Follow the ‘ApAt DApAt’ to DeAl with DiAbetes

By Rory Visco | Contributor

Nowadays, diabetes mellitus is described as a lifelong disease where the blood contains a high level of sugar or glucose.

Around the world, Dr. Sahagun said those who have diabetes mellitus continue to grow. In fact, in the Western Pacific region where the Philippines is part of, it is estimated that by the year 2045, there will be 183 million Filipinos who have diabetes, which is 15 percent higher than in 2017 where there were about 159 million Filipinos with diabetes mellitus.

The symptoms manifest themselves if there is excessive increase in blood glucose levels for a long period of time or there are diabetic complications present already.

By Maria Cheng & Jonel Aleccia

Time and again, people are reminded to “always” seek professional help and consult doctors and specialists in their field for any type of ailment. It’s not because a treatment regimen that worked on one person means it will work on others, as what doctors usually say. An example is diabetes.

According to Dr. Jereel Sahagun, an active consultant at the Department of Internal Medicine of the Mary Johnston h o spital, there are now a lot of sources of information with regard to diabetes, whether in print or broadcast media, or even social media and the internet. But despite this, he said fake news and incorrect information is still rampant.

“People should not believe it outright, especially information from social media and the internet,” according to Dr. Sahagun during the Philippine College of Physicians (PCP) health forum, which was held recently in cooperation with the Philippine College of e n docrinology, Diabetes and Metabolism (PC e D M), and titled “Ingat sa mga Tsismis, Alamin ang Tama sa Diabetes” as part of the observance of Diabetes Week 2023. h e said that the PC e D M and the Metabolic Syndrome Advocacy and Study Council continue to advise people to be critical of whatever information they hear, read or watch about diabetes. “Sadly, not all information that we read or hear in social media and the internet is true. That is why we encourage patients to regularly consult with their doctor or healthcare provider so that whatever it is that is difficult to understand can be explained or clarify any doubts,” Dr. Sahagun pointed out.

What is Diabetes Mellitus?

DIAB e T e S is a Greek word that means releasing water just like a faucet, while Mellitus is a Latin word that literally means “as sweet as honey.” That is why in the early days, Dr. Sahagun said, diabetes was illustrated as a condition in a person that urinates so much sugar that it leads to many medical complications. h e n arrated that in the early days, there were people who were tagged as “water tasters” whose task is to “taste” the urine of a person to diagnose whether the person has diabetes or not.

With this, Dr. Sahagun said internal medicine specialists and endocrinologists like him urge their patients to read about their ailment. But then again, the challenge is how would people know if the information they have is correct or mere hearsay?

Diabetes-fact or fiction?

IT IS true, Dr. Sahagun said, that those with high glucose levels in their blood don’t manifest diabetes symptoms.

But is diabetes curable? Unfortunately, the answer is no, Dr. Sahagun said, but it can be controlled. “Aside from diet and exercise, medicines can help control the level of glucose in the blood.” h o wever, there is what he called “diabetes remission” where diabetes is controlled without any medication and only through proper diet and regular exercise. “If you think you are a candidate for diabetic remission, consult a doctor. You still need doctor’s guidance if medication will be stopped and just focus on diet and exercise to control diabetes.”

Should medication be stopped once blood glucose levels drop or normalize? This is not advisable, according to Dr. Sahagun so better consult a doctor if diabetic medication should be discontinued. For those with Type 1 Diabetes Mellitus where the body cannot produce its own insulin, insulin medication should continue while those with Type 2 Diabetes Mellitus, where insulin produced by the body is not effective anymore, should consult a doctor to know about the right medicine and dosage.

Dr. Sahagun also reiterated that diabetes medications vary so again, patients should consult a doctor first before drinking medicines for diabetes. Doctors usually look for many angles if a particular medicine will suit or be effective on an individual or not.

“People who have diabetes are unique. They have different diabetes types, blood glucose levels, reactions toward medicines, genetic makeup, nutrition, physical activities and others. That is why medications of those with diabetes are not always the same,” he said.

Also, some people are wary of the popular diabetic drug “Metformin” for it allegedly damages the kidneys. Dr. Sahagun said this is not true because “Metformin” is effective and safe and is the first drug recommended for those with Type 2 diabetes, but only if the kidneys are still functioning well. “Remember that it is diabetes that damages the kidneys, not the medicine,” he added.

What makes Metformin popular for those with Type 2 diabetes is that it has been proven effective for the longest time, it is affordable and even given free in health centers, and there’s a low chance for those with diabetes to experience “hypoglycemia” or a sudden drop in blood glucose levels, it doesn’t make one gain weight, and is readily accessible.

“This is why we always remind our patients the ‘Apat Dapat’ rule, which involves proper diet, exercise, proper and regular medication, and regular consultation with their doctor. Remember also to be always critical of all information about diabetes or any other ailment that you read so best to consult a medical professional.”

The World h e alth Organization’s cancer agency has deemed the sweetener aspartame, found in diet soda and countless other foods, as a “possible” cause of cancer, while a separate expert group looking at the same evidence said it still considers the sugar substitute safe in limited quantities.

The differing results of the coordinated reviews were released last week. One came from the International Agency for Research on Cancer, a special branch of the W hO. The other report was from an expert panel selected by W hO a nd another U.N. group, the Food and Agriculture Organization.

The Lyon, France-based cancer agency periodically reviews potential cancer hazards, but does not determine how likely they are to cause cancer in their evaluations which range from “possibly” carcinogenic to “probably” to cancer-causing.

Aspartame joins a category with more than 300 other possible cancer-causing agents, including things like aloe vera extract, Asian-style pickled vegetables and carpentry work.

The guidance on use of the sweetener, though, isn’t changing.

“We’re not advising consumers to stop consuming [aspartame] altogether,” said W hO ’s nutrition director Dr. Francesco Branca. “We’re just advising a bit of moderation.”

See “Soda,” C2