HEALTH | Diabetes: When insulin goes haywire

Considered one of the infamous silent killers, diabetes ranks fourth among the chronic diseases in the country. It has no cure and symptoms in most instances are undetectable at its early stages.

If symptoms manifest, the most common are increased hunger, increased thirst, weight loss, frequent urination, blurry vision, extreme fatigue, and sores or wounds that don’t heal. In addition, men with diabetes may have a decreased sex drive, erectile dysfunction, and poor muscle strength. Women, on the other hand, can have these additional symptoms: vaginal dryness, urinary tract infections, yeast infections, and dry, itchy skin.

“Diabetes kills one person every 8 seconds,” lamented Dr. Joy Arabelle C. Fontanilla, chair of the National Assembly of Diabetes Educators. “Together with cardiovascular disease, cancer and lung disease, diabetes is responsible for over 80% of deaths due to non-communicable diseases.”

In the Philippines, the prevalence of diabetes is approximately 4.6% to 7.2%, according to a study nursinganswers.net, which reviewed related literature on the subject. “This figure expands to 17.8% after adding those who have pre-diabetes (impaired fasting glucose or impaired glucose tolerance or both) which has a prevalence of 10.6%,” it said. “Therefore, one out of every 5 Filipinos could potentially have diabetes or pre-diabetes.”

Unfortunately, diabetes awareness among Filipinos is very low, according to Dr. Roy Ferrer, an assistant secretary of the Department of Health and diabetologist.

Normal people have several misconceptions about the disease, he said. “Most think that when a child is fat, he is healthy,” Dr. Ferrer explained. “That’s a myth. Children who are fat have a higher possibility of acquiring the disease because they eat a lot of food that has large amounts of sugar, which increases the sugar level in their blood.”

Actually, diabetes has something to do with insulin, the hormone released from the pancreas. “Insulin controls the amount of sugar in the blood,” explains The Merck Manual of Medical Information. “When a person eats or drinks, food is broken down into materials, including sugar, that the body needs to function.

“Sugar is absorbed into the bloodstream and stimulates the pancreas to produce insulin. Insulin allows sugar to move from the blood into the cells. Once inside the cells, sugar is converted to energy, which is either used immediately or stored until it is needed.”

The levels of sugar in the blood vary normally throughout the day. “They rise after a meal and return to normal within about two hours after eating,” says the Merck manual. “Once the levels of sugar in the blood return to normal, insulin production decreases.”

But with diabetes, something goes awry. “The pancreas becomes irresponsible,” states The Doctors Book of Home Remedies. “It either stops producing the hormone completely (Type 1 diabetes) or else produces too much, which leads to insulin resistance (Type 2 diabetes).”

Either way, concentration of sugar in the blood shoots sky-high.

“We have been saying that diabetes is not a disease to be toyed with,” said Dr. Antonio Litonjua, founding president of the Philippine Society of Endocrinology. “It should be viewed with concern because if left untreated then there may be serious consequences.”

The Geneva-based World Health Organization (WHO) states: “Diabetes is a major cause of blindness, kidney failure, heart attacks, stroke, and lower limb amputation.”

“Every diabetic’s goal is to maintain his blood sugar and blood fat as close to normal levels as possible,” the home remedies book says. “A diabetic regimen has three cornerstones: nutrition, weight control, and exercise.

“The good news is that you can virtually eliminate all symptoms of diabetes – in other words, ‘control’ it – by carefully following the regimen you and your doctor work out.” Just remember this: what is good for one diabetic person may be bad for another diabetic.

Data from the International Diabetes Foundation showed the average cost of treatment and maintenance for a Filipino diabetic patient grew from US$61 in 2010 to US$234 in 2017. The figure must have gone further these days.

Rice, the staple food of Filipinos, is not good if you eat too much of it. A study conducted by the Harvard School of Public Health showed that eating white rice on a regular basis may increase the risk for type 2 diabetes.

“The researchers found that people who ate the most rice – three to four servings a day – were 1.5 times more likely to have diabetes than people who ate the least amount of rice,” said the study which was published in the British Medical Journal.

It must be recalled that in 2018, the Davao City Rice Conservation Ordinance was approved by the city council. It is also known as the Half Rice Ordinance as it requires all business establishments serving food to include a half-cup of rice in their menu.

If you want to know whether you are diabetic or not, see a doctor. There are several tests and screenings available to help doctors diagnose a person and track the progress of a person’s diabetes. Among the common tests are blood glucose monitoring, urine testing, and insulin sensitivity testing. Screening of diabetes also includes blood pressure, cholesterol, and thyroid measurements.

Most Filipino endocrinologists or diabetologists are having clinics in major cities in the country. In Davao City, you can visit any of the following: Davao Doctors Hospital, Metro Davao Medical and Research Center, and Southern Philippine Medical Center.

During the National Diabetes Week last July, the city government of Davao – through the City Health Office (CHO) – has offered to all residents of the city – 20 years old and above – to avail themselves of free diabetes assessment and screening conducted every Friday in all barangay and district health centers.

“Our health centers are always open,” said Chona Dazon, the CHO Non-Communicable Diseases Program Coordinator, adding that those diagnosed with the disease are encouraged to register under the CHO’s Diabetes and Heart program, in order for the diabetic patients to receive free medication. It is this program that made Pepito recuperate from his illness.

In addition, CHO offers both oral medicines and insulin shots to diabetic patients.

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