21. In the 21st century, diabetes has become one of the fastest growing chronic diseases in society. Over the past 20-30 years, the number of patients suffering from diabetes in the world has more than doubled. Currently, one in every 11 adults in the world has diabetes. It is estimated that there are 350 million diabetic patients in the world today. Unfortunately, our country has not been able to escape this rapid increase in diabetes. The prevalence of diabetes in Turkey has approximately doubled in the last 10 years. As a result of this increase, our country has become one of the countries where diabetes is most common in the world.
90% of diabetic patients have Type 2 diabetes. Genetic predisposition is important in the development of type 2 diabetes. However, even if the factor that loads the gun is genetics, the mechanism that pulls the trigger is diet and unhealthy lifestyle. Diabetes is growing like a snowball as a result of the rapid increase in obesity and sedentary lifestyles in our country and around the world. With the transition to the digital age, sedentary lifestyle and unhealthy nutrition have increased. Young people and children now spend their time playing games on computers or mobile phones, instead of street games and sports. Among adults, the amount of time spent in front of the television and computer, as well as sedentary and unhealthy snacks, is increasing. Although we observe the negative reflections of the digital age in terms of the increase in diabetes, technological developments are breaking new ground in the monitoring and treatment of diabetes.
Self-monitoring of blood sugar is extremely important in regulating blood sugar in diabetic individuals and evaluating the effectiveness of treatment. The frequency of these measurements varies depending on the type of diabetes and the characteristics of the patient. While measurements 1-2 times a week are sufficient for some patients, some patients require 7-8 measurements a day. However, some factors such as pain and fear caused by finger punctures and social phobia are important factors that reduce the frequency of blood sugar measurements in patients and therefore may make the treatment unsuccessful. Nowadays, it is possible to monitor blood sugar 24 hours a day with continuous glucose monitoring (SGM) systems. Thanks to this system, blood sugar regulation can be made much better, and the patient can eliminate mistakes related to diet and lifestyle. It can often be detected, and treatment changes are possible more effectively and quickly. In this system, which is also available in our country, a button-sized device placed on the skin remains for 14 days and can measure blood sugar uninterruptedly every 5 minutes. Instant blood sugar level can be learned with a special device placed close to it or with a program installed on a mobile phone. . The measurements taken by the device every 5 minutes throughout the day can be stored and then the measurement values can be documented in different formats such as daily, weekly or day-night statistics. Apart from this, systems that are placed under the skin and can measure for 6 months have also been developed.
Today, insulin therapy is one of the only and most effective forms of treatment for Type 1 diabetes and occasionally necessary for Type 2 diabetes. Insulin is usually injected under the skin. Another way to deliver insulin is subcutaneous pumps that provide continuous insulin release. It consists of a catheter placed under the skin and a pump system that has been reduced to the size of a matchbox with developing technology. They offer the opportunity to adjust the insulin dose according to the patient's daily needs and the amount of meals eaten. There are many studies showing that pump use improves blood sugar levels in many patients. An important development in pump systems is the new generation wireless pumps. Today, pump systems are combined with glucose measurement systems. The two systems communicate via Bluetooth. Thus, when the sensor senses a sudden drop in blood sugar, it notifies the pump and insulin delivery is stopped and the patient is warned. With these systems, which are also available in our country, hypoglycemia (low blood sugar), which is the most important fear of diabetic patients, is largely prevented. Additionally, the system can warn the patient or, if desired, the patient's relative or even the doctor when blood sugar tends to rise. The final point that this technological development can reach is the "artificial pancreas". In this system, which has made great progress but has not yet been implemented, the glucose measuring system and the pump will automatically calculate and give the insulin doses the patient needs using artificial intelligence and an algorithm, without any intervention from the patient. In this way, the patient himself Blood sugar levels will be kept at normal levels without any internal intervention. Studies are continuing to use very short-acting insulin and the glucagon hormone, which also plays a role in blood sugar regulation, in these systems. It is expected that this technological development, which may lead to a breakthrough in diabetes treatment, will be used in the near future.
Apart from these, diabetes education is given and exercise is encouraged (physical activity programs) thanks to various mobile applications downloaded to mobile phones and tablets. ), the amount of carbohydrates in the meal eaten can be calculated and the appropriate insulin dose can be recommended, medication or insulin application times can be reminded, blood sugar levels and graphs can be kept and shared with healthcare professionals. Apart from this, technology is used extensively in many promising studies such as stem cell studies, protection of insulin-producing cells from the immune system in islet transplants, conversion of various cells into insulin-producing cells and their protection, and it seems that serious advances will be made in the not too distant future, thanks to the developing technology in the treatment of diabetes. They appear.
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