What is Diabetes and What Are Its Symptoms? A Comprehensive Guide

Diabetes is a chronic metabolic condition characterized by blood glucose (sugar) levels rising above normal. It occurs when your body loses its ability to regulate blood sugar or cannot effectively use the insulin it produces. When the sugar you get from food cannot enter your cells to be converted into energy, it builds up in your bloodstream and eventually begins to damage your organs over time. With early diagnosis, proper medical intervention, and lifestyle changes, you can keep diabetes under control and lead a fully healthy, active life.

• Diabetes is a condition in which the pancreas does not produce enough insulin or the body becomes resistant to it.
• The most common types are Type 1, which usually begins in childhood, and Type 2, which typically emerges in adulthood.
• Excessive thirst, frequent urination, unexplained weight loss, and fatigue are the most prominent early signs.
• During the diagnosis phase, Fasting Blood Sugar, HbA1c (3-month average), and OGTT (glucose tolerance) tests are used.
• The treatment process includes a personalized nutrition plan, regular exercise, and physician-supervised medication or insulin use.

What is Diabetes and Who Gets It?

Diabetes develops as a result of a deficiency or dysfunction of insulin, the hormone responsible for transporting glucose—the body's primary energy source—into the cells. Insulin is produced by the pancreas, a gland located just behind the stomach. In a healthy individual, the pancreas secretes insulin in proportion to the amount of sugar in consumed food. However, when diabetes develops, this balance is disrupted. Blood sugar cannot enter the cells and continues to circulate at high levels in the blood vessels. Over the long term, this can lead to permanent damage to the heart, blood vessels, eyes, kidneys, and nervous system.

The most common forms of the disease in society are Type 1 and Type 2 diabetes. Type 1 diabetes occurs when the immune system attacks and destroys the insulin-producing cells in the pancreas, and it usually begins in childhood or adolescence. Type 2 diabetes, on the other hand, is mostly seen in adults, particularly in individuals who are overweight and lead a sedentary lifestyle. In this type, the body produces insulin, but the cells develop a resistance to it. Additionally, gestational diabetes, which emerges during pregnancy and usually resolves after childbirth, is another important type of diabetes and must be closely monitored for the health of both the mother and the baby.

Causes and Risk Factors of Diabetes

The causes of diabetes vary greatly depending on the type of the disease. While the exact cause of Type 1 diabetes is not fully known, it is widely accepted that it occurs as a result of a combination of genetic predisposition and environmental factors (such as certain viruses) triggering the immune system. The body perceives its own cells as foreign and permanently damages the insulin production center. This condition develops entirely independent of a person's lifestyle.

Type 2 diabetes, however, largely emerges from a combination of lifestyle and genetic inheritance. An unbalanced diet, excess weight (especially fat accumulation around the abdomen), and a sedentary lifestyle cause cells to become desensitized to insulin. Individuals with a family history of diabetes, those over the age of 45, patients with high blood pressure or cholesterol, and women who have previously been diagnosed with gestational diabetes are in the high-risk group. The cause of gestational diabetes is the insulin resistance triggered by hormones produced by the placenta during pregnancy. When the pancreas cannot produce enough extra insulin to meet this increased demand, blood sugar levels rise.

What Are the Symptoms of Diabetes?

Diabetes symptoms vary depending on how high the blood sugar is and the type of the disease. While Type 1 diabetes symptoms usually appear very rapidly and severely within a few weeks, Type 2 diabetes can progress insidiously over many years. In fact, many Type 2 diabetes patients experience no noticeable complaints until the disease reaches advanced stages. However, once blood sugar rises above a certain level, the body begins to send out warning signals.

The most fundamental symptoms of the disease include excessive thirst and urinating much more frequently than normal. The kidneys work intensely to filter out and eliminate the excess sugar accumulating in the blood, which increases urine output. Because the body loses fluid, there is a constant need to drink water. When cells cannot get the energy they need from glucose, muscle and fat tissues begin to be used as energy sources; this leads to unexplained weight loss despite an increased appetite, as well as a constant feeling of fatigue. Other common symptoms include:

• Blurred vision and difficulty focusing
• Numbness, tingling, or a burning sensation, especially in the feet
• Dry skin, itching, and recurrent fungal infections
• Cuts, sores, or bleeding gums that heal much slower than normal
• Darkening of the skin in the neck, armpits, or groin areas (Acanthosis nigricans)

How is Diabetes Diagnosed at the Hospital?

When you visit the hospital with suspected diabetes, your doctor will first listen to your complaints, review your medical history, and perform a detailed physical examination. To make a definitive diagnosis, specific laboratory tests that measure blood sugar levels are utilized. These tests objectively evaluate the amount of glucose in your blood to determine the presence or risk level of the disease.

The most frequently used method during the diagnosis phase is the Fasting Blood Sugar (FBS) test. The glucose level is measured in a blood sample taken after at least 8 hours of overnight fasting. Another critical test is the HbA1c (Glycated Hemoglobin) test. This test measures the amount of sugar attached to the hemoglobin in red blood cells, providing information about your average blood sugar levels over the past 2-3 months. In suspicious cases or during pregnancy, an Oral Glucose Tolerance Test (OGTT), or sugar loading test, is performed. In this test, after the fasting blood sugar is measured, the patient is given a liquid containing a specific amount of sugar to drink, and then blood sugar is measured again at specific intervals to observe how the body tolerates the sugar.

Diabetes Treatment and Lifestyle Changes

Diabetes treatment is fully personalized according to the type of the disease, the person's age, overall health status, and lifestyle. In the treatment of Type 1 diabetes, since the pancreas produces no insulin at all, patients must take external insulin for life. Because insulin is broken down by stomach acid, it cannot be taken as a pill; it is administered into the body via subcutaneous injections or continuous insulin pumps. For these patients, carbohydrate counting and administering the appropriate dose of insulin for the food consumed is of vital importance.

The foundation of Type 2 diabetes treatment consists of medical nutrition therapy (diet) and regular physical activity. Many patients in the early stages can keep their blood sugar within normal limits simply by losing weight and eating healthily. To improve your dietary habits and stay away from refined sugar, you can review the practical suggestions in our article titled Sugar-Free January: A Guide to Sugar Detox and Healthy Eating. In cases where lifestyle changes are insufficient, oral antidiabetic drugs (sugar pills) that increase the insulin sensitivity of cells or stimulate the pancreas are prescribed. As the disease progresses, Type 2 diabetes patients may also need to transition to insulin therapy.

Long-Term Harms and Complications of Diabetes

Prolonged high blood sugar gradually damages the entire vascular system and nerve network in the body. The microvascular (small vessel) complications of diabetes include damage to the retina of the eye (diabetic retinopathy), loss of the kidneys' filtering ability (diabetic nephropathy), and damage to the nerve endings (diabetic neuropathy). Macrovascular (large vessel) complications significantly increase the risk of heart attacks, strokes, and peripheral artery disease.

Diabetic neuropathy, in particular, can cause loss of sensation in the hands and feet, severe pain, and unnoticed wounds that can become infected and turn into diabetic foot ulcers. If nerve damage progresses or spine-related neurological complaints are added to the picture, a multidisciplinary approach is essential. For the evaluation of such advanced neurological issues and the treatment of nerve compressions requiring surgery, you can safely seek support from our specialist physicians in our Neurosurgery department.

When to See a Doctor and Emergencies

Diabetes is a condition that requires continuous monitoring and care. If you have a family history of diabetes, are overweight, or experience one or more symptoms such as frequent urination, dry mouth, or slow-healing wounds, you should visit a healthcare facility without delay to have your blood sugar measured. Early intervention is the most effective way to prevent organ damage.

For patients diagnosed with diabetes, a sudden drop in blood sugar (hypoglycemia) or a severe spike (hyperglycemia) are life-threatening emergencies. If you experience any of the following symptoms, you should immediately call the 112 emergency service to seek medical help:

• Confusion, difficulty speaking, or a feeling of fainting
• A sharp odor on the breath resembling rotten apples or acetone
• Severe abdominal pain, uncontrollable vomiting, and rapid breathing
• Cold sweats, severe shivering, and extreme fatigue accompanied by heart palpitations
• Sudden loss of vision or double vision

Diabetes Diagnosis and Treatment Process at BHT CLINIC

At BHT CLINIC İstanbul Tema Hastanesi, the diabetes diagnosis and treatment process is carried out with a holistic, patient-specific approach under the coordination of our Internal Medicine and Endocrinology departments. For our patients who present with suspicion, all necessary blood tests, HbA1c measurements, and advanced laboratory investigations are quickly concluded on the same day. Once diagnosed, the most suitable diabetic nutrition plan is created for you accompanied by our expert dietitians, and detailed medication/insulin training is provided.

To keep the potential effects of diabetes on the eyes, kidneys, or nervous system under control, an integrated follow-up system with other medical specialties in our hospital is implemented. For our patients experiencing sudden fluctuations in blood sugar or carrying a risk of diabetic coma, our fully equipped Emergency Department, which operates 24/7, provides uninterrupted medical support. To take control of your health and schedule your routine screenings, you can call our contact center or easily book your appointment through our website.

Frequently Asked Questions

What is prediabetes?

Medically referred to as prediabetes, it is the transitional period where a person's blood sugar level is higher than normal but not high enough to be diagnosed as diabetes. At this stage, the development of Type 2 diabetes can be halted or delayed for years with proper nutrition and exercise.

What should diabetes patients avoid eating?

Diabetes patients should stay away from refined carbohydrates that rapidly spike blood sugar, such as white bread, rice, pastries, syrup-soaked desserts, processed fruit juices, and carbonated drinks. Instead, whole grains, fibrous vegetables, legumes, and healthy protein sources should be preferred.

What is the difference between Type 1 and Type 2 diabetes?

Type 1 diabetes is a condition where the body's immune system attacks the pancreas, resulting in no insulin production, making external insulin intake mandatory. Type 2 diabetes is generally a condition where the body cannot use the insulin it produces (insulin resistance), often due to excess weight and physical inactivity.

Does diabetes ever go away completely?

Type 1 and Type 2 diabetes are chronic diseases and do not disappear completely. However, Type 2 diabetes patients can enter a period of remission where they can control their blood sugar levels without medication through significant lifestyle changes and weight loss.

What happens if gestational diabetes occurs during pregnancy?

If gestational diabetes is not kept under control, it can lead to the baby being born larger than normal, premature birth, and sudden low blood sugar in the baby after birth. With diet and, if necessary, insulin treatment, the health of both the mother and the baby is safely protected.

This article is for informational purposes only; please consult your physician for diagnosis and treatment.