Thursday, Nov. 14, is World Diabetes Day, and here in Turkiye, those living with diabetes and their loved ones will have the opportunity to learn more about how to live healthy with the disease from doctors and nurses and to connect with others facing similar challenges.
According to estimates by the International Diabetes Federation, one out of every 10 people has diabetes or prediabetes, with almost half unaware of having the condition. This figure is expected to rise to one out of every eight people having diabetes over the next two decades, which would bring the grand total to approximately 763 million and is a near 50% increase to the 537 million estimated to have the disease in 2021. By 2030, that figure is anticipated to rise to 643 million. An even more startling figure is that in the U.S., it is estimated that one out of every three people are living with diabetes or prediabetes, yet 81% are said to not even know. 90% of people with diabetes have type 2 diabetes, considered to be a modern-day disease that has culminated as a result of urbanization, our sedentary lifestyles, and the highly processed food most people around the world tend to eat.
Unfortunately, Türkiye is no exception, as an article published in the National Library of Medicine states that 11% of the population will have received a diabetes diagnosis by 2022. One study showed that the figure may even be as high as 17% in terms of those who do not yet know they have the disease, a majority of which are men.
I am also a diabetic who was diagnosed in Türkiye, and unlike the much more common and lifestyle-based Type 2 diabetes, mine is the Type 1 variation that is a result of the pancreas simply not functioning how it is supposed to. This means that rather than making lifestyle changes that could lead to the diminishing of the disease, mine is a chronic sentence that has to be managed by carefully calculating what I eat and how I exercise and injecting insulin accordingly. I received the diagnosis in Türkiye after feeling extremely lethargic and was admitted and administered a sugar-loading procedure to test the pancreatic reaction, which I was told by my doctor was basically non-existent. Considered to be the result of an auto-immune response, my life radically changed in the course of a single day.
Luckily, I have navigated this illness in Türkiye through state insurance, which has always provided me with the insulin and the various doctor’s appointments I need to prevent the onset of complications. While we are not yet covered for insulin pumps and continuous glucose monitors and I do sometimes have to pay for a portion of the blood sugar testing strips out of pocket, other than that, my care has been comprehensive and covered, which I am ever-so grateful for, especially as I nearly died from the disease this summer when I went into ketoacidosis, otherwise known as a diabetic coma.
I had spent this particularly sweltering summer following all of the horrific stories from the neighboring isles in Greece of tourists falling prey to excessively hot temperatures in which they either fell or got lost and most likely were dehydrated and even perhaps delirious from the heat. I never would have imagined that from what I thought were the safe confines of my air-conditioned home that, I would also fall prey to a life-threatening situation due to the heat. You see, similar to anxiety and stress, excessive heat can also contribute to the rising of blood sugar to dangerous levels.
Coupled with catching a nasty virus that had me vomiting for days and sent even those with a clean bill of health to the emergency room, when the electricity shut down in what was over 40 degrees Celsius weather, I found myself no longer able to stand and hyperventilating. Luckily, a few days prior, I had visited my local family physician, who is an integral part of the health care here in Türkiye, as every neighborhood in the country is assigned to a physician at a local health center. Referred to as the Sağlık Ocağı (Community Health Center), when I could no longer breathe nor function normally, I called my local family physician. He was well aware I had been ill and had given me medication and prescribed a vitamin b shot, so when I called him up even though he didn’t understand a word I said as supposedly I was slurring, he immediately called an ambulance to my home. He instructed me to unlock the front door and to crawl to do so if I had to, which I thankfully did.
I had also called my mother, who lives a few hours’ drive in Bodrum, and thankfully jumped in her car to come check on me when I seemed to be slurring and speaking gibberish. She said it sounded as if I had been drinking alcohol, which I don’t, but somehow, that was the effect of the poison from having excessive sugar and ketones in my blood. My mother arrived at the same time the ambulance did, which is the last thing I remember until I awoke hours or maybe even days later in intensive care with no phone, money, memory, or mother, as no visitors were allowed under the Muğla Research Hospital’s emergency care. It was both terrifying and a relief as I can recall moments of having EKGs, X-rays, bloodwork, serums and eye checks, among just a few of the plethora of treatments they provided me. I thank everyone involved, especially the doctors, nurses, cooks, and janitors, for their compassion and care.
I must admit since then, it’s been a slow road to recovery. With a blood pH of 6.5, I was told by the chief of internal medicine and the fluent English-speaking doctor-in-training that I would have died that night had I not made it to the hospital in time. I remember pleading for water, which I was not allowed to drink because, as the doctor explained later, he was hesitant to alter a single molecule as, at any moment, something in me was near ready to explode. I will be eternally grateful for their efforts and am also so thankful this happened in Türkiye, where the fellow patient I shared my room with to all of the members of the hospital staff made me feel safe and, perhaps even more importantly, like family.
I continue to see various doctors regularly and make appointments through the state’s online medical portal, aka E-Nabız; all of the different branches have easy access to obtaining patients’ records and blood tests. While some procedures, such as ultrasounds, may have a few weeks’ wait, for the most part, appointments are obtained quickly and timely. On Thursday, the hospital’s conference hall will be dedicated to spreading awareness of diabetes and the preventative measures out there for the disease and its complications. That is open to all and will be an opportunity for patients like me to become even more informed and connected on living with this challenging and chronic disease.
After taking a few months off from working and writing, it seems quite appropriate that my comeback would be on coverage of what set me back in the first place: this disease that affects nearly all of us, whether we live with it or know others who do. For many who have type 2 diabetes, this is a chronic disease that can be avoided through awareness and lifestyle changes. For those like me who are Type 1, for which it is somewhat of a lifetime curse, this means that we must make living a healthy lifestyle mandatory to delay the onset of complications and to exist with as much peace of mind as possible.
