Diabetes

It is a lifelong disease that progresses with high blood sugar and causes damage to many vital organs in our body (eyes, heart and kidneys).

Insulin; It tries to ensure that the blood sugar secreted by the pancreas, after the nutrients taken with food are absorbed from the intestines and mixed into the blood, is stored by the liver and burned by the muscles to be used as energy.

If the insulin hormone does not perform this process completely, blood sugar remains constantly high and diabetes occurs.

Types of Diabetes

Type I DM (Insulin dependent DM)

In these patients, insulin production is almost non-existent. It occurs at a very early age. Even in periods when there are no clinical symptoms yet, diagnosis can be made by detecting a substance called antibodies in the blood. These proteins called antibodies stop the production of insulin by killing the insulin-secreting beta cells produced by the body’s immune system. For this reason, insulin must be used in the treatment of type I DM patients. The incidence is between 10-15%, age is 35< is seen more frequently. In its treatment; Insulin+diet+exercise

Type II (Non-insulin dependent DM)

There is insufficiency in insulin secretion or resistance to insulin in the tissues. It is seen at the age of 35 and above. The incidence is slightly higher in women. It is very closely related to obesity. In treatment; Diet + Exercise + Oral Antibiotic + Insulin

Diagnosis of Diabetes

Diagnosis is made if the 8-hour fasting glucose level is above 126 mg/dL when measured for the first time.

A glucose tolerance test is performed to detect hidden sugar. If it is above 200 mg/dL measured in 2 hours, the diagnosis is made. If it is between 140-200, there is impaired glucose tolerance and these people are candidates for diabetes in the future.

Symptoms of Diabetes

Frequent feeling of hunger and thirst
Urinating very frequently
Eating too much but still losing weight
Blurred vision
Frequent infections
Delayed healing of wounds,
Numbness in hands and feet
Redness and dryness of the skin
Fatigue and weakness
Itching in genital organs
Gestational Diabetes
It is mostly seen in the last three months of pregnancy. It may pass after birth or continue as type II DM. 40% may develop DM within 15 years.

Treatment: Diet + Exercise + Insulin

Complications

It affects almost every organ of the body and can cause permanent diseases in some. Today, diabetes is one of the most important causes of blindness all over the world. Likewise, one of the most common causes of kidney failure is diabetes.
Strokes affecting the brain vessels,
Heart attack, heart failure by affecting the cardiovascular vessels
As a result of involvement of leg veins; Severe leg pain occurs that increases while walking and relieves with rest.
In addition, high blood pressure causes numbness, tingling and pain in the feet and hands.
Sexual impotence, diarrhea and less commonly constipation,
Urinary incontinence
The frequency of stones in the gallbladder,
Osteoarthritis,
Drop in blood pressure when standing up,

There is no rule that these symptoms will necessarily appear. These diabetes-related disorders depend in part on the duration and severity of the disease.
According to research conducted in recent years, when diabetes is treated very well,
These symptoms either do not appear or are mild.

Treatment of Diabetes

Diet; Those who are obese should definitely be reduced to their ideal weight.
It should be eaten regularly as 3 main meals and 3 snacks every day.
Stay away from quickly absorbed carbohydrates (sugary foods) and solid fats
It is recommended to increase the consumption of fibrous foods.
Exercise; A conscious exercise ensures that the glucose accumulated in the muscles is burned. Blood sugar can be lowered by accelerating the use of sugars from foods by cells.
Blood pressure improves
Provides weight control
Increases joint movements.
Increases muscle strength.
Regulates blood fats
Increases HDL.
Reduces LDL.
Increases heart rate.
Reduces heart rate.
It is appropriate to exercise 1 hour after meals. Exercising on an empty stomach may cause hypoglycemia. If blood sugar is below 100mg/dL or insulin is 250mg/dL, exercise should be postponed. If insulin is used, insulin should not be applied to the active area during exercise. Example; If running, insulin should be administered to the arm, not the leg. Insulin administered to the active site may lower blood sugar and cause hypoglycemia.

As exercise;
Brisk walking (120 steps/1 minute)
walking jogging
Basketball, volleyball.

Insulin ;
It is the hormone that allows the sugar we get from food to enter the cell. The sugar entering the cell is used for energy and thus blood sugar does not rise.

Who needs insulin therapy?

Those with Type I DM
Pregnant women with Type II DM whose BG cannot be controlled with diet and exercise.
Those with type II diabetes that cannot be controlled with sugar pills,
Diseases caused by diabetes-related organ damage (Eye, Heart, Kidney),
Patients who underwent surgery
Diabetics with fever or infectious disease.

To which area is insulin applied?

On the upper outer part of the arms,
4 fingers outside the navel area,
To the lower outer parts of the legs,
To the upper outer part of the hips,

How to administer insulin;

Insulin should be applied to the subcutaneous tissue.
It is administered with an insulin syringe, insulin pens or insulin pumps. The subcutaneous tissue is lifted with two fingers and the metal part of the needle is inserted vertically all the way.
The direction of the needle should not be changed after it penetrates the skin.
Insulin is injected by pushing the plunger all the way.
Insulin should be given for 10-20 seconds before removing the needle to prevent it from escaping back out of the skin.
Insulins should NOT be frozen.
It should not be exposed to direct sunlight or heat source.
Insulin should not be administered through clothing.
It should not be applied to the same area continuously.
The area where insulin is administered must be clean and hands must be washed.

Hypoglycaemia

Blood sugar is below 50mg/dL.

Symptoms; Sweating, tremors, excitement, irritability, dizziness, headache, nausea, palpitations, weakness, confusion, difficulty speaking, pale facial color, feeling of faintness and cold sweat on the forehead, vomiting.

Reasons; Skipping or delaying meals, increased physical activity in any case, irregular increase of insulin or medication, excessive alcohol consumption.

Things to Do; Blood sugar measurement at the time of symptoms, drinking 1 glass of water with 3 or 4 sugar cubes (nothing is given orally to an unconscious person)
If there is a glucagon needle and we know how to inject it, it will be injected or directed to the nearest health center.

Hyperglycemia; It is a condition of increased blood sugar level.

Symptoms;Drinking too much water, dry mouth, blurred vision, frequent urination, fatigue

Reasons; Using less insulin, reducing the dose of medication, overeating, consuming sugary foods, any illness, excessive stress,

What needs to be done; Plenty of fluids (2-3 liters and liquid foods)
Controlling and renewing the meal and medication routine,