Diabetes, a chronic disease in which blood sugar cannot be controlled due to the body's inability to produce enough of the insulin hormone or to use it effectively, is spreading rapidly in the world and in Turkey.
This disease is triggered by malnutrition, sedentary life, genetic predisposition and weight problems; If not diagnosed and treated on time, it can cause permanent damage that threatens heart, kidney and eye health.
The picture in Turkey shows that the problem is not only medical but also a deep socioeconomic crisis.
CARBOHYDRATE-HEAVY NUTRITION AND DEEPENING POVERTY
The incidence of diabetes in Turkey exceeded the world average and reached 16.5 percent.
Dr. Pointing out that the biggest reason for this rapid climb is the economic crisis and impoverishment, Ahmet Mehlepçi said, "Approximately 35 percent of the population has difficulty accessing basic foods. This makes it impossible to have a healthy and balanced diet, confining people to cheap carbohydrate sources such as bread, pasta, rice and pastries."
Mehlepçi reminded that while the intense working tempo and sedentary life in metropolitan cities further increase this risk, low-income individuals have almost no access to sports and physical activity areas, he said that although the development of diagnostic facilities in the family medicine system enables the detection of hidden patients, it is unfortunately not possible under today's conditions for family physicians, who are forced to care for 100 to 150 patients a day, to provide qualified, holistic and preventive health services.
'Not ONLY BLOOD SUGAR, BUT ALSO MENTAL HEALTH IS TIRED'
Emphasizing that diabetes treatment is not only a physical process, Mehlepçi pointed out that patients have to spend mental work 24 hours a day.
Stating that this situation causes diabetes burnout, Mehlepçi warned, "Diabetes burnout is the patient's mental, emotional and behavioral fatigue over time from this process that requires constant self-care and loses resistance to disease management. We can never see this simply as 'non-compliance with treatment'."
Stating that the health system focuses only on measurable biological results (blood sugar), Mehlepçi pointed out that psychologists should be employed in coordination with family physicians in family health centers and warned: "Good diabetes management is not only about reaching good glucose values, but also about preserving the psychological well-being of the person trying to reach those values."
'SENSORS SHOULD BE A RIGHT, NOT A LUXURY'
Stating that continuous glucose monitoring systems and smart insulin pumps save lives, Mehlepçi emphasized that the cost of these technologies is not accessible to every citizen and said, "Technology is no longer a comfort, it is the most vital part of the treatment. However, since access to these devices has become dependent on the economic power of the person, the health outcomes of two people with the same disease are completely different."
Pointing out that the inclusion of sensors in the scope of reimbursement for children is an important achievement, but there are major deficiencies in terms of adult patients and insulin pumps, Mehlepçi added, "The real measure of technological progress in health is not how advanced devices we produce, but how many people can benefit from these developments equally and sustainably."
THE INVISIBLE BURDEN ON WOMEN'S SHOULDERS
Stating that the treatment process of women living with gestational diabetes or currently living with diabetes directly intersects with gender roles, Mehlepçi touched upon the heavy responsibilities that the male-dominated structure imposes on women and said, "While the woman is held responsible for the family's health and household chores, on the other hand, she has to manage her own disease. The husband's inability to participate in housework and child care prevents the woman from resting and going to check-ups. Failure of family members to comply with the recommended diet causes the woman to have to prepare meals for herself."
Mehlepçi stated that when this situation is combined with economic difficulties, it would be unfair to reduce treatment success to individual efforts.
'CHILDREN WITH TYPE 1 DIABETES ARE ALONE'
Drawing attention to the contradictions experienced by school-age children with Type 1 diabetes, Mehlepçi summarized the vulnerabilities in the current education system with the following words:
"While we cannot even provide one free lunch to all students, it is unrealistic to expect the special nutrition of a student with Type 1 diabetes to be arranged. It is a great contradiction to expect a nurse to be a nurse in an environment where schools cannot even find cleaning staff."
Emphasizing that a child with diabetes being able to administer insulin at school, measure blood sugar and receive help in an emergency is not a privilege, but a basic requirement of a safe education environment, Mehlepçi stated that today the safety of these children is left entirely to the personal struggle of families and the sensitivity of teachers.
PREJUDICES IN BUSINESS LIFE
Mehlepçi, who criticized the profit-oriented approach in business life overriding employee health, conveyed the discrimination faced by individuals with diabetes with the following words:
"The fact that employers and public administrators perceive diabetes as 'a condition that reduces working capacity' creates a great prejudice. Therefore, individuals are forced to hide their diseases in order not to lose their jobs or be discriminated against."
Stating that hiding the disease creates life risks by delaying intervention in emergency situations such as hypoglycemia (low sugar), Mehlepçi emphasized that it is both the right to work and the most basic right to health for individuals with diabetes to be able to work in safe conditions appropriate to their health status, without discrimination.
