
Diyabetin insülin hormonunun yetersizliği veya insülin etkisinin azalması sonucu kan şekeri (glukoz) artışı ile seyreden kronik metabolik bozukluk olduğunu söyleyen İAÜ VM Medical Park Florya Hastanesi’nden Endokrinoloji ve Metabolizma Hastalıkları Uzmanı Doç. Dr. Elif Turan, “Glukoz, hücre için enerji kaynağı olarak kullanılır. İnsülin kan glukozunun hücre içine girmesini sağlar ve kan glukozu normal aralıkta tutulur. İnsülin yetersizliği ve etkisinde azalma olduğu zaman kan şekeri yükselmeye (hiperglisemi) başlar. Hiperglisemi, yorgunluk, ağız kuruluğu, çok su içme, idrara çıkma, sık tekrarlayan idrar yolu enfeksiyonu, kaşıntı, iştah artışı, kilo artışı veya zayıflama, bulanık görme gibi şikâyetlere neden olabilir” diye konuştu.
HAREKETSİZ YAŞAM DİYABETİ TETİKLİYOR
Obezite ve hareketsiz yaşam tarzının artmasına paralel olarak dünyada diyabet prevelansının (yaygınlık) giderek artış gösterdiğini işaret eden Doç. Dr. Turan, “Uluslararası Diyabet Federasyonu’nun (IDF) 2021 verilerine göre, 537 milyon insan, yani dünyadaki yaklaşık her 10 yetişkinden birinin diyabeti olduğu biliniyor, yine verilere göre bu hastaların yarısı diyabete sahip olduklarından habersiz yaşıyor. Ayrıca 541 milyon yetişkin, Tip 2 diyabet geliştirme riski altındadır. 1,2 milyondan fazla çocuk ve ergen (0-19 yaş) Tip 1 diyabetle yaşıyor. Türkiye’de de hastalığın görülme sıklığı dünya ile paralel giderek artmaktadır. 1998’de yapılan TURDEP -1 çalışmasına göre diyabet prevelansı yüzde 7,2 iken 2010’daki TURDEP-2’de ise oran yüzde 13,7’ye ulaşmıştır” ifadelerini kullandı.
TİP 2 DİYABET DAHA SIK GÖRÜLÜYOR
Doç. Dr. Turan, genel olarak üç tip diyabet olduğunu söyleyerek şu bilgileri paylaştı:
“Tip 1 diyabet, Tip 2 diyabet ve gebelikle ilişkili gestasyonel diyabet vardır. Tip 1 diyabet, pankreasın otoimmün nedenli insülin üreten hücrelerinin harabiyeti ile gelişir. Harabiyet yüzde 80’nin üzerinde olunca diyabet kliniği ortaya çıkar. Hastalar daha genç yaştadır, zayıflardır ve tedavide insülin kullanmak zorundadırlar. Tip 2 diyabet ise tüm diyabet formlarının yüzde 90’ını oluşturur. Yaş, obezite, genetik, sedanter (hareketsiz) yaşam ile ilişkili insülin etkisinde azalma ile ortaya çıkar. Hastalar daha şişman ve ileri yaştadır. Yaşam tarzı değişikliği, ağızdan ilaçlar ve gerektiğinde insülin tedavide kullanılır. Gebelik diyabeti özellikle gebeliğin son haftalarında ortaya çıkar ve gebelikten sonra çoğunlukla kaybolur.”
DİYABETTE KAN ŞEKERİNE DİKKAT EDİLMELİ
Kontrolsüz diyabette kan şekeri yüksekliği vücutta birçok sistem ve organın olumsuz etkilenmesine yol açtığının altını çizen Doç. Dr. Turan, “Kalp ve damar hastalıkları, inme, görme bozukluklarına, sinir ve böbrek hasarına neden olabilir. Ayakta yara oluşması, kangren ve buna bağlı uzuv kayıpları oluşabilir. Diyabet körlüğün en önemli nedenlerinden biridir. Kronik böbrek yetmezliğinde diyalize giren hastaların yarısı diyabetiktir. Kaza dışı ayak/bacak kaybının en önemli nedeni yine diyabettir. Sağlıklı beslenme, egzersiz, ilaçların düzenli alınması kan şekerlerinin istenilen düzeyde tutulmasını sağlar. Bu da diyabete bağlı görülebilecek organ hasarlarını önemli ölçüde azaltır” dedi.
DİYABET TEDAVİSİNDE YENİ YÖNTEMLER GELİŞTİRİLİYOR
Son yıllarda diyabetli bireylerin glikoz regülasyonu için öz yönetimlerini artırmak ve güçlendirmek için bilişim teknolojileriyle desteklenmeleri görüşünün arttığını ve bu konuda yeni yöntemlerin geliştirildiğinin altını çizen Doç Dr. Turan, “Diyabetteki teknolojik ilerlemelerin temeli, sürekli deri altı insülin infüzyonu (CSII veya insülin pompası) ve sürekli glikoz izleme (CGM) sistemlerinin geliştirilmesi üzerinedir. İmplante edilebilir subkütan CGM sistemi üst kolun subkütan dokusuna yerleştirilir. Mobil bir cihaza hipoglisemik, hiperglisemik uyarıları ve bildirimleri iletir, ayrıca mobil cihaz yakınlarda olmasa bile vericiden vücuda titreşim uyarıları sağlanmaktadır. İnsülin pompa tedavisi, HbA1c düzeylerini düşürmek ve hipoglisemi riskini azaltmak için kullanılabilecek bir araçtır. 670G Hybrid Close Loop (HCL) sistemi, otomatik insülin iletim cihazı hastanın kendi kendini yönetme yükünü azaltır. Hipoglisemi uyarı bilekliği, akıllı mikro iğne yama gibi ürünler diyabetli hastanın kullanımına sunulmuş önemli cihaz ve uygulamalardır. Ayrıca uzaktan sağlık sistemi uygulamaları, bilişim teknoloji ürünleri vasıtasıyla diyabetli bireyler ve sağlık profesyonelleri arasındaki coğrafi engelleri kaldırarak, sağlık hizmetlerinin toplumdaki her bireye ulaşılabilir olmasına imkân veren bir sağlık hizmeti olmuştur” diyerek açıklamalarını sonlandırdı.
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