All About Diabetes

In recent years, the world has recognized diabetes as one of the most daunting challenges posed by chronic diseases. The number of sufferers worldwide is currently estimated to be about 135 million; this number is expected to rise to almost 300 million by year 2025. The World Health Organization (WHO) and the Department of Health (DOH) estimate that diabetes affects between 5 and 10 million Filipinos at present, more than half of which are not aware that they have the disease. Thus, with the majority of patients being unaware of the primary disease, it is not surprising that knowledge about the complications of diabetes, including retinopathy is poor. (more…)

As patients or relatives and friends of diabetics, we can do the following to help improve the chances against loss of vision due to diabetic retinopathy: (more…)

Smoking is dangerous to your health.” This slogan has been on cigarette packs for years and yet, people who smoke do not seem to realize the slogan has much truth in it. Cigarettes contain nicotine, the addictive substance which makes people want to smoke. Apart from it, cigarettes also contain thousands of chemicals that are harmful to the body.

While smoking is harmful to people in general, it poses more health hazards to people with diabetes. Smoking increases their risk of complications brought about by diabetes such as heart attack and stroke. Here are some tips to help people with diabetes break the smoking habit. (more…)

In a Christian country such as the Philippines, prayer has become a part of many Filipino’s lives.  Whether it is for thanksgiving, forgiveness, or healing, prayer is a tool that many a suffering soul uses to cope with whatever hardships are encountered.

For patients with diabetes, can being prayerful help them better deal with their condition?  Is prayer an effective tool in managing diabetes?

Prayer and Diabetes

A research conducted at Duke University’s Center for the Study of Religion/Spirituality and Health investigated how intrinsic religiosity affects a person’s medical outcome and general wellness.  Intrinsic religiosity i defined as one’s religious or spiritual beliefs rather than participation in organized religious activities.

The study found that people with higher levels of intrinsic religiosity better survived severe illnesses, experienced less depression in older age, less disability and mortality when faced with chronic disease, and had stronger immune system.

Another very small, unpublished study looked at the possibilities of enhancing self-management with the use of a prayer wheel.  Nine study participants with type 2 diabetes used the prayer wheel for a span of three months adding to their usual self-care diabetes management.  Glycosylated hemoglobin (HbA1c) values were measured before and after the three-month period and compared with the HbA1c values of a similar group of nine who were not involved in a prayer wheel study.

The study revealed that among nine participants, seven experienced a reduction in HbA1c levels during the study period.  The drop in HbA1c level averaged 0.9 percent.  The other two participants experienced an average increase of 0.4 percent in their HbA1c levels.

Meanwhile, five participants in the control group experienced an average drop of 0.5 percent in HbA1c and four experienced an average increase in HbA1c of 0.8 percent.  The study was done in October to January – months when common holidays such as Halloween and Christmas were celebrated and often result in an increase in HbA1c for many people.

The results of the unpublished study suggest that the use of prayer, when combined with other holistic approaches in diabetes management, have beneficial effects on one’s HbA1c level.

Benefits of Prayer

According to Dr. Regina Grace Ravara, a medical doctor and currently Dean of the College of Arts and Sciences at St. Paul University Manila, one benefit of being prayerful for diabetes patients is that it helps them accept their condition.  ”When you tend to be more prayerful, you tend to be more accepting.  And if you are an accepting person, your stress level is lower than those who are still in denial of their condition,” explains Dr. Ravara.

Accepting the fact that you are diabetic, lowers your stress level and reduces your cholesterol level as well, adds Dr. Ravara.  ”There is a decrease in the level of cholesterol because it can also be converted to sugar.  It adds to the level of sugar if you tend to be more stressed secondary to the stage of a disease condition,” says Dr. Ravara.

Pastor Richard mendoza, health director of the Central Luzon Conference of Seventh-day Adventists, says that prayer has indirect benefits to diabetics, and that it makes them hopeful and optimistic. “Prayer is a source of comfort and healing,” says Pr. Mendoza.  He adds that being prayerful helps diabetes patients become compliant with their medication and treatment.

Dr. Ravara believes that the act of praying is an act of sacrifice.  It is a way to completely entrust one’s self to God.  Dr. Ravara says that when we are sick, we become more faithful to God.  It is because sickness or disease may lead one closer to death, says Dr. Ravara.  As such, the act of praying and being spiritual can help a person cope with whatever disease condition.

According to Pr. Mendoza,the act of praying and being spiritual also helps promote healthy habits.  Most churches teach healthy lifestyle and temperance which includes exercise, good diet and nutrition.  These practices are fit and good for diabetics.

Spiritual and Emotional Healing

For people with diabetes, spiritual and emotional well-being is necessary for cure and survival, say Pr. Mendoza.  Diabetics who lack spiritual and emotional support are found to get worse, develop more complications and live miserably while suffering from their chronic disease.

Dr. Ravara agrees that spiritual and emotional healing is vital for diabetic patients.  ”It direct us on how we are going to cope with our problems,” explains Dr. Ravara.  She adds that it also gives diabetics a chance to accept things as they are.  Dr. Ravara emphasizes that significant people play a big role in a patient’s spiritual and emotional healing. “The way other people look at us would also contribute to our self-esteem,” explains Dr. Ravara.

Being prayerful and spiritual can definitely help diabetics accept their condition and better manage their disease.  However, it is still important to follow the advice of healthcare professionals on how to deal with diabetes and not rely solely on prayers.  Holistic management of any disease is still the key.

But when all else fails, leaving it all up to God has proven wonders for many.  As Pr. Mendoza says, “Let diabetics pray and be spiritually healthy.  They won’t regret the hope, the comfort, the willpower, the faith, and the joy brought about by putting their trust in the Lord.”

For people with diabetes, checking blood sugar everyday is important. It is part of the routine they must do to keep their diabetes under control. And because it is routinely done, checking their blood sugar becomes automatic. Sometimes, diabetics get so used to the idea that they are not bothered by the regular needle pricks at all. But for some, they get tired of the daily process and lose interest in doing it altogether. And before they know it, the worst happens, and complications set in.

(more…)

The world of people with psychosis has been described as frightening, lonely and tormented. The technical definition of psychosis does not even begin to capture the despair of those who suffer from it. Psychosis refers to a group of disorders that affect the way a person thinks, feels and understands, such that the affected individual may appear to have some loss of contact with reality. There are hallucinations end delusions — seeing or hearing things that others cannot or do not perceive. Because of such manifestations, there is frequent disruption of relationships, jobs and day-to-day functions. They are unable to keep jobs or enjoy the company of others, even friends and family. Sadly, it affects people who are at the prime of their lives, affecting mostly young adults. (more…)

Most often, low blood sugar and weight gain are two main concerns of patients with type 2 diabetes. For a time the only solution has been injecting insulin to normalize blood sugar level. “Hypoglycemia is the most difficult obstacle in the management of blood sugar in people with diabetes;’ said Dr. Phillip Cryer, a professor of Endocrinology and Metabolism at Washington University School of Medicine in St. Louis.

And because diabetes is a complex disease, optimal disease control is solely not addressed by injecting insulin. Dr. Harold E. Lebovitz, professor of Medicine at the State University of New York observed, “Indeed, emerging evidence suggests the importance of an additional therapeutic target: GI (Gastrointestinal) hormone regulation”.

Januvia (Sitagliptin phosphate) works by generating the release of incretin hormones. This hormone produced in the gastrointestinal (GI) tract is responsible in activating the production of insulin in the body and slowing the rate of absorption in the GI tract. It triggers the body to naturally produce insulin that is needed in the body. At the same time, it slows down the emptying of the stomach to limit food intake.

“Incretin therapy offers an alternative option to currently available hypoglycemic agents for non-pregnant adults with type 2 diabetes with modest efficacy and a favorable weight change profile”, remarked Dr. Renee E. Amori of Tufts-New England Medical Center in Boston, based on the analysis of 29 studies he and his colleagues conducted.

Moreover, one big advantage of Januvia (Sitagliptin phosphate) over injected insulin is that it is taken orally. Aside from this, it works with the body in such a way that when the body’s blood sugar level rises, it immediately triggers the production of insulin.

“For the millions of Americans with type 2 diabetes, who continue to have inadequate blood sugar control, the approval of Januvia marks an important advance in the fight against diabetes… We now have another new option that treats the disease in an entirely new way that can be added to existing treatment regimens to help patients gain more control over their blood sugar levels”, declared Dr. Steven Galson, director of Food and Drug Administration’s Center for Drug Evaluation and Research in the United States.

Diabetes embraces numerous complications, and bone disease is not an exception.The illness attacks bone mass without hesitation. Poor bone health is usually associated with type 1 diabetes, with decreasing bone mass as one of its complications. But type 2 diabetics are not at all safe. The American Diabetes Association reveals that even though type 2 diabetes increases bone mass, the risk of bone fracture is still high. There are things that one can do to maintain bone health. We suggest the following ways: (more…)

To further understand the rational application and use of insulin among people with diabetes, Endure Medical, Inc. brought Dr. Michael Villa, chief of the Section of Diabetes, Endocrinology and Metabolism at St. Luke’s Medical Center, to Iloilo.

Dr. Villa’s three separate lectures—one for patients with diabetes from major hospitals in Iloilo, another for resident physicians of St. Paul Hospital in Iloilo City, and the last one for consultants and residents from major Iloilo hospitals—all delved on the vital role of insulin in diabetes management.

The first event of the day was a lay forum dedicated for the better understanding of diabetes, its complications, and current treatment strategies. Held at the Ayala Hall of the Center for Professional Values and Development in Iloilo City, the forum’s participants included nurses and elderly citizens from the diabetic group of St. Paul’s Hospital, Iloilo Doctors Hospital, and the West Visayas State University Hospital, among others.

“What’s important to us is that if you are diabetic, your blood sugar should be controlled,” said Dr. Villa. He also emphasized that between hyperglycemia and hypoglycemia, though both are considered easy to treat among doctors, the latter poses a greater danger since severe hypoglycemia can cause coma. “It is therefore important that you always eat and not miss a meal and always check your blood sugar,” he advised.

The lay forum was immediately followed with a scientific session for residents and nurses of St. Paul’s Hospital. Receiving a warm welcome from Dr. Henry Gonzales, chair of the Department of Family Medicine, and the medical staff, Dr. Villa proceeded with a presentation focused on the in-hospital management of hyperglycemic and critically-ill patients, especially in the outcomes of tight glycemic control. “Insulin as a treatment has been a protective factor against hyperglycemia and increased free-fatty acids,” said Dr. Villa. He added that these are just two factors that affect morbidity and mortality among patients, especially in the intensive care unit (ICU) and in the neurology ICU.

The last session of the day is dedicated for lectures among consultants and residents from major hospitals in Iloilo. This time, Dr. Francis Pasaporte, president of the Philippine Association of Diabetes Educators, joined Dr. Villa and centered on the role of insulin in outpatient management. Dr. Villa, on the other hand, focused on the effective use of different insulin types inside the hospital .

Endure Medical Inc. hopes that through these informative lectures on the vital role of insulin in diabetes and glycemic control, patients and doctors alike will be more aggressive and less hesitant to prescribe and advocate the use of insulin.

For people with diabetes, a bout with cough, cold or low-grade fever is no simple matter. It could increase their blood glucose levels making them more susceptible to graver conditions. When we are sick, our body produces certain hormones which help fight off the illness. However, these hormones can raise blood sugar levels, thus disabling the effects of insulin.

On the other hand, illnesses that cause vomiting, diarrhea and dehydration need more attention, as they may trigger diabetic ketoacidosis (DKA) or hyperosmolar hyperglycemic state (HHS). These conditions may warrant hospitalization if not treated properly and promptly. Being alert and armed with knowledge can help you go a long way in planning for your sick days. Here are some helpful do-it-yourself tips on effective sick day management.

DOs:
Know when to call your doctor. When you are sick, it is best to know when to call your doctor. Some signs that should warn you to seek medical attention are: blood sugar level that has been higher than 240 mg/dL for over 24 hours or lower than 70 mg/ dL; urine ketone level that is moderate to high; diarrhea or vomiting; sleepiness or inability to think clearly; dry, cracked lips or tongue, and fever over 101 degrees Fahrenheit or 38.3 degrees Celsius.

Regularly check blood sugar and urine ketone levels. For those with type 1 diabetes, it is suggested that you check your blood sugar level and urine ketone levels every four hours. While for those with type 2 diabetes, it is best that you check four times a day.

Know what to eat. Try to stick to your diabetes meal plan to maintain blood sugar stability. However, with nausea, vomiting and diarrhea, it may be tough to eat your usual fare. You may need to take 45 to 50 grams of carbohydrates every four hours to prevent ketone development and low blood sugar attacks. Here’s a list of more tummy-friendly foods that contain about 15 grams of carbohydrates: 1 cup clear soup, 1/2 cup regular gelatin, 1/2 cup non-caffeinated regular soft drink (like 7-up or Sprite), 1 double-stick frozen fruit popsicle, 1/2 cup unsweetened applesauce, 1/3 cup apple juice, 1 cup sports drink (like Gatorade or Pocari Sweat), 6 saltine crackers, 3 graham crackers, 1 slice dry toast, 1/2 banana.

Let a friend know you’re sick. If you have diabetes, wear a medical tag to let people know of your condition when an emergency arises. When you are sick, it is also very important to let others know, especially those who can give immediate help like neighbors, friends and relatives.

Be prepared. Keep medication, insulin, blood glucose and ketone test strips, emergency phone numbers, a thermometer, sugar-free cough or cold preparations handy. Talk to your doctor about your sick day management plan and agree on how to manage your blood sugar and other medical conditions during sick days.

DON’Ts:

Stop your medications. Take your medications as usual if you are eating normally. Missing your insulin or other medications can lead to ketosis. If you are unable to keep food or liquids down, you will need to adjust medicine doses, so call your physician.

Self-medicate unwisely. Over-the-counter medications and herbal remedies may contain sugar and alcohol and thus may wreak havoc on your blood sugar levels, so read the labels carefully. Medications like ibuprofen and paracetamol may be harmful for people with kidney and liver problems respectively. Decongestants may also raise blood pressure. When in doubt, get your physician’s okay.

Avoid fluids. To prevent dehydration especially when you have nausea, vomiting and diarrhea, drink at least 240 mL of water or non-caffeinated calorie-free liquid such as broth every hour while you’re awake.