Let's learn everything about Diabetes Mellitus simply and accurately!

Diabetes is a disease that is being talked about by many people today, and perhaps even a little scary in your mind. Some people also call it 'sugar disease'. What exactly is diabetes? Let's talk about it clearly, in a way that you can understand. Don't be afraid, once you understand it properly, managing it is not a big deal.

Simply put, diabetes is a condition in which your blood sugar (or glucose ) levels are consistently high. This happens because your pancreas doesn't make enough of the hormone insulin , or because your body's cells don't respond properly to the insulin it makes. It can develop at any age. Many types of diabetes are lifelong (chronic), but all types can be controlled with medication and lifestyle changes.

Our bodies get most of their glucose, or sugar, from the foods we eat, especially foods that contain carbohydrates (like rice, bread, and sweets). This glucose is the main fuel that gives energy to our body's cells. It's like gasoline for a car. So, this glucose needs to go into the cells from the blood to make energy. Think of glucose as someone trying to enter a house, and they need a key to get into that house. That key is insulin. This hormone called insulin is made by our organ called the pancreas.

Now, if your pancreas doesn't make enough of this insulin key, or if it does, but your body's cells don't open the door properly (i.e., don't respond to insulin properly), that glucose can't get into the cells. Then all that glucose builds up in the blood, and the blood sugar level just goes up. This is what we call high blood sugar (hyperglycemia) .

If blood sugar levels remain high for a long time, many health problems can occur, such as heart disease, nerve damage, and eye problems.

The medical name for diabetes is Diabetes Mellitus . There is another disease with the word 'diabetes' in it, called Diabetes Insipidus . But it is very different from the diabetes we are talking about. The name 'diabetes' has been given to both of them because they both cause excessive thirst and frequent urination. However, Diabetes Insipidus is very rare.

Common Types of Diabetes

Okay, now let's look at the main types of diabetes. You may have heard of these names.

Type 2 Diabetes

This is the most common type of diabetes. It occurs when your body doesn't make enough insulin, or your body's cells don't respond to insulin properly. We call this insulin resistance . Imagine that key in the door lock is rusty and doesn't work properly. This mostly affects adults, but it can also happen to young children.

Prediabetes

This is actually a stage before the development of Type 2 Diabetes. Your blood sugar levels are higher than normal, but not high enough to be diagnosed with Type 2 Diabetes. It's like a yellow light, a warning sign . If you manage it properly at this stage, you can prevent or delay the development of Type 2 Diabetes.

Type 1 Diabetes

This is an autoimmune disease . That is, your own body's immune system, for some unknown reason, attacks and destroys the insulin-producing cells in your pancreas. It's like our own army attacking our own camp. About 10% of people with diabetes have this type. It's most often diagnosed in children and young adults, but it can develop at any age.

Gestational Diabetes

This is a type of diabetes that some women develop during pregnancy. It often goes away after the baby is born. However, if you develop diabetes during pregnancy, you are at higher risk of developing Type 2 Diabetes later in life.

Other Types of Diabetes

In addition to these main types, there are several other types of diabetes. They are a little rarer, but it's good to be aware of them.

• Type 3c Diabetes: This occurs when there is damage (not autoimmune damage) to your pancreas, affecting its ability to make insulin. For example, diseases such as pancreatitis, pancreatic cancer, cystic fibrosis, and hemochromatosis can cause this condition. This type of diabetes can also occur if the pancreas is surgically removed (pancreatectomy).
• Latent Autoimmune Diabetes in Adults (LADA): This is also caused by an autoimmune reaction, like Type 1 Diabetes, but it develops in a much older population than Type 1. People diagnosed with LADA are usually over the age of 30.
• Maturity-Onset Diabetes of the Young (MODY): This is also called monogenic diabetes . It is caused by a genetic mutation that is passed down through generations. This mutation affects the way your body makes and uses insulin. There are more than 10 types of MODY. About 5% of people with diabetes may have this type, and it often runs in families.
• Neonatal Diabetes: This is a very rare type of diabetes that develops in babies within the first six months of life. This is also a type of monogenic diabetes.
• Brittle Diabetes: This is a severe form of Type 1 Diabetes. It is characterized by frequent and severe episodes of high blood sugar and low blood sugar.

How Common is Diabetes?

Diabetes is actually a more common disease than you might think. Millions of people around the world live with diabetes. Type 2 Diabetes is the most common type. Statistics show that the number of people with diabetes is increasing in our country as well. Therefore, it is very important to be aware of this.

What are the symptoms of diabetes? (What are the Symptoms of Diabetes?)

The symptoms of diabetes can vary from person to person, and they can also vary depending on the type of diabetes. But there are some common symptoms that you may experience. If you have any of these, it's best to see a doctor for advice.

Common symptoms:

• Frequent excessive thirst (polydipsia) and dry mouth.
• Frequent need to urinate (especially at night)
• Excessive tiredness and fatigue despite sleeping well.
• Blurred vision.
• Unexplained weight loss (especially in type 1 diabetes)
• Numbness or tingling in the limbs.
• Wounds take time to heal.
• Frequent yeast infections of the skin and/or vagina.

Important: If you or your child has these symptoms, be sure to see a doctor.

Now let's see how the symptoms vary depending on the type of diabetes:

Symptoms of Type 1 Diabetes:

Symptoms of Type 1 Diabetes can appear very quickly, over a few weeks or months. Sometimes, symptoms can begin with signs of a dangerous complication called Diabetes-related Ketoacidosis (DKA) . DKA is a life-threatening condition that requires immediate medical attention. Symptoms of DKA include vomiting, stomach pain, a fruity smell to the breath, and difficulty breathing.

Symptoms of Type 2 Diabetes and Prediabetes:

In these types, you may not have any symptoms at all. Or you may not notice them because the symptoms come on so slowly. Sometimes, a simple blood test can reveal high blood sugar levels. Another sign of prediabetes is darkening of the skin in some areas of your body (such as your neck and armpits). This is called acanthosis nigricans .

Symptoms of Gestational Diabetes:

You may not usually notice the symptoms of gestational diabetes during pregnancy. Your doctor will test you for it between 24 and 28 weeks of pregnancy.

What Causes Diabetes?

Regardless of the type of diabetes, diabetes occurs when your blood glucose levels are too high. However, the cause of this high blood sugar level varies depending on the type of diabetes.

Here are the main reasons:

• Insulin Resistance: This is the main cause of Type 2 Diabetes. It can be caused by obesity, lack of exercise, poor diet, hormonal imbalances, genetic influences, and some medications.
• Autoimmune Disease: Type 1 Diabetes and LADA occur when your own immune system attacks the insulin-producing cells in your pancreas.
• Hormonal Imbalances: During pregnancy, hormones released by the placenta can cause insulin resistance. Also, other hormone-related diseases such as acromegaly and Cushing's syndrome can cause diabetes.
• Pancreatic Damage: Physical damage to the pancreas can affect its ability to produce insulin, leading to Type 3c Diabetes.
• Genetic Mutations: Certain genetic mutations can cause MODY and neonatal diabetes.

Long-term use of certain medications (e.g., medications for HIV/AIDS, corticosteroids) can also cause diabetes.

What are the complications of diabetes? (What are the Complications of Diabetes?)

If diabetes is not properly controlled, a number of acute and long-term complications can occur.

Acute complications of diabetes:

These can be life-threatening and require immediate medical attention:

• Hyperosmolar Hyperglycemic State (HHS): Blood sugar levels become very high, causing severe dehydration and confusion.
• Diabetes-related Ketoacidosis (DKA): When the body lacks insulin, fat is burned to form ketones, which makes the blood acidic.
• Severe hypoglycemia: A very low blood sugar level. Common in people taking insulin. Immediate glucagon treatment may be necessary.

Long-term complications of diabetes:

If blood sugar levels remain high for a long time, blood vessels and nerves are damaged.

• Cardiovascular system problems: Coronary artery disease, heart attack, stroke, atherosclerosis.
• Nerve damage (Neuropathy): numbness, pain.
• Nephropathy: Kidney failure.
• Eye disease (Retinopathy): blindness.
• Diabetes-related foot problems, skin infections, and amputations.
• Sexual dysfunction, gastroparesis, hearing loss, oral health problems (e.g., periodontal disease).

Living with diabetes can also affect your mental health. People with diabetes are more likely to develop depression .

How is Diabetes Diagnosed?

Doctors diagnose diabetes by checking your glucose levels with a blood sample. There are three main tests:

• Fasting Blood Glucose Test: A test performed after fasting for 8 hours.
• Random Blood Glucose Test: Can be done at any time.
• A1c test (HbA1c test): Shows average blood sugar levels over the past 2-3 months.

An oral glucose tolerance test is performed to diagnose gestational diabetes.

How is Diabetes Managed?

There are four main areas of diabetes management:

• Blood Sugar Monitoring: This can be done with a glucose meter or a continuous glucose monitor (CGM).
• Oral Diabetes Medications: Medications such as Metformin, which are commonly prescribed for type 2 diabetes and prediabetes.
• Insulin: Essential for type 1 diabetes. Some type 2 patients also need it. It can be taken as a syringe, pen, pump, or inhaled insulin.
• Diet: A healthy diet and counting carbohydrates are important.
• Exercise: Regular exercise increases insulin sensitivity.

Also, maintaining a healthy weight , blood pressure , and cholesterol levels is very important.

Prognosis for Diabetes

The future of diabetes depends on the type of disease, how it is managed, the age at diagnosis, other diseases, and complications.

But, the most important thing is that you can live a healthy life with diabetes. To do this, lifestyle changes, regular exercise, diet control, and regular blood sugar testing are essential.

Studies show that maintaining A1c levels below 7% can reduce the risk of complications.

How Can I Prevent Diabetes?

Autoimmune and genetic types of diabetes cannot be prevented. However, you can reduce your risk of developing prediabetes, type 2 diabetes, and gestational diabetes by doing the following:

• Eat a healthy diet (e.g. Mediterranean diet ).
• Be physically active (at least 30 minutes a day, 5 days a week).
• Maintain a healthy weight.
• Manage stress.
• Limit alcohol consumption.
• Get enough sleep.
• Quit smoking.

When Should I See My Healthcare Provider?

If you have not yet been diagnosed with diabetes, see a doctor immediately if you have symptoms of diabetes (e.g., excessive thirst, frequent urination).

If you have diabetes, see the doctor who helps you manage your diabetes (e.g., an endocrinologist) regularly.

Finally, remember this (Take-Home Message)

Being diagnosed with diabetes is a life-changing event. But that doesn't mean you can't live a happy, healthy life. Managing diabetes requires ongoing care and attention. While it may seem overwhelming at first, over time you will gain a better understanding of how to manage the condition and start to feel better about your body.

Be sure to see your doctors regularly. Managing diabetes is a team effort. You will need the support of medical professionals, friends, and family. Don't be afraid to ask them for help if you need it. Remember, you are not alone!

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