What is diabetes? What are the symptoms? How is it treated? What should diabetics do? Responding to the questions asked about, Turkey İşbank subsidiary Bayındır Kavaklıdere Hospital Endocrinology and Metabolic Diseases Section Leader Uzm. Dr. S. We learned from Şen ILGIN.
Diabetes, also known as diabetes in the middle of the public, is among the chronic diseases that are seen more and more every day. Diabetes, which does not only cause an increase in the sugar rate in the body, affects all vital organs of the body, from heart health to eye health. Stating that diabetes is a chronic and progressive disease that occurs when the insulin hormone in the body is deficient or inactive, Türkiye İş Bankası subsidiary Bayındır Kavaklıdere Hospital Endocrinology and Metabolic Diseases Section Leader Specialist. Dr. S. Şen ILGIN made statements about diabetes. Diabetes is a chronic metabolic disease that always requires medical care, which manifests itself as a result of a total or partial insufficiency or deficiency of insulin secretion of the pancreas, an organ located behind our stomach, manifested by the high level of sugar in the blood, and in which the organism cannot properly benefit from carbohydrates, proteins and fats. being defined.
SYMPTOMS OF DIABETES
Stating that the symptoms seen in diabetes are divided into classical symptoms and less common symptoms, Bayındır Kavaklıdere Hospital, a subsidiary of Türkiye İş Bankası, Head of Endocrinology and Metabolism Diseases Department, Dr. Dr. S. Şen ILGIN, “The classic symptoms of diabetes are drinking a lot of water, frequent urination, eating a lot or loss of appetite, weakness, fatigue, dry mouth, and urination at night. Less common symptoms include blurred vision, unexplained weight loss, persistent infections, recurrent fungal infections and itching.
HOW IS DIABETES DIAGNOSED?
In the diagnosis of diabetes, fasting blood glucose (FG), 75 g glucose test (OGTT) result, 2nd hour blood glucose, blood glucose taken at a random time (blood glucose measurement at a random time of the day, regardless of meal) and the hemoglobin A1c (HbA1c) results, which show the high blood sugar in the 8-10 weeks before the test, are very valuable. Dr. S. Şen Ilgın said, “The fasting blood sugar is higher than 126 mg/dl, the 2nd hour blood sugar as a result of the glucose load test, 200 mg/dl random blood sugar and hemoglobin A1c higher than 6.5% are diagnostic numeric cutoff costs. . Values whose blood sugar levels are higher than usual but do not meet the criteria for diabetes diagnosis are called prediabetes. Impaired sugar tolerance and impaired fasting sugar, previously referred to as borderline diabetes or publicly unknown sugar, are now accepted as prediabetes. Mind blood glucose 100-125 mg/dl, OGTT-2. If the hourly blood glucose is 140-199 mg/dl, random blood glucose is 140-199 mg/dl, and HbA1c is between 6-6.5%, the individual should be followed up with prediabetes. Prediabetes is the pre-diabetes condition and can turn into diabetes when conditions occur. Prediabetes is a valuable risk factor for diabetes and cardiovascular disease.” he said.
TYPES OF DIABETES
Exp. Dr. S. Şen Ilgın gave information about the most common types of diabetes, type 1 diabetes, type 2 diabetes and diabetes during pregnancy (gestational diabetes).
· Type 1 diabetes: It constitutes 10% of all diabetics. It is a condition characterized by absolute insulin deficiency, resulting from the destruction of the insulin-secreting beta cells in the pancreas by the immune system. It usually starts very suddenly under the age of 30. Patients are underweight or of normal weight. Long-term use of insulin is mandatory. If not used, coma and death develop.
· Type 2 diabetes: It constitutes 90% of diabetes patients. The majority of patients are overweight. It occurs as a result of insulin not being able to enter and use enough of the cell due to insulin resistance at the cellular level. It is usually seen over the age of 40 and can be diagnosed with its complications. It is insidious and slow-moving. It has a strong genetic predisposition and can be seen at an earlier age in the next generation as the genetic density increases in the family.
· Gestational diabetes (gestational diabetes): It is seen in 2-8% of pregnancies. It is a form of diabetes that occurs during pregnancy in women who do not have diabetes before. It occurs more than once during the last trimester of pregnancy. It usually resolves after birth. However, the possibility of recurrence in subsequent pregnancies is high. In order to investigate diabetes occurring during pregnancy, 24-28. It is recommended to perform a sugar load test in the middle of the week. Thus, the high blood sugar in the mother is detected in time and measures can be taken to prevent the harmful effects of this situation on the baby/fetus in the mother’s womb. Women diagnosed with GDM have a higher risk of developing type 2 diabetes in later years.
THINGS TO BE DONE BY PATIENTS WITH DIABETES
In the treatment of diabetes, educating the patient about diabetes, systematic training, providing a good diet, changes in life style, and administering medication in a form that will keep blood sugar at the target price are inseparable. Saying that it is a cut, Uzm. Dr. S. Şen Ilgın explained what should be done by diabetes patients:
· Patients should learn how to live with diabetes and what they should pay attention to when doing their self-care through the training of diabetes education nurses.
· 3-5 days a week, 30 minutes of walking should be done 1 hour after the meal.
· A good nutrition program should be made under the leadership of a nutritionist (dietician), if there are any problems with intermittent inspections, it should be emphasized, and weight control should be ensured.
· The indispensable treatment component in all periods is a change in life style. Proposals for dietary habits and physical activity, the two components of lifestyle change, should be determined individually based on the individual’s characteristics.
HOW SHOULD THE NUTRITION BE IN DIABETES?
Medical nutrition therapy should be started under the supervision of a nutritionist, whether there is a harmony problem, weight loss status and how these are reflected in blood tests should be checked with certain mediums. Dr. S. Şen Ilgın said, “Nutrition in individuals with diabetes should be individually planned, the necessary amount of food should be taken according to the needs of the person, and it should be eaten at appropriate times. Body weight suitable for height should be calculated, in case of overweight and obesity, further weight gain should be prevented first, and then weight loss should be aimed to protect health.
Exp. Dr. S. Şen Ilgın listed the things that diabetes patients should pay attention to as follows:
· Sugar and sugar-containing foods should be excluded from the diet. Low-carb diets that keep the daily carbohydrate intake below 130 g are not recommended. Low-carb diets provide similar weight loss as low-fat diets, but increase LDL-cholesterol levels. The short-term positive effects of low-carbohydrate nutrition models cannot be sustained in the long term. Carbohydrates should be adjusted to meet 45-65% of the daily power requirement (at least 130 g).
Protein intake is 0.8-1 g/kg (ideal weight)/day (15-20% of daily power requirement) considering the quality of dietary protein (protein ratio of animal and vegetable origin) as recommended for the non-diabetic population. si) is planned. White meat (fish, chicken, turkey) that is easier to digest should be preferred instead of red meat.
· Fat intake is calculated as 30% of daily power requirement. <7% of the daily power requirement is planned as saturated fat, 12-15% as monounsaturated fat. Trans fat intake should not exceed <1% of daily power requirement (2 g/day).
· Vitamin-mineral support is not recommended unless there are clinical or laboratory signs of deficiency. They should be tried to be taken naturally.
· Daily fiber consumption should be increased, it is calculated as 14 g/1000 kcal (25-35 g/day) according to the calories of the diet.
· Regular and planned eating should become a lifestyle. The diet should be tried to be implemented in every environment and in every situation, and when, where and what to eat should not be left to chance. Although the daily calorie requirement will be met, it should be tried to be fed with 3 main and 3 middle meals by paying attention to the food variety. It should be focused on individual preferences, neediness and goals rather than the application of nutritional models.
HEALTHY FOODS TO CHOOSE IN DIABETES
Carbohydrates: Cereals, flour and flour foods, legumes, potatoes, vegetables and fruits
Protein: Meat, eggs, cheese , milk, yogurt)
Fat: Foods containing fat and fat such as meat, cheese, milk, yogurt)
Vitamins and minerals: All foods, especially vegetables and fruits
Pulp: Vegetables, fruits, whole grains, legumes
