Diabetes continues to be among the top killer diseases in the Philippines. In 2020, it has become the 4th leading cause of mortality in the country with over 39 thousand reported cases. With the pandemic limiting the continuous medical maintenance of diabetic patients and living an active, healthy lifestyle, more and more people are being at risk to develop the disease.
In line with World Diabetes Day, the Philippine Society of Endocrinology, Diabetes and Metabolism (PSEDM), the Philippine Pharmacists Association (PPhA), Mercury Drug Corporation (MDC), and MSD in the Philippines organized a health discussion to empower Filipinos on how they can discover, prevent, and manage diabetes. The said webinar, hosted by broadcast journalist Jing Castaneda, aims to guide patients and at-risk individuals in their patient journey so that they can make informed choices about their healthcare in the “new normal”.
Diabetes 101 and How to Manage It
Diabetes is a chronic disease, which occurs when the pancreas does not produce enough insulin, or when the body cannot effectively use the insulin it produces. This leads to an increased concentration of glucose in the blood (hyperglycaemia).
Dr. Cecilia Jimeno of the UP College of Medicine discussed that there are two types of diabetes: Type I, which is usually detected early in children, or also called insulin dependent diabetes. “Due to a damaged pancreas early on, the body of the patient is unable to produce its own insulin and must receive regular insulin shots to be able to regulate their own blood sugar,” Dr. Jimeno explained.
The more common is Type II, or “adult diabetes”. This type is prevalent among people with a family history of diabetes, thus making it hereditary. Risk factors also include unhealthy eating habits, sedentary lifestyle, taking medicines infused with steroids, and irregular sleeping patterns.
Dr. Jimeno also put emphasis on how frequent lack of sleep can be a risk factor of diabetes. “Insulin is a type of hormone. Hormones are usually produced at night when we sleep,” she explained. “But if we stay up late due to work-related activities or suffering from sleeping problems, our brain tends to produce more stress hormones, which then signals the brain to use up more blood sugar for energy. The irregular processing of blood sugar is the main complication of those suffering from Diabetes.”
She further elaborated that before people get diagnosed with the illness, there is “pre-diabetes’ that has to be detected early on to prevent the onset of the actual disease. Through the ‘ABC’ test– A1C test for blood sugar count, Blood pressure checks, and Cholesterol level monitoring– one can detect the onset of pre-diabetes to be able to develop a health program to avoid the disease from worsening.
A1C, or HbA1c, is a test that measures blood glucose control over the past two to three months. The A1C target for most people is under 7%. Meanwhile, monitoring blood pressure is one way to check if your heart can still regulate blood circulation, thus the processing of insulin too. For most people with high blood pressure and diabetes, blood pressure levels should be <130/80 mm Hg.
Patients are also advised to check their cholesterol level through determining the number of the low-density lipoprotein (LDL), and high-density lipoprotein (HDL) at least once a year. The goal for most people may be modified based on their respective individual risk profile.
For her part, Dr. Aurora Macaballug from PSEDM added the “Apat Dapat” checklist that patients should follow to be able to maintain their blood sugar level. The checklist includes eating healthy, regular exercise, strictly sticking to their prescribed medication, and having regular check-ups with their physicians. They must learn to adapt these practices as diabetic patients are three times more prone to infection. Besides intaking their regulating medicines, they are also encouraged to get vaccinated, especially against viral infections such as Influenza and Pneumonia. Having diabetes also exposes patients to a 50% risk in getting auto-immune diseases.
Making Diabetes Care Accessible to All
“The challenges we met during the pandemic were the lack of supply of the needed medicines, and the limitation of face-to-face consultation,” Dr. Macaballug said. “Due to ECQ, our patients cannot go out nor go straight to clinics and hospitals for their consultations out of fear of contracting COVID. The lack of supply was brought about by the stalling of shipping to our country. But this year, we have seen improvements in these areas,” she said.
Hospitals and clinics have started conducting teleconsultations through their official websites and other online platforms. Even if the patients cannot go out yet, they are now able to reach doctors online to ask about their condition. “We can also see the slow opening of ports, thus medicines are on the way,” she said.
There are some instances wherein patients are hesitant to meet their doctors despite the available channels. But Mr. Bryan Posadas of PPhA posed this as a hazard, as some of these patients use the excuse of being “on medication” anyway, which is not supposed to be a lifelong intake. With this, he shared that in this area, pharmacists can help patients greatly, especially on the matter of their treatment plans.
Posadas underscored that pharmacists are also qualified health professionals who can advise especially on medication, and can also conduct immunization for diabetic patients. The expanded role of pharmacists as adult immunizers is in line the Philippine Pharmacy Act of 2016 (RA 10918).
One example is Mercury Drug Corporation (MDC), where selected store pharmacists are being trained by expert endocrinologists to help educate and counsel patients on all relevant aspects of diabetes management.
Furthermore, to strengthen its efforts in elevating diabetes care in the Philippines and ensure that Filipinos have access to diabetes care, MDC has set up Get Well at Mercury Drug Diabetes Care specialty corners, found at select Mercury Drug branches, which aim to provide convenience for customers by offering a complete assortment of products needed by diabetics, and in-store patient counseling by trained pharmacists.
The theme for World Diabetes Day 2021 is access to diabetes care. The theme reminds us about the importance of collaborative and multi-stakeholder efforts to raise awareness about how to improve diabetes prevention, diagnosis, and management.
Diabetes care should be grounded on correct and proper knowledge of the disease and easy access to medicine and treatment to encourage people to be proactive partners in preventing diabetes, especially during these challenging times.
ADVT