What is Diabetes (Sugar Disease)? A Comprehensive Information Guide

Diabetes, one of the most common chronic health problems today, is a serious condition affecting millions of people worldwide. Commonly known as "sugar disease," this condition occurs when the body loses its ability to regulate blood sugar levels. So, what exactly is diabetes and how does it affect the body? In this comprehensive guide, we will delve into the causes, symptoms, and different types of diabetes, starting with a basic definition.

Our guide provides detailed answers to the question "What is diabetes?" while also focusing on topics such as diabetes diagnosis, modern treatment methods, and practical management strategies that can be applied in daily life. Our aim is to provide our readers with the necessary tools to make informed decisions by offering a broad perspective, from preventing complications caused by diabetes to strategies for prevention. Early diagnosis and correct management strategies form the basis of living a high-quality life with this chronic condition.

What is diabetes?

Diabetes is a chronic condition that occurs when the body loses its ability to regulate blood sugar levels. Also known as sugar disease, this condition causes blood sugar levels to rise because the sugar (glucose) from food cannot enter the cells sufficiently. Our bodies need glucose for energy, but the transport of glucose to the cells requires the hormone insulin, produced by the pancreas.

The pancreas is responsible for regulating blood sugar by producing a hormone called insulin. Insulin acts as a key, allowing glucose from the food we eat to pass from the bloodstream into the cells. In diabetes, either the pancreas doesn't produce enough insulin (Type 1 diabetes) or the body's cells don't respond properly to the insulin produced. This is called insulin resistance (Type 2 diabetes). In both scenarios, glucose cannot enter the cells and accumulates in the blood, leading to high blood sugar levels. Uncontrolled high blood sugar can cause serious damage to various organs and systems in the body in the long term.

Diabetes is a rapidly spreading global health problem. According to the International Diabetes Federation (IDF), more than 537 million adults worldwide live with diabetes, and this number is projected to continue increasing. The situation is similarly serious in Türkiye. Current data from the Turkish Ministry of Health and epidemiological studies such as TURDEP-II show that approximately 15% of the adult population in our country has diabetes, and the number of individuals at risk of developing diabetes is also quite high.

Causes and Risk Factors of Diabetes

There is no single cause for the development of diabetes; genetic and environmental factors play a combined role in the process. At its core, the disease stems from the pancreas's inability to produce sufficient insulin or the body's inability to efficiently utilize the insulin produced. Various diabetes causes and risk factors trigger these underlying mechanisms and pave the way for the disease. Understanding these diabetes causes and risk factors is critical for prevention and management.

Although the mechanisms by which different types of diabetes develop vary, lifestyle habits and genetic inheritance play a major role in the development of Type 2 diabetes in particular. The main diabetes risk factors that can trigger this condition are:

• Genetic Predisposition: A family history of diabetes, especially in first-degree relatives, increases the risk of developing the disease. Genetic predisposition, when combined with other risk factors, raises the likelihood of developing diabetes.
• Obesity and Excess Weight: A high body mass index, and especially abdominal fat, are among the most important factors triggering the development of insulin resistance. Excess weight makes it difficult for the body to use insulin efficiently, forcing the pancreas to work harder and eventually leading to fatigue.
• Lack of Physical Activity: A sedentary lifestyle not only increases the risk of obesity but also reduces the sensitivity of cells to insulin. Regular exercise, on the other hand, acts as a natural mechanism for regulating blood sugar.
• Age: Advancing age, especially after 45, is a significant risk factor for Type 2 diabetes. With age, the slowing of metabolism and weakening of pancreatic function can predispose individuals to unbalanced blood sugar levels.
• Polycystic Ovary Syndrome (PCOS): This hormonal disorder, which affects women, is often accompanied by insulin resistance and significantly increases the risk of type 2 diabetes.
• High Blood Pressure (Hypertension): Persistently high blood pressure is closely related to diabetes. Both conditions represent a common risk factor for cardiovascular disease and may indicate a problem with the body's overall metabolic balance.
• High Cholesterol and Triglyceride Levels: High levels of bad cholesterol (LDL) and triglycerides in the blood not only threaten heart health but are also a major component of metabolic syndrome, which accelerates the development of Type 2 diabetes.
• Previous Gestational Diabetes: Gestational diabetes that develops during pregnancy and resolves after delivery is a significant indicator of an increased risk of developing Type 2 diabetes in the future for both mother and baby.
• Unhealthy Eating Habits: A diet rich in sugary drinks, processed foods, and saturated fats disrupts blood sugar balance, directly increasing the risk of diabetes.
• Stress: Long-term and intense stress can raise levels of hormones like cortisol in the body, negatively affecting blood sugar balance and contributing to the development of diabetes.

What are the symptoms of diabetes?

Diabetes is a chronic condition in which the pancreas produces insufficient insulin or the body cannot use insulin effectively, leading to elevated blood sugar levels and potentially serious long-term health problems. Early diagnosis is crucial in preventing these complications, so being aware of common diabetes symptoms is extremely important. Symptoms often develop gradually and may initially be underestimated, but can worsen over time. Here are some common symptoms of diabetes and the underlying causes:

• Frequent Urination (Polyuria): The body tries to eliminate excess glucose through urine to balance elevated blood sugar levels. This causes the kidneys to work harder than normal, increasing urine production. Frequent awakenings, especially at night, are a significant sign of this symptom.
• Excessive Thirst (Polydipsia): Frequent urination leads to fluid loss (dehydration) in the body. To compensate for this loss, the body constantly sends thirst signals. Therefore, a person may feel that they cannot quench their thirst no matter how much water they drink.
• Unexplained Weight Loss: When cells cannot obtain the glucose they need for energy, the body begins to burn muscle and fat tissue as alternative fuel. Weight loss despite adequate nutrition is among the common symptoms of diabetes, especially in Type 1 diabetes.
• Excessive Hunger (Polyphagia): The body constantly sends hunger signals to compensate for the energy deficit because cells cannot utilize glucose in the blood. This leads to a feeling of fullness even shortly after eating, and a constant desire to eat.
• Fatigue and Energy Deficiency: The inability of cells to efficiently use glucose for energy leads to feelings of constant fatigue and exhaustion. This reduces motivation to perform daily activities.
• Blurred Vision: High blood sugar can affect the structure of the eye's lens, causing it to swell and leading to focusing problems. This results in blurred vision and usually resolves when blood sugar levels return to normal.
• Slow-Healing Wounds and Frequent Infections: High sugar levels weaken the immune system and impair blood circulation. As a result, wounds heal more slowly, and the body becomes more susceptible to conditions such as urinary tract or skin infections.
• Numbness or Tingling in Hands and Feet (Neuropathy): Long-term uncontrolled high blood sugar can damage nerves. This condition manifests itself with symptoms such as numbness, tingling, or loss of sensation, especially in the hands and feet, and is called diabetic neuropathy.
• Skin Problems: Diabetes can cause dryness, itching, and dark spots (acanthosis nigricans) on the skin, especially in areas like the neck or armpits.

What are the types of diabetes?

Diabetes is not a single disease; it refers to a group of metabolic disorders with different causes that lead to blood sugar imbalance. There are various types of diabetes, primarily resulting from insufficient insulin production or the body's inability to use it effectively. Each type has its own specific causes, symptoms, and treatment approaches.

How is diabetes diagnosed?

Early diagnosis of diabetes is vital for disease management and the prevention of potential complications. Diagnosis is usually made through blood tests that consider symptoms and risk factors. During this process, physicians evaluate laboratory results using a holistic approach based on specific criteria.

One of the most common methods used in diagnosing diabetes is fasting blood sugar measurement. This test is performed after the person has fasted for at least eight hours. In a normal individual, fasting blood sugar is expected to be below 100 mg/dL. If the measurement result is between 100-125 mg/dL, this is interpreted as "prediabetes" (latent diabetes). A value of 126 mg/dL and above strengthens the diagnosis of diabetes. To confirm the diagnosis, this test is usually repeated on a different day.

Another important diagnostic method is the Oral Glucose Tolerance Test (OGTT). In this test, after an initial blood sample is taken on an empty stomach, the individual is given a liquid containing a standard amount of glucose to drink, and blood sugar levels are measured again after two hours. Normally, the blood sugar value at the second hour should be below 140 mg/dL. A value between 140-199 mg/dL is called prediabetes (glucose intolerance). An OGTT result of 200 mg/dL or higher is a strong criterion for diagnosing diabetes. The OGTT test is used to clarify the situation, especially in individuals with borderline fasting blood sugar levels.

Another modern test frequently used in the diagnosis and monitoring of diabetes is HbA1c (glycated hemoglobin) measurement. This test does not require fasting and can be performed at any time of day, as it shows the average blood sugar level over the past two to three months. An HbA1c value below 5.7% is considered normal. A value between 5.7% and 6.4% indicates prediabetes, while an HbA1c value of 6.5% and above confirms a diagnosis of diabetes. This test is very useful for screening for diabetes in asymptomatic individuals and monitoring blood sugar control in patients undergoing treatment.