulin pumps are used to keep blood sugar at the required level. Dr. Yıldırım emphasized that lifestyle changes and weight control are important in preventing Type 2 diabetes.
When should insulin treatment be started in diabetes?
Noting that there is no other option but insulin treatment for Type 1 Diabetics and that it should be started immediately, Dr. Güzin Oğuz Yıldırım said, "For Type 2 Diabetics, although the treatment approaches of physicians regarding the use of insulin vary, the use of insulin is the most reliable way in cases where patients carry a life risk and need to be treated in the hospital. Apart from this, if there is a very high blood sugar in the first detection and the test that allows us to predict the average 3-month blood sugar, which we call HbA1c, is 10% and above, we prefer insulin therapy until we rest the pancreas and provide life change adaptation."
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How should diabetics eat?
Stating that proper and balanced nutrition is important in diabetics, Dr. Güzin Oğuz Yıldırım said, "When creating a nutrition plan for diabetics, our aim is to provide and maintain individualized goals in blood glucose levels, lipid profile, blood pressure and body weight that will reduce the risk of cardiovascular disease by ensuring the formation of healthy eating habits specific to the individual and supporting practices."
Even weight loss of around 5% reduces insulin resistance
Stating that even weight loss of around 5% in overweight and insulin-resistant obese individuals reduces insulin resistance, Dr. Yıldırım said, "Therefore, weight loss is recommended for overweight or obese individuals at risk of diabetes. The initial weight of the patient can be reduced by 5-7% with structured programs focused on lifestyle change, including less than 30% of energy from fats, regular physical activity and regular monitoring. Reducing 500-750 kcal from daily energy intake provides 2-3 kg weight loss per month."
Low carbohydrate diet may increase LDL-cholesterol levels
Emphasizing that low-carbohydrate diets that keep daily carbohydrate intake below 130 g are not recommended, Dr. Yıldırım said, "Low-carbohydrate diets provide similar weight loss to low-fat diets but increase LDL-cholesterol levels. The short-term positive effects of low-carbohydrate diets cannot be maintained in the long term. The Mediterranean diet, Dietary Approach Stop Hypertension (DASH) and plant-based diets are examples of healthy eating models; studies have shown positive results, but an individualized nutrition plan should focus on personal preferences, needs and goals rather than the implementation of specific dietary models."
Stomach reduction operations may be considered
Stating that 5-10% weight loss can be achieved when drug treatment, lifestyle change and physical activity are combined to reduce body weight, Dr. Yıldırım said, "Bariatric surgery Surgical intervention may be considered in individuals with type 2 diabetes with BMI >35 kg / m2. Studies on the risk and long-term benefits of bariatric surgery in individuals with prediabetes and diabetes are ongoing. Bariatric surgery should be performed in well-equipped centers with experienced physicians. These individuals should undergo a multidisciplinary, detailed examination in terms of previous dietary interventions, secondary causes of obesity and obesity-related risks before surgery, and lifelong follow-up in terms of metabolic and specific nutritional requirements starting from the perioperative period."
Carbohydrate counting should be learned
Dr. Güzin Oğuz Yıldırım noted that the dietary pattern required for good health should include carbohydrate foods such as whole grains, fruits, vegetables and low-fat milk.
Noting that low-carbohydrate diets that keep daily carbohydrate intake below 130 grams are not recommended in the treatment of diabetes, Dr. Yıldırım said, "Monitoring carbohydrate intake through carbohydrate counting, change lists or experience-based calculation is the key point in ensuring glycemic control. Type 1 and type 2 diabetics who self-adjust their insulin at mealtime or use an insulin pump should adjust their insulin dose according to their carbohydrate intake (carbohydrate/insulin: HR/I ratio). For this, the individual should be given detailed nutritional education for the calculation of HR count and HR/I ratio and insulin sensitivity factor (IDF), and the effect of carbohydrates on blood glucose should be explained by associating individual-specific blood glucose measurement results and food consumption records."
