What is Type 2 Diabetes? Symptoms and Treatment Guide

“I've been very thirsty lately, I drink a lot of water, but my mouth is still dry. I have to go to the toilet at night, I can't get any rest.” This is one of the most common statements we hear from patients over the age of 40 in our outpatient clinic. Most of the time, these complaints are postponed as “age-related”. However, behind this picture may be Type 2 diabetes that has progressed silently for years. It is known that one in every eight adults in Turkey has diabetes and a significant number of these people have not yet been diagnosed. For many individuals living in Sultanbeyli and surrounding districts of Istanbul, Type 2 diabetes is a chronic disease that progresses unrecognized but whose quality of life can be maintained with timely intervention. In this guide, we discuss what Type 2 diabetes is, what symptoms it presents with, how it is diagnosed and how to manage it throughout life from a patient-oriented perspective.

What is Type 2 Diabetes?

Type 2 diabetes is a chronic metabolic disease in which the body cannot use the hormone insulin effectively enough and insulin production decreases over time. Insulin secreted by the pancreas is responsible for transporting sugar (glucose) from the food we eat into the cells. In type 2 diabetes, cells develop a kind of “insensitivity” to insulin. In medical terms, this is called insulin resistance. Initially the body secretes more insulin to overcome this resistance, but over the years the pancreas becomes tired and is unable to keep blood sugar within normal limits.

Hastalık genellikle 40 yaş sonrası başlar; ancak son yıllarda obezite ve hareketsiz yaşam tarzının yaygınlaşmasıyla birlikte daha genç yaşlarda da sıklıkla görülmektedir. Dünya Sağlık Örgütü (WHO) verilerine göre küresel ölçekte diyabetli birey sayısı son kırk yılda dört kattan fazla artmıştır. Türkiye Endokrinoloji ve Metabolizma Derneği’nin TURDEP-II çalışması, ülkemizde yetişkin nüfusun yaklaşık %13,7’sinin diyabetli olduğunu ortaya koymaktadır.

The insidious nature of type 2 diabetes often manifests itself in the fact that a person lives for many years without realizing it. Some patients are only diagnosed during a blood test for a different reason or at the stage of a complication such as hypertension, visual impairment or foot ulcers. Early screening and regular check-ups are therefore decisive not only for the success of treatment but also for changing the course of the disease.

What is the Difference Between Type 1 and Type 2 Diabetes?

Diabetes is not a single disease; there are multiple types with different mechanisms. The most confusing distinction for relatives is the difference between Type 1 and Type 2.

• Type 1 diabetes is an autoimmune disease in which the immune system damages insulin-producing cells in the pancreas. It usually starts in childhood or young adulthood. It requires the patient to take insulin from outside for life.
• Type 2 diabetes is a condition based on insulin resistance and relative insulin insufficiency. It is usually seen in adults and often progresses with obesity and metabolic syndrome. Lifestyle changes and oral medications are at the center of treatment; some patients switch to insulin therapy in the advanced period.

Although the symptoms of the two diseases are similar, the mechanisms, age of onset and treatment approach are markedly different. Making the right distinction is the first and most critical step for treatment success.

What are the Symptoms of Type 2 Diabetes?

Type 2 diabetes may not show symptoms clearly for a long time. This is why it is also known as the “silent disease”. A significant proportion of patients receive the diagnosis years later. Nevertheless, recognizing the symptoms is important in terms of consulting a physician without wasting time.

The most common symptoms are:

• Frequent urination (polyuria): Significant increase in the frequency of urination, especially at night
• Excessive thirst (polydipsia): Persistent dry mouth despite drinking plenty of water
• Unexplained weight loss: Decline in weight despite increased appetite
• Constant fatigue: A feeling of weakness that does not go away despite rest
• Blurred vision: Visual acuity disorders due to the effect of high blood sugar on the lens of the eye
• Delayed healing of wounds: Small cuts or scratches, especially on the feet and legs, take a long time to close
• Tingling in the hands and feet: Numbness or burning sensation, which is considered an early sign of nerve damage

If one or more of these symptoms persist for a long time, it is recommended that you consult an internist for a fasting blood glucose and HbA1c test.

Urgent Warning: Very high blood glucose levels can lead to the life-threatening condition diabetic ketoacidosis (DKA) or hyperosmolar hyperglycemic state. If you have the following symptoms, contact the emergency room immediately:

• Deep and rapid breathing, acetone (fruit) odor on breath
• Severe abdominal pain, persistent vomiting
• Excessive drowsiness, confusion or fainting
• Severe weakness with dry mouth

Type 2 Diabetes Risk Factors

Type 2 diabetes is a multicomponent disease in which genetic predisposition and environmental factors play a role together. Recognition of risk factors forms the basis of a preventive approach.

Major risk factors:

• Age: The risk increases significantly over the age of 45
• Family history Diabetes in first-degree relatives (mother, father, siblings)
• Overweight and obesity: Especially fat around the waist (visceral obesity)
• Sedentary lifestyle: Lack of regular physical activity
• Hypertension (high blood pressure): Chronically high blood pressure
• Dyslipidemia: High cholesterol or triglyceride levels
• History of gestational diabetes: Having diabetes during pregnancy or giving birth to a baby over 4 kg
• Polycystic ovary syndrome (PCOS): A hormonal condition that increases insulin resistance in women

It is recommended that individuals with several of the risk factors should not neglect HbA1c and fasting blood glucose tests at their annual check-ups, even in the absence of symptoms.

How is Type 2 Diabetes Diagnosed?

The diagnosis of type 2 diabetes is based on blood tests and international standards are very clear. The diagnostic criteria published by the Turkish Society of Endocrinology and Metabolism are based on the following tests in line with the American Diabetes Association (ADA) and WHO.

Fasting Plasma Glucose (FPG)

It is the blood glucose value measured after at least 8 hours of fasting. The result interpretation is generally as follows:

• 70-99 mg/dL: Normal limits
• 100-125 mg/dL: Impaired fasting glucose (prediabetes)
• 126 mg/dL and above: Diabetes (needs to be repeated on a different day)

HbA1c (Glycosylated Hemoglobin)

It is a test that reflects the average blood glucose level over the last 2-3 months. It does not require fasting. The general classification is as follows:

• %5.7 below: Normal
• %5.7 to 6.4: Prediabetes
• %6.5 and above: Diabetes

Oral Glucose Tolerance Test (OGTT)

After drinking a solution containing 75 grams of glucose, blood glucose measured at 2 hours is evaluated. Results of 200 mg/dL and above support the diagnosis of diabetes. It is frequently used especially in gestational diabetes screening and in individuals with borderline values.

Random Plasma Glucose

A value of 200 mg/dL and above in a blood sample taken regardless of fasting status is considered diagnostic with classical diabetes symptoms.

From our Internal Medicine Unit A single measurement of high blood glucose is not always sufficient for the diagnosis of diabetes. In a significant portion of the patients we evaluate in our outpatient clinic, the diagnosis is made by repeated tests on different days and interpreted together with HbA1c. It should not be forgotten that stress, acute infection or some medications may temporarily raise blood sugar.

Type 2 Diabetes Treatment: Lifestyle, Medication and Insulin

Treatment for type 2 diabetes is not based on a single medication or a single step. A successful treatment plan is a holistic approach that combines lifestyle adjustments, medication, regular follow-up and patient education. The main goal of treatment is not only to lower blood sugar levels. It is also to protect cardiovascular health, keep target organs such as the kidneys and eyes free from complications and improve the patient's quality of life.

1. Lifestyle Changes

It is the first step and the strongest foundation of treatment. In individuals with newly diagnosed type 2 diabetes and mild to moderately elevated blood glucose levels, significant improvements in blood glucose levels can be achieved with a healthy diet, regular physical activity and weight management. In some patients, lifestyle changes alone may be sufficient for a long time.

2. Oral Antidiabetic Drugs

If lifestyle changes are not enough or if the HbA1c value is high at the time of diagnosis, your doctor may recommend oral diabetes medications. There are drug groups with different mechanisms of action such as SGLT-2 inhibitors, GLP-1 receptor agonists, DPP-4 inhibitors and sulfonylureas, especially metformin. The choice of medication is individualized according to many factors such as the patient's age, comorbidities (heart failure, kidney disease), HbA1c level and weight status.

3. Insulin Therapy

In the advanced stages of the disease, insulin therapy is initiated when the pancreas“ insulin production is markedly reduced or when target values cannot be reached with oral medications. Although it is common to comment that ”diabetes worsens" when insulin treatment is initiated, this is a transition related to the natural course of the disease. Insulin started with the right timing can delay complications.

Sana Medical Center Internal Medicine Unit, offers comprehensive services in the creation of personalized treatment plans, regulation of medication doses and long-term follow-up of individuals with Type 2 diabetes. You can easily apply through our online appointment system to get information about your treatment plan.

Nutrition and Exercise: Pillars of Treatment

In the management of type 2 diabetes, nutrition is a component of treatment that is often seen as “equivalent to medication”. The same diet list is not valid for every patient. It is essential to create a personalized nutrition plan according to age, weight, physical activity level, comorbidities and personal preferences.

The general principles of a diabetes-friendly diet can be summarized as follows:

• Allocating a significant portion of the plate to vegetables
• Prefer whole grain, high fiber carbohydrates
• Greatly limiting sugary drinks and processed foods
• Include healthy fat sources (olive oil, fish, walnuts) in the daily plan
• Regularize meal times; avoid prolonged fasting

On the exercise side, at least 150 minutes of moderate-intensity aerobic activity (e.g. brisk walking, swimming, cycling) and strength training 2-3 days a week are recommended. It is known that exercise not only lowers blood sugar, but also improves insulin sensitivity and reduces cardiovascular risk.

From our Nutrition and Dietetics Unit: In our polyclinic, the word “diet” evokes restriction, prohibition and unhappiness in most patients. However, the basis of Type 2 diabetes nutrition is based on balance, not prohibition. A significant portion of your favorite Turkish cuisine dishes can be part of your diabetes treatment with portion control, the right cooking method and appropriate side dishes.

Sana Medical Center to create your individual nutrition plan Nutrition and Dietetics Unit You can get support from dietitians.

Long-Term Complications of Type 2 Diabetes

High blood sugar levels over many years can cause permanent damage to the body's small and large blood vessels. This damage often affects the eyes, kidneys, nervous system and cardiovascular system. Early diagnosis and regular monitoring can delay or alleviate many of these complications.

Diabetic Retinopathy

High blood sugar can damage the small vessels of the retina. If left untreated, it can lead to vision loss. It is recommended that people with diabetes undergo a retinal examination by an ophthalmologist every year. Sana Medical Center Eye Diseases Unit, carries out retinal follow-up of patients with diabetes in a systematic manner.

Diabetic Nephropathy

It means that the filter function of the kidneys is impaired. In the early stages, microalbumin (small amounts of protein) is seen in the urine. Kidney function can be monitored with regular blood and urine tests.

Diabetic Neuropathy

Nerve damage most commonly manifests as tingling, burning, numbness and pain in the feet and legs. Decreased sensation can lead to unrecognized small wounds and the development of diabetic foot ulcers.

Cardiovascular Diseases

Type 2 diabetes significantly increases the risk of coronary artery disease, heart attack and stroke. For this reason, blood sugar control as well as blood pressure and cholesterol management are integral parts of treatment.

Diabetic Foot

It is a combination of nerve damage and vascular damage. Even a small cut can turn into serious infections. Regular foot examinations, appropriate footwear selection and daily foot care are the basis of preventive practices.

Can Type 2 Diabetes be Prevented?

Tip 2 diyabet, büyük ölçüde önlenebilir ya da geciktirilebilir bir hastalıktır. Uluslararası geniş ölçekli çalışmalar (DPP, Finnish Diabetes Prevention Study), prediyabetli bireylerde yaşam tarzı değişiklikleriyle diyabet gelişme riskinin yaklaşık %58 oranında azaltılabileceğini göstermiştir.

Preventive steps are based on the following:

• Body weight management: Reducing current weight by %5-10 in overweight individuals
• Regular physical activity: At least 150 minutes of moderate-intensity exercise per week
• Balanced nutrition: Increasing fiber and limiting sugar and processed products
• Smoking cessation
• Regular health check-ups: Annual HbA1c and fasting blood glucose monitoring in individuals in the risk group

For many individuals who have not yet been diagnosed, the most reliable way is regular check-ups. Sana Medical Center Check-Up Programs, It includes diabetes and metabolic syndrome screening with packages structured according to age and risk status.

Which Branch to Apply for?

“Which doctor should I see in case of suspected diabetes?” is a common confusion. The essence of the rule is as follows: The primary specialty in the diagnosis and follow-up of type 2 diabetes is Internal Medicine. In complex cases, referral may be made to Endocrinology.

The following units work together in the Type 2 diabetes process at Sana Medical Center with its multi-specialty structure:

• Internal Medicine: Diagnosis, initiation of drug treatment, HbA1c monitoring
• Nutrition and Dietetics: Personalized nutrition plan and weight management
• Ophthalmology Annual retinal examination
• Radiology Imaging studies of comorbidities
• Check-Up Unit Annual comprehensive health assessment

This multispecialty approach ensures that the patient receives a holistic follow-up under the same roof.

Frequently Asked Questions

Is type 2 diabetes completely cured?

Type 2 diabetes is a chronic disease and today's medicine does not offer a treatment that completely eliminates the disease. However, especially in some individuals diagnosed at an early stage, who are able to lose weight and maintain lifestyle changes, the disease may enter a long-term period called “remission”. In this case, blood glucose can remain within normal limits without medication; however, regular follow-up is still necessary.

What should the HbA1c value be?

The HbA1c target differs for each patient. Although below %7 is considered a common target in the general population, this value may vary depending on age, comorbidities and risk of hypoglycemia. The best approach is to discuss your individual target with your internist.

Which foods should I avoid for type 2 diabetes?

“Instead of a list of foods that should be ”completely avoided“, a more current and sustainable approach is to consider foods that should be ”limited and consumed at the right time". Sugary drinks, white flour pastries, fried foods and ready-to-eat processed foods stand out as the main group recommended to be limited in quantity. Dietitian support is recommended for an individual plan.

Can I play sports in type 2 diabetes?

For most people with Type 2 diabetes, regular exercise is not only safe but an essential part of treatment. However, in individuals with advanced heart disease, severe retinopathy or foot ulcers, an exercise program should be planned with the approval of a physician. Low-impact activities such as walking, swimming and cycling are generally recommended.

Does my private health insurance cover diabetes treatment?

Many private health insurances evaluate the diagnosis and follow-up of diabetes according to the medications used and the policy coverage. Since insurance details and exclusions vary from company to company, we recommend that you contact your insurance company before your appointment. Sana Medical Center provides services in agreement with many private health insurances.

How can I make an appointment for Type 2 diabetes follow-up in Sultanbeyli?

Individuals living in Sultanbeyli and Anatolian Side can start the diagnosis and follow-up process of Type 2 diabetes through Sana Medical Center Internal Medicine Unit. You can make an appointment at any time through our online appointment system or our hotline at 0216 496 10 10.

Early Step in Type 2 Diabetes Saves Lives.

The most challenging aspect of type 2 diabetes is that it is often silent and “goes unnoticed”. But its strengths are just as clear: when diagnosed early, the course of the disease can be drastically changed. With lifestyle changes, the right choice of medication and regular follow-up, blood sugar can be kept under control and target organs such as eyes, kidneys and heart can be protected for years to come.

If you are experiencing any of the symptoms listed above or if you have any of the risk factors, you do not need to wait until a complaint worsens to get checked. A blood test is a short, simple and highly informative step. Early detection is the most powerful way to prevent long-term complications.

Sana Medical Center for Type 2 Diabetes in Sultanbeyli

Sana Medical Center offers Type 2 diabetes diagnosis and follow-up under a single roof with its multi-branch structure operating in Sultanbeyli, Istanbul. In the Internal Medicine Unit, our experienced internal medicine specialists plan all diagnostic and follow-up tests, especially HbA1c and fasting blood glucose, in a coordinated manner. Depending on individual needs, our Nutrition and Dietetics, Ophthalmology, Radiology and Check-Up units can be activated within the same process.

Easily accessible from the districts of the Anatolian Side of Istanbul, especially Sultanbeyli, Pendik, Ümraniye, Kartal and Tuzla, our center provides holistic diabetes management with modern laboratory infrastructure, advanced imaging facilities and patient-oriented follow-up protocols. With the right follow-up, diabetes is no longer an obstacle to a healthy life; it becomes a manageable chronic condition.

In our center, which is contracted with many private health insurances, you can contact our team before your appointment to find out if you can receive services within the scope of your insurance. For type 2 diabetes control, HbA1c test or general health assessment, you can easily make your appointment through our online appointment system or by calling 0216 496 10 10.