One out of every 7 adults in Turkey has Type-2 diabetes. Many people are unaware that they have diabetes because the disease does not show any symptoms at first. Specialists recommend blood glucose tests for early diagnosis for those who are overweight, patients with high blood pressure, and those over 45 years old. Yeditepe University Hospitals Internal Medicine and Endocrinology Specialist answered questions about Type-2 Diabetes and Type-2 Diabetes treatment. 

What is Type-2-Diabetes?

It is possible to define Type-2 diabetes as a condition in which blood glucose rises due to the inability of the pancreas to secrete enough insulin or the insufficient use of the secreted insulin. It is a common disease worldwide.

What is the Frequency of Type-2 Diabetes?

The incidence of Type-2 Diabetes in Turkey was found to be .7 among adults. In other words, 1 out of every 7 adults has diabetes. If we add prediabetes to this, we can say that 30% of the adult population has diabetes or prediabetes. People with Type-2 diabetes make up 95% of people with diabetes.

What are the Causes of Type-2 Diabetes?

Genetic predisposition, obesity, and physical inactivity are among the factors that trigger Type-2 diabetes. Apart from this, for women with gestational diabetes or giving birth to a baby weighing more than 4 kg, diseases such as hypertension and high cholesterol are among the risk factors for Type-2 diabetes. We can say that the highest risk factor is family history, namely genetics. However, it would be wrong to use a definite statement that every person with a family history will also have Type-2 diabetes. The highest risk factor among environmental factors is weight.

What is the Blood Glucose Level in Healthy People Without Diabetes?

Under normal conditions, a healthy person's fasting blood glucose should be below 100 mg/dl. If it rises above 125 mg/dl, we consider blood glucose "high". This condition is also called diabetes.

Does It Need a Continuity? Or Can Type-2 Diabetes be Diagnosed When This Data is Detected in an Instantaneous Sugar Measurement?

If it is above this value in at least two measurements, a diagnosis of Type-2 diabetes is made. If the figure is between 100-125 mg/dl, it is called prediabetes, which is popularly known as latent diabetes. A person with prediabetes has a 40% chance of developing Type-2 diabetes within 10 years.

Could Measures to Be Taken Postpone This Period or Even Prevent Type-2 Diabetes at All?

It is possible to prevent or postpone this by making lifestyle changes. If a person has a sedentary life, he/she can reduce this possibility by exercising regularly, losing excess weight, eating a healthy and balanced diet, and quitting smoking and alcohol use.

What Are the Symptoms of Type-2 Diabetes?

Mild diabetes has no symptoms. In moderate and severe diabetes, the symptoms begin to be evident. Frequent urination, dry mouth, drinking a lot of water and delayed healing of skin wounds are the most common symptoms. These symptoms begin to appear when the patient's blood glucose rises above 180 mg/dl. When it is below this level, it usually does not show any symptoms and is silent. If the patient does not have his/her blood glucose measured, he/she continues his/her life without realizing that he/she has diabetes.

Is There a Possibility of Healing a Patient Diagnosed with Type-2 Diabetes?

Unfortunately, it is not possible to eliminate Type-2 diabetes. However, it is possible to put the disease to sleep when you reverse the factors that cause the disease in the patient. We call this "remission". In this case, if the patient starts medication, eats regularly and healthily, and exercises, diabetes returns to normal. However, if inactivity begins, he/she gains weight and eats unhealthily, diabetes-related complaints will return.

There is an important point here. When diabetes is put to sleep, it is possible to reduce the risk to be created by Type-2 diabetes for other diseases. It is also possible to eliminate diseases that can be caused by diabetes, such as heart attack, stroke, vascular occlusion, visual disturbances, and kidney failure due to Type-2 diabetes.

In Which Age Groups Is Type-2 Diabetes More Common?

Type-2 diabetes usually occurs after the age of 45. For this reason, it is necessary to measure blood glucose once a year after the age of 45. However, people under the age of 45 who have risk factors for diabetes may also need to have their blood glucose measured at least once a year.

Type-2 diabetes is highly associated with obesity. As the prevalence of obesity in children increases, the incidence of Type-2 diabetes also increases. This is the main reason for the increase in the incidence of Type-2 diabetes in children, especially in recent years.

How to Treat Type-2 Diabetes?

In Type-2 diabetes, treatment is applied according to the blood glucose level of the patients. If the patient's blood glucose is very high and the symptoms are severe, insulin therapy is started. In mild or moderate diabetes patients, we start treatment with oral medications. If the blood glucose of the patient we follow up with for 3 or 6 months does not decrease, then we start insulin therapy. The aim here is to control blood glucose rather than which treatment to give.

What Is Effective in the Success of the Treatment Apart from Medication Treatment?

The basis of treatment is nutrition and weight control. Even when a person receives insulin therapy, he/she cannot control his/her blood glucose if he/she eats desserts, pastries, and baklava. As a result, Type-2 diabetes is not a disease that can be controlled only with medication treatment.

However, it is necessary to change the lifestyle. Therefore, the patient himself/herself and what he/she does or does not do are very important in the success of the treatment.

What to Do to Prevent Type-2 Diabetes?

Especially people with a family history should pay attention to their lifestyle, and he/she should control his/her weight and exercise regularly. If he/she is over the age of 45, he/she should have his/her blood glucose level measured once a year.

Some endocrine diseases such as blood pressure, heart diseases, cholesterol patients, obesity, PCOS, hyperthyroidism, Cushing's syndrome, and some hormonal diseases such as acromegaly can also cause diabetes. For this reason, it is beneficial to screen people with the aforementioned diseases for diabetes.

Is There a Possibility of Healing a Patient Diagnosed with Type-2 Diabetes?

Unfortunately, it is not possible to eliminate Type-2 diabetes. However, it is possible to put the disease to sleep when you reverse the factors that cause the disease in the patient. We call this "remission". In this case, if the patient starts medication, eats regularly and healthily, and exercises, diabetes returns to normal. However, if inactivity begins, he/she gains weight and eats unhealthily, diabetes-related complaints will return.

There is an important point here. When diabetes is put to sleep, it is possible to reduce the risk to be created by Type-2 diabetes for other diseases. It is also possible to eliminate diseases that can be caused by diabetes, such as heart attack, stroke, vascular occlusion, visual disturbances, and kidney failure due to Type-2 diabetes.

In Which Age Groups Is Type-2 Diabetes More Common?

Type-2 diabetes usually occurs after the age of 45. For this reason, it is necessary to measure blood glucose once a year after the age of 45. However, people under the age of 45 who have risk factors for diabetes may also need to have their blood glucose measured at least once a year.

Type-2 diabetes is highly associated with obesity. As the prevalence of obesity in children increases, the incidence of Type-2 diabetes also increases. This is the main reason for the increase in the incidence of Type-2 diabetes in children, especially in recent years.

How to Treat Type-2 Diabetes?

In Type-2 diabetes, treatment is applied according to the blood glucose level of the patients. If the patient's blood glucose is very high and the symptoms are severe, insulin therapy is started. In mild or moderate diabetes patients, we start treatment with oral medications. If the blood glucose of the patient we follow up with for 3 or 6 months does not decrease, then we start insulin therapy. The aim here is to control blood glucose rather than which treatment to give.

What Is Effective in the Success of the Treatment Apart from Medication Treatment?

The basis of treatment is nutrition and weight control. Even when a person receives insulin therapy, he/she cannot control his/her blood glucose if he/she eats desserts, pastries, and baklava. As a result, Type-2 diabetes is not a disease that can be controlled only with medication treatment. However, it is necessary to change the lifestyle. Therefore, the patient himself/herself and what he/she does or does not do are very important in the success of the treatment.

What to Do to Prevent Type-2 Diabetes?

Especially people with a family history should pay attention to their lifestyle, and he/she should control his/her weight and exercise regularly. If he/she is over the age of 45, he/she should have his/her blood glucose level measured once a year.

Some endocrine diseases such as blood pressure, heart diseases, cholesterol patients, obesity, PCOS, hyperthyroidism, Cushing's syndrome, and some hormonal diseases such as acromegaly can also cause diabetes. For this reason, it is beneficial to screen people with the aforementioned diseases for diabetes.

What to Eat in Type-2 Diabetes?

• The first rule is regular nutrition. People with diabetes should eat three meals without skipping meals.
• The second rule is that they should avoid all foods and beverages containing white flour and sugar, known as simple carbohydrates. They should also consume brown flour and grain products in limited quantities. They can eat bread made from brown flour, provided that they do not exceed 2 slices in one meal. However, if there are starch-containing carbohydrates such as rice, pasta, and potatoes in the meal, bread should not be consumed. In this sense, it is necessary to maintain a good balance in carbohydrate consumption.
• In general, it can be said that the Mediterranean diet is beneficial for Type-2 diabetes patients. A diet with plenty of vegetables, greens, olive oil, and red meat at a moderate level, where white meat can be added to meals from time to time, and plenty of grain products and fruits is ideal for diabetic patients.
• The first rule is regular nutrition. People with diabetes should eat three meals without skipping meals.
• The second rule is that they should avoid all foods and beverages containing white flour and sugar, known as simple carbohydrates. They should also consume brown flour and grain products in limited quantities. They can eat bread made from brown flour, provided that they do not exceed 2 slices in one meal. However, if there are starch-containing carbohydrates such as rice, pasta, and potatoes in the meal, bread should not be consumed. In this sense, it is necessary to maintain a good balance in carbohydrate consumption.
• In general, it can be said that the Mediterranean diet is beneficial for Type-2 diabetes patients. A diet with plenty of vegetables, greens, olive oil, and red meat at a moderate level, where white meat can be added to meals from time to time, and plenty of grain products and fruits is ideal for diabetic patients.