Diabetes mellitus is a metabolic disease characterized by high blood glucose levels, primarily due to insulin resistance or inadequate insulin production. Type 2 diabetes, which often affects individuals over 40 and is associated with obesity, can be managed through lifestyle changes, proper diet, and education about the disease. Effective prevention and control measures can significantly reduce the incidence and complications of diabetes, emphasizing the need for regular screening and health education.

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INTRODUCTION
Diabetes mellitus is a metabolic disease in which the blood glucose is abnormally
high because the organism is unable to use it as a food. Glucose is a pure sugar that is
essential for brain and muscle nutrition. It comes from a certain kind of foods: sugar and
candy, starchy foods such as bread or potatoes, which are degraded in glucose in the
digestive system. It can also be excreted from the liver, which stores glucose that is not
immediately needed. In order to use glucose as a food, the insulin hormone is indispensable.
When glucose in the circulation increases, after a meal, insulin is excreted from the
pancreas by allowing glucose to enter the cells and use it as energy. Insulin, therefore, plays
a decisive role in the use of glucose in the body. When there is a lack of insulin, or the existing
insulin does not function properly, glucose will accumulate in the circulation and diabetes
will occur. Type 2 diabetes occurs when the pancreas still secretes insulin but in insufficient
amount to meet the increased need of the organism. Reduced insulin ability to stimulate the
absorption of glucose into the muscles, liver and other tissues is known as insulin resistance,
most likely due to damage to the insulin effect after binding to the receptor on the cell
membrane. There is a genetic predisposition, which is formed in older ages, and is
associated with long-lasting unbalanced nutrition and excessive intake of calories and
increased body mass. Another name for this disease is "insulin-independent type" because it
is due to peripheral tissue abnormality and makes about 90% of all cases of diabetes.
Patients are usually older than 40 years and most of them are obese. The onset of the
disease is gradual and is often detected accidentally. In most cases, blood glucose levels may
be reduced to normal values of proper diet or diet by taking tablets, thus significantly
improving the quality of life and prolonging the life expectancy. Diabetes is associated with
various complications. Expressing oxidative stress leads to damage to the basal membrane
of the blood vessels, and thus to a modified function, and results in accelerated
atherosclerosis, causing visual disorder (retinopathy), kidney damage (nephropathy) and
peripheral nerve (neuropathy). In severe cases where major arteries are damaged in the
heart, the brain may result in ischemic heart disease, stroke and lower extremity gangrene.
Today, as one of the diseases with the highest incidence, diabetes also shows a paradox.
Namely, the methods and results of the ultimate treatment outcomes are improving at the
same time, and in everyday life the incidence of diabetes is increasing.
Starting from the early fifties of the last century industrial-developed countries 1

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faced with a real explosion in terms of increasing the incidence of this disease. They have
been considered the most important health problem in these countries for the past few
years. Health services responded largely to the measures that were directed to the
treatment. This led to a large increase in the funds spent for these purposes, but there were
no expected effects on reducing the illness. Research conducted over the last few decades
has led to new findings on the risk factors associated with an increase in the incidence of
these illnesses and have shown that it is possible to influence their incidence, that is, they can
be prevented. This has led to a significant milestone and orientation to prevention, and to an
increasing extent of health education. Diabetes is a major cause of work disability, invalidity,
high costs of health care and premature death. Type 2 diabetes can be prevented by a
healthy lifestyle, healthy body mass and physical activity. That is why it is very important to
keep sending a message that sufficient education about diabetes and prevention measures
saves long-term money but also improves the quality of life of people with diabetes and
people at risk of developing diabetes.
Activates of primary prevention are subject to:
1. Identification of a risk population: Type 2 screening for diabetes involves diagnosis
of glaucoma in persons older than 45 years in periods of 3 years. It is also recommended
that people with type 2 diabetes risk identify a simple questionnaire with information such
age, sex, family history, cardiovascular disease and pregnancy.
2. Education about the very illness through numerous methods of health education:
Primary prevention is an important role of educators to raise risk factors, modify them and
to set realistic health improvement targets for people with elevated risk.
3. Regular glycemic control: Endocrinologist or his associates - nurses - perform diabetes
training for self-control of the disease. The self-control program includes the following:
• Special diet regime, body weight control and physical activity;
• Providing insulin or taking tablets;
• Regular measurement of blood sugar levels;
• Review of urine or blood through the ketone height (acetone);
• Records of results obtained by check-ups;
• Use of appropriate minerals, vitamins and antioxidants.
Self-measurement of blood glucose level is a necessary measure of successful
therapy, and it is necessary for the patients to be educated about it. People with diabetes
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control their own glycemic level either directly using simple blood drops or indirectly
controlling the sugar content of the urine. Control of regulation by glycolised hemoglobin -
HbA1C control in healthcare institutions, a test that reflects the level of diabetes regulation in
the last 6-8 weeks.
4. Inform about the treatment: diet, weight loss and increased physical activity are
the first necessary measures to control blood glucose levels. In type 2 diabetic patients, if
lifestyle changes do not give adequate sugar reduction, oral hypoglycemic therapy is used, if
insulin therapy is needed.
The therapeutic goal of all types of diabetes is to maintain the level of glycaemia as close as
possible to normal values. This is expected to reduce body fat in obesity, eliminate
symptoms, and reduce the risk of developing cardiovascular disease, which is particularly
common in diabetic patients.
Diet forms the basis for the treatment of diabetes. In obese diabetics, weight loss is
one of the main goals as well as normalizing glycaemia, lipid and blood pressure and
preventing acute and delaying chronic complications. First of all, carbohydrate intake (55-
60% of the total amount of food) is limited, fatty intake (25-30%), cholesterol (<300 mg
daily), and adequate protein intake (up to 20%), which serve as building material. The
medical person must teach each diabetic patient about the importance of maintaining a
dietary diet. Everyone must know how to recognize fats, carbohydrates and protein in foods.
If training is done in a well-established and professional manner, while clearly setting goals,
it will reduce the need for treatment and care. In the main lines this diet involves avoiding
foods rich in sugars and fats. Carbohydrate intake should be reduced and not excreted from
the diet, as most patients think. If the diabetic body does not have enough sugar, it starts to
use its own fat reserves, and thus brings the organism into a ketoacidosis condition. First of
all it is forbidden to eat concentrated carbohydrates (cakes, chocolate, sugar). There are
artificial sweeteners that allow diabetics to consume sweet drinks smoothly. Increased
dietary fiber intake slows down resorption of sugar from food and prevents large leaks of
glycemic after meals, and enhances healthy bowel function. It is also necessary to reduce
the fat intake and to release foods rich in cholesterol. Limiting fat intake lowers calorie
intake and enhances the desired weight loss. In addition, the risk of developing
cardiovascular disease is reduced. As elevated salt intake associated with elevated blood
pressure is recommended, restrictive salt use is recommended. The protein intake meets
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most of the body's needs. It is recommended to take dairy products and non-fat meat. There
is no single diet plan or equal menu for all the sufferers. There are only principles,
recommendations, and good examples that help you get better. Health workers must
constantly alert the patient to complications and consequences if they do not adhere to the
recommended dietary diet and help them understand their condition seriously.
REFERENCES
Mayfield, J. (1998) Diagnosis and Classification of Diabetes Mellitus: New Criteria. Am Fam
Physician, 58 (6), 1355-63.
Sicree, R, Shaw, J. E., and Zimmet, P. Z. (2003) The Global Burden of diabetes. In: Gan D, ed.
Diabetes Atlas. 4th ed. Brussels: International Diabetes Federation.
Gwen, H. (2008) Structured Education in Diabetes, Journal of Practice Nurse, 36 (5), 35.
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