Diabetes Mellitus is a group of diseases characterized by increased blood sugar and abnormalities in HR, protein and fat metabolism as a result of damage to insulin production or activity.
Since not enough insulin is secreted in diabetics, hyperglycemia occurs with insulin deficiency.
Classification of Diabetes Mellitus;
Type 1 Diabetes
Type 2 Diabetes
Prediabetes
Gestational Diabetes ( GDM)
1)Type 1 Diabetes
It is the type of diabetes that usually appears under the age of 30. General symptoms are excessive thirst, spontaneous weight loss, frequent urination and fatigue. This situation can be solved through nutrition and medication.
2)Type 2 Diabetes
TYPE 2 diabetes constitutes 90-95% of all diabetics. Genetic factors, environment, excessive weight gain (obesity), advanced age, and physical inactivity are factors that are effective in the emergence of TYPE 2 diabetes. It should be supported with medical nutrition (diet), physical activity and medications. Energy (calories), saturated fat, trans fat, cholesterol, sodium and salt should be restricted. It will be healthier to use products with a low glycemic index.
Diabetes Mellitus Definition and Epidemiology
Diabetes Mellitus (DM) is a beta-inflammatory substance of the pancreas. It is an endocrine and metabolic disease that has a chronic course and can lead to permanent organ (renal, ocular, neurological and cardiovascular) damage, which occurs due to the lack or low secretion of the insulin hormone secreted from the cells.
There are various different types of DM. These start from the first years of life and continue until adulthood or old age. Every individual is a candidate for DM disease, directly or later. Complications caused by diabetes cause loss of organ functions, affecting life expectancy and quality, and bringing about social and economic burden with workforce losses.
The prevalence of DM, which is increasing in the world and seen at early ages in Turkey in recent years, is a common cause. Its frequency varies from society to society depending on age, gender, race, nutritional habits, genetic predisposition and environmental factors. It is especially called adult diabetes and is generally seen in the elderly. The incidence of DM type 2 has increased since adolescence and childhood due to obesity, sedentary life, smoking-alcohol use and stress.
In 1985, there were 30 cases in the member countries of the International Diabetes Federation (IDF). While there are millions of people with diabetes, there were 246 million in 2007, 425 million in 2018, and it is estimated that this number will reach 629 million in 2045. In addition, according to the latest data of the International Diabetes Federation, 12% of global health expenditures are spent on diabetes and it is known that 2/3 of diabetic patients live in cities. Again, 2/3 of people with diabetes are in working life and adulthood.
The World Health Organization has estimated that the number of people with diabetes in Turkey, which was approximately 3 million in 2000, will reach 6.5 million in 2030, but this is not the estimate for 2030. This value was exceeded in 2014 and the number of diabetics in Turkey exceeded 7 million, and the prevalence of diabetes in Turkey increased by 90% in 12 years.
Etiology of Diabetes Mellitus
Increasing population average age and consumption of ready-made foods, inactivity, obesity, genetic predisposition, pancreatic diseases, widespread use of various drugs and some genetic syndromes play a role in the etiology of the disease.
Risk Factors of Diabetes Mellitus >
Non-Modifiable Risk Factors
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Genetic Predisposition
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Age
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Gender
Modifiable Risk Factors
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Sedentary Life
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Those with First Degree Relatives with Diabetes nbsp;
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Hypertension
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Hyperlipidemia
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Polycystic Ovary Syndrome
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Using Atypical Antipsychotic Medication
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History of Cardiovascular Disease
Etiological Classification of Diabetes Mellitus
DM is generally classified as four types.
Type 1 Diabetes: It is the type of diabetes that develops as a result of insufficient or absent production of the insulin hormone. .
Type 2 Diabetes: It is the type of diabetes that is associated with insulin deficiency and develops as a result of insulin resistance.
Gestational Diabetes: It develops during pregnancy. There is a risk of developing Type 2 diabetes afterwards.
Other Types: It may develop due to pancreatic diseases, endocrine disorders, infections, side effects of drugs or chemicals used.
Diabetes. Mellitus Signs and Signs
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Increase in blood glucose level
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Glucose excretion in urine
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Ketones in urine
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Polyuria (frequent urination)
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Polydipsia (increased thirst)
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Polyphagia (excessive desire to eat)
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Anorexia
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Weight loss
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Fatigue
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Abdominal pain
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Blurred vision
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Recurrent and persistent infections
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Itching
Inulin
Pancreasin is a polypeptide with 51 amino acids. It consists of two amino acid chains connected to each other by a disulfide bridge. These chains are called A and B. There is also a disulfide bridge in the A amino acid chain. The A chain contains 21 amino acids and the B chain contains 30 amino acids. When these two chains are separated from each other, the effect of insulin disappears.
Insulin is synthesized in the endoplasmic reticulum in the beta cells in the islets of Langerhans. After being synthesized here, it is transported to the Golgi apparatus. When it is secreted from here, it fuses with the cell membrane and is thrown out of the cell via exocytosis, and from there it mixes with the blood. Insulin secreted into the blood does not bind to any carrier protein and remains free in circulation. It is located in the lake. Insulin binds to its own receptor while being transported to the target cell.
Glucose is the most important energy source that continues the life cycle for the body. However, insulin is needed to transport glucose to cells and therefore use it in vital activities. Insulin and glucose are transported within the cell by passing through the cell membrane with the harmony of a key and lock, and begin to be used in the function of body metabolism.
Storage of glycogen in the liver and muscles
After glucose enters the cell, it functions in two ways. If the cell needs glucose to provide energy, it can use it immediately; otherwise, the glucose is converted into glycogen and stored. The breakdown of glucose to provide energy is called glycolysis. The cell's storage of glucose as glycogen is called glycogenesis. Glucose is stored in the muscles and liver. Glycogen stored in the muscle and liver is converted into triglyceride when it reaches saturation point in these cells. When used, the first liver is chosen as the storage center. The situation where stored triglycerides are converted into glucose and used in metabolic events is called glyconeogenesis.
The effect of insulin on carbohydrate metabolism
In people with a carbohydrate-rich diet, following food intake, glucose is absorbed into the blood and insulin begins to be released from the pancreas. If too much glucose enters the liver cells, insulin converts this glucose into fatty acids. This increases the storage of fatty acids as triglycerides.
Effect of insulin on fat metabolism
Insulin In its absence, the breakdown of fats and their use as energy increases. If the breakdown of fats increases, ketosis and acidosis occur. In cases where diabetes increases, atherosclerosis occurs rapidly in the vessels.
The effect of insulin on protein metabolism and growth
In the absence of insulin, protein synthesis and storage stops. Catabolism increases in the body. Loss begins, especially in muscle tissue. In the same process, there is an increase in the amount of urea excreted in urine due to the rapid breakdown of amino acids. Patient People lose weight rapidly and urinate frequently.
Definition and etiology of Type 1 Diabetes mellitus
It is a type of diabetes that develops due to damage or total loss of pancreatic beta cells and occurs with a permanent insulin deficiency.
Immediately before type 1 DM becomes clinically evident, the cells in the islets of langerhans of the pancreas are affected. It is known that autoimmune destruction develops in beta cells. The factors that play a role in the development of this damage to beta cells are viruses, toxins and some foods. Mumps, upper respiratory tract infections, cow's milk, rubella, and toxins that develop during childhood are the factors that initiate the autoimmune mechanism.
Definition and etymology of Type 2 Diabetes mellitus
It is the most common type of diabetes all over the world. It is also generally defined as advanced age diabetes. Signs and symptoms begin after the age of 40. It is thought that there is a genetic predisposition. Insulin release in the body is not sufficient.
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