Endocrinology and Metabolism

The Pandemic of the Modern Age: Type 2 Diabetes Mellitus

Diabetes Mellitus is a chronic and progressive metabolic disorder that affects the way our bodies use energy. Type 2 diabetes results from the body’s inability to effectively use the insulin it produces (insulin resistance) or to produce enough insulin. This type accounts for approximately 90–95% of diabetes cases worldwide.

The Global Reality of Diabetes

Today, approximately 589 million people aged 20–79 worldwide are living with diabetes. This highlights the fact that one in every 10 adults has diabetes. Moreover, more than 40% of these individuals are not even aware they have the disease.

This number is expected to reach 853 million by 2050. Additionally, 635 million adults with impaired glucose tolerance are at risk of developing diabetes.

In 2024, more than 3.4 million deaths were caused by diabetes and diabetes-related complications, accounting for 9.3% of all deaths. That same year, healthcare spending on diabetes exceeded $1 trillion.

The Reality of Diabetes in Turkey

Today, one in every six adults in Turkey lives with diabetes. The number of patients, which stood at 9.6 million in 2024, is expected to approach 14 million by 2050.

With this increase, Turkey:

• rank 10th globally in the number of adults with diabetes,
• 9th in the world for adults with diabetes aged 65 and older,
• and is projected to rank first in Europe.

This picture shows that diabetes is not merely a health issue for Turkey, but a major impending social and economic challenge.

Therefore, in the fight against diabetes, it is possible to create a meaningful and lasting impact not only through clinical treatments but also by raising awareness across society, adopting sustainable lifestyle changes, and implementing strong health policies.

Risk Factors: Who Is at Risk?

Type 2 diabetes typically results from a combination of genetic predisposition and lifestyle factors.

• Body Weight: Being overweight (BMI > 25 kg/m²) or obese is a key risk factor.
• Sedentary Lifestyle: Lack of physical activity triggers insulin resistance.
• Genetics: A family history of diabetes among first-degree relatives is one of the key risk factors.
• Age: While the risk increases in individuals aged 45 and older, diabetes has also begun to appear in childhood due to a sedentary lifestyle.
• Gestational Diabetes: Individuals with a history of elevated blood sugar during pregnancy may be at risk.

The Body’s Warning Signs (Symptoms)

Many patients may not experience any symptoms until their blood sugar reaches very high levels. However, the following signs should be watched for:

• Polyuria: Urinating more frequently than normal (especially at night).
• Polydipsia: Excessive thirst and a dry mouth.
• Polyphagia: Increased appetite or a constant feeling of hunger.
• Fatigue: Weakness caused by the body’s inability to produce energy from sugar.
• Slow Healing: Wounds that heal more slowly than normal and recurrent infections.

Diabetes Management and Treatment Strategies

Living with diabetes means learning to manage it. The treatment approach is multidisciplinary:

Medical Nutrition Therapy and Lifestyle
For a person with diabetes, the concepts of “portion control” and “glycemic index” are more important than “forbidden foods.” Proper distribution of carbohydrates and increasing fiber intake can help prevent blood sugar fluctuations.

Physical Activity
Regular exercise increases muscle sensitivity to insulin and directly lowers blood sugar.

Pharmacological Treatment

• Oral Antidiabetics: Pills that help regulate the many systems disrupted by diabetes (for example, by suppressing the body’s sugar production, supporting insulin production, increasing insulin sensitivity, etc.).
• Injectable Treatments: Insulin or new-generation treatments.
• Self-Monitoring: The patient’s active participation in treatment by measuring blood sugar at home is the key to success.

Sources:

• IDF Diabetes Atlas, 11th edition, 2025
• Ministry of Health of the Republic of Turkey, Turkey Diabetes Program (2023–2027)
• TEMD, KEDD, TDV Current Diabetes Diagnosis, Treatment, and Follow-up Guidelines