Innovations and technological advances in treatment methods, as well as developments that are gradually leading to production of an artificial pancreas and modern glucose meters that operate just like smartphones, are aimed to increase the life quality of diabetics.
Diabetes, which has an adverse effect on life quality and lifespan by progressing silently when not diagnosed, is a disease of which the rate of incidence has been on the rise lately. What is more is that many diabetics are not even aware that they have the disease! In fact, most of them are content to describe themselves as “having a sweet tooth”. Being aware of the presence of diabetes and performing the necessary lifestyle changes is essential in preventing the damage this disease may cause. In this article, we share with you the information we received from Doctor Yaser Süleymanoğlu, an internal diseases specialist in the Diabetes Clinic of Acıbadem Bağdat Street Outpatient Clinic, on diabetes, treatment methods and patient-friendly technological products for diabetics.
What is the significance of diabetes in relation to human health?
Diabetes is a disease that needs to be analyzed extensively. The disease, which can be briefly described as blood sugar imbalance, glucose level is higher than normal. This condition leads to short or long term damage in organs. The rate of incidence for diabetes has been increasing in recent years. This disease, which is usually accompanied by fatness (in other words, obesity), is more common in metropolises. The burden of diabetes, as well as the health problems it causes, are very heavy. The disease has many adverse effects, such as vision problems, cardiac disorders, damage to nerve endings and decrease in the lifespan.
The number of those who have the disease without being aware of it is not low at all. What symptoms does the disease manifest itself with?
Diabetes develops in two forms, which are type 1 and type 2. Type 1 diabetes generally develops in children. It can manifest itself through sudden stress, severe influenza or urinary tract infection without revealing any indications beforehand. The children who are diabetics are generally brought in for consultation with problems such as frequent urination and mouthy dryness. The disease can be diagnosed instantly through detection of a high glucose level in the urine or blood of patients. These children, however, comprise only 5% of the total diabetic population. In treatment of type 1 diabetes, the patients are started on insulin right away and placed under close supervision. The real problem involves the patients that are in the remaining 95% of the population. This group, which generally involves individuals over the ages of 35 or 40, consist of overweight people with a family history of diabetes who do not exercise or eat healthy. Those who work all day long without caring to eat and end up in front the fridge frequently during the evening are also in this group. The disease generally tends to progress slowly and insidiously in these people’s bodies.
It emerges with symptoms such as having a sweet tooth, being frustrated when hungry, becoming sleepy after meals and craving for specific foods. Type 2 diabetes itself appears in two forms, which are borderline diabetes, a condition that does not show symptoms, and normal diabetes, a disease that emerges with certain symptoms. The group with the highest risk consists of people with borderline diabetes. Since these people do not feel the need to consult a doctor, they do not become aware of the fact that they have a medical condition. They simply believe that they love food and gain weight due to this. The ones with normal diabetes, on the other hand, are diagnosed and given treatment quickly.
Is it possible to fully recover from diabetes?
The cases in which the disease is apparent, 50 to 60% of the pancreas is already lost. Therefore, diabetes is a condition which is for life. Treatment requires changes in lifestyle, healthy eating, exercise and medications. Medications may not become necessary in cases where the disease can be kept under control with exercise and a healthy diet. In other cases, however, patients need one or two drugs. Sometimes it is also necessary for patients to use insulin in addition to drugs. What is important here is for the blood glucose level to be kept properly under control. This ensures prevention of organ damage that may arise from diabetes.
Could you tell us about the developments in the treatment of this disease which affects the whole world?
Diabetes treatment requires lifestyle changes and medical therapy.
“The rate of incidence for diabetes has been increasing in recent years. This disease, which is usually accompanied by fatness (in other words, obesity), is more common in metropolises.”
Medical therapy involves use of pills or insulin, or, both. There are also technological developments which are reflected in products that increase patient comfort. For instance, it was possible for glucose meters to yield wrong results in the past; now, however, it is possible for blood glucose to be measured in 3 to 10 seconds with results of high accuracy that are very close to actual glucose levels. Furthermore, certain modern computer programs help in calculation of the daily dietary needs of patients, based on the fat, protein and sugar levels in the foods consumed. These are very important in monitoring of patients.
Another development in this field involves sensors used by people who need to measure their blood glucose level frequently. The sensors, which are placed under the skin, will gradually become available for public use in one or two years. These sensors, of which laboratory processes are completed and tests are finished, can currently be used to monitor blood glucose levels through a mobile phone application. The biggest problem in diabetes treatment is the loss of consciousness which occurs in cases of low blood glucose level or hypoglycemia, mainly known as diabetic coma. This circumstance, which is most undesirable for doctors, can be encountered in those who use insulin and medications that lower blood glucose. Insulin pumps, which come to the fore in this case, can be used to increase patient comfort under current circumstances. The system of these methods determine the amount of insulin required by the body. Another exciting development in the field is the artificial pancreas! The pancreas releases insulin when the blood level increases and secretes glucagon, which has effects that are opposite to those of insulin, when the blood level decreases. Since there are currently no products that are capable of performing both these functions, the patients need to take these hormones externally. Therefore, the artificial pancreas is considered to be a development which will increase patient comfort significantly.
What measures can be taken to prevent the disease?
Modern laboratory techniques make it possible to determine whether an individual will develop diabetes in the following 5 or 6 years. Insulin resistance tests, oral glucose tolerance tests and genetic factors are very helpful in this process. The number of current medical treatment options are much higher than that of the past. Now there are new-generation drugs that stimulate the pancreas. These make combined treatments possible. The drugs are no longer determined via trial and error.
IS OBESITY SURGERY THE ANSWER TO DIABETES?
Obesity, of which the prevalence has increased rapidly in not only our country but also the rest of the world, entails many other diseases. While doctors attempt to control obesity via recommending lifestyle changes and healthy eating, surgery can be an option for patients that are at advanced stages. Obesity operations, which are collectively referred to as “bariatric surgery”, have become very common in recent times. Doctor Yaser Süleymanoğlu states that these operations, which enable weight loss, are very helpful for those with type 2 diabetes and says, “It is especially essential for overweight patients with high insulin resistance who do not respond to medical treatment and continue to gain weight to undergo this surgery in order to prevent damage to organs. Obesity surgery has two types, which are gastric sleeve and gastric bypass. The type of operation to be performed on patients is determined via cooperation of a diabetes specialist and a surgeon. When performed properly on suitable patients and followed by regular checks, these operations are significantly successful. However it is very important for them to be carried out on patients who are fit for it”.