DiabetEASE October-November 2013 by Dan Cisneros

OCTOBER-NOVEMBER 2013

CONTENTS

behindthescenes

COVER STORY AND FEATURES

Football and Beyond

8 Top Covers

World Diabetes Day 2012: How the World Celebrated

Brothers James and Phil Younghusband sat down with Mylene C. Orillo and shared about their lives as athletes, the future of football, and raising their sister after the death of their mother Susan.

Jose Martin Punzalan looks back at the eight years of the magazine with the covers of the eight best-selling issues that captured everyone’s attention.

As the world commemorates World Diabetes Day this November, Micahaela Sarah de Leon gives a report on the 2012 celebration around the world.

Diabetes: Things I Wish I Knew About You

Breaking the Limits of Sports Medicine

Is there a cure? What food can I eat? Nicole Limlengco approached four people to reveal the questions about diabetes they wished they knew the answers to before being diagnosed.

The team takes a photo with the cover boys

regulars 6 | EDITOR’S EDICT 8 | WE’VE GOT MAIL 9 | SWEET NEWS ON THE COVER: Azkals and Meralco Sparks’ players James and Phil Younghusband are the poster boys of football, taking in endorsements and admiration from fans. But staying healthy and raising their sister remain on top of their priority list.

More people are now becoming health-conscious by doing more physical activity, but also run the risk of injuries. Alexa Villano interviews health experts in the fast- growing field called sports medicine.

in depth 22

The 8 Top Tips in the Care of Diabetic Hearts

24 2

Cardiologist Dr. Juan Dionisio Foronda discusses the steps to prevent diabetes complications on one of the most vulnerable organs in the body-the heart.

8 Best Care Strategies for Diabetic Eyes

Dr. Fernandino Fontanilla explains how diabetes can damage the eyes, and how this can be prevented. OCTOBER-NOVEMBER 2013

Photography by Fritz Tentativa Styling by RJ Roque Assisted by Lord Rebueno Blue and white shirts by The Dalhin Shirts Grooming by Carlos Roque Shot at Bulb Studios Special thanks to Cathy Nazareno and Maxine Chua of Mac2Group Manila

8 Best Practices To Care For Diabetic Nerves

8 Best Care Tactics for Diabetic Kidneys

Did you know that Diabetes can also damage the nerves? Dr. Josephine Tuason teaches how it can be avoided.

The kidneys help rid the body of toxins. What happens when diabetes gets so bad they can’t function anymore? Dr. Isabel de Leon-Duavit gives tips to protect them.

columns 14

Educator’s Corner

Fightin’ For Fitness

8 Misconceptions about Diabetes Dr. Jocelyn C. Isidro dissects the facts and myths on diabetes, and some of them are surprising.

Achieving an Hourglass Figure Envy the perfect “coca-cola” shape of famous personalities? Fitness instructor Cyrus Eleuterio lists down exercises you can do to achieve that figure.

Righteous Recipes

Good Food Guide

3 Must-try Brown Rice Recipes Chef Junjun de Guzman is back and whips up dishes that can be made from this alternative grain.

Cleansing Diets, Anyone? Confused with the many cleansing diets on the market? Nutritionist Edreilyn Manalo presents the advantages and disadvantages of undergoing this latest fad.

OCTOBER-NOVEMBER 2013

sections 19

You Ask, We Answer

Is theta healing effective for diabetes? So what exactly is theta healing and how does this help those with various illnesses? Dr. Maria Leonora Capellan investigates this new program.

Product Spotlight

Living Well

Diabetes Must-haves for the Busy Bee With many products now available, what do people with diabetes need to take with them? Aencille Santos writes some of the product must-haves that are hassle-free.

Two Faces of Diabetes Excel Dyquiangco gets to know two men managing a condition that changed their lives.

Stress Busters

8 Stress-reducing Tips With a fast-paced lifestyle, stress is not far behind. Ma. Cristina Arayata lists down ways to live a stress-free life.

69 71 76

Dos and Donâ&#x20AC;&#x2122;ts

8 Tips for the Newly Diagnosed As a newly diagnosed patient, what are the guidelines that one should remember? Emil Karlo dela Cruz gives the low-down on the ways to cope as a new patient.

Affairs to Remember Doodles & Dreams

OCTOBER-NOVEMBER 2013

EDITOR’S EDICT

Eight Work eight hours and sleep eight hours and make sure that they are not the same hours. - T. Boone Pickens Eight is certainly an auspicious number. In the Chinese culture, it’s considered lucky, denoting wealth and prosperity; in ancient Japan, it is considered a holy number. It also resembles the infinity symbol, a perfect fit for wedding anniversaries. Eight too is shaped like an hourglass figure signifying health and beauty. As DiabetEASE turns auspiciously eight this October, we have several treats for you. We have asked experts to tell us the 8 best ways to care for the body parts most vulnerable to diabetes complications - eyes, kidneys, nerves and hearts. In the following pages, you will also find the 8 common misconceptions about diabetes, 8 great stress busting tips, 8 cool coping tips for the newly diagnosed, as well as 8 simple exercises to help you get that hourglass figure right in your own home. And speaking of the hourglass figure, we have the double pleasure of two male versions of it gracing our cover – superstar strikers James and Phil Younghusband. Having lost their mother to diabetes two years ago, recently orphaned and already playing guardian to their younger sister, these brothers certainly can be admired both on and off the football field. As an added bonus this issue, we also feature the covers of our all-time top-selling issues on the newsstand as of July. I was a bit surprised that most of the covers that made the list were not those of hot household-name celebrities but rather, most of them were concept covers. It seems that our dear readers appreciate the magazine more for its content than its packaging. And I’m glad that one of my personal favorites actually made it to number 1 – that of the Father of Endocrinology, Dr. Augusto D. Litonjua. The battle cry this year for World Diabetes Day on November 14th is Diabetes: Protect our future. We at DiabetEASE certainly join our voice with the rest of the world to help stop the diabetes epidemic so the coming generations need not suffer its dire consequences. Hope you enjoy this eighth anniversary issue, and may we all have infinite wealth of mind, body and spirit! Peace and thank you,

Joy C. Fontanilla, MD, FACE, FPCP, FPCDE, FPSEM, CCD

Editor-in-Chief

OCTOBER-NOVEMBER 2013

MEDICAL ADVISORY BOARD Ramon F. Abarquez Jr., MD Professor Emeritus, University of the Philippines College of Medicine; Academician, National Academy of Science and Technology Mary Ann Lim-Abrahan, MD Past President, Philippine Lipid and Atherosclerosis Society; Professor, University of the Philippines College of Medicine–Endocrine Section Abdias V. Aquino, MD President, Philippine Society of Hypertension; Past President, Stroke Society of the Philippines; Past President, Philippine College of Physicians Corazon VC. Barba, PhD, RND Past President, Nutritionist-Dietitian’s Association of the Philippines Ricardo E. Fernando, MD Founder and President, Institute for Studies on Diabetes Foundation, Incorporated Ruby T. Go, MD Past President, Philippine Lipid and Atherosclerosis Society; Head, Endocrine Section, Chinese General Hospital Augusto D. Litonjua, MD President, Philippine Center for Diabetes Education Foundation; Founding President, Philippine Society of Endocrinology and Metabolism; Philippine Association for the Study of Overweight and Obesity Roberto C. Mirasol, MD Past President, ASEAN Federation of Endocrine Societies; Past President, Philippine Society of Endocrinology and Metabolism Antonio R. Paraiso, MD Medical Specialist III, National Kidney and Transplant Institute; Assistant Professor, College of Medicine, University of the East Ramon Magsaysay Memorial Medical Center Ma. Teresa Plata-Que, MD Past President, Philippine Diabetes Association; Consultant, East Avenue Medical Center; National Kidney and Transplant Institute Tommy S. Ty-Willing, MD Past President, Diabetes Philippines; Trustee, Philippine Center for Diabetes Education Foundation; Founding President, Philippine Lipid Society; Consultant, Metropolitan Hospital

CONTRIBUTORS Dr. Fernandino A. Fontanilla, MD

Publisher: FAME Publishing, Inc. Editor-in-Chief: Joy Arabelle C. Fontanilla, MD Assistant Editors: Mylene C. Orillo Emil Karlo dela Cruz Michaela Sarah de Leon Art Directors: Donna I. Pahignalo Michael Patricio Editorial Coordinator: Alexa Villano Senior Writers: Ma. Cristina Arayata Jose Martin Punzalan Aencille Santos

Dr. Fontanilla is an ophthalmologist at the Asian Hospital and Medical Center, Alabang. A graduate of the U.P. College of Medicine, he did his residency training in Ophthalmology at the Philippine General Hospital and his Unveitis and Ocular Immunology fellowship at the University of Illinois, Chicago.

Dr. Josephine T. Tuason, MD Dr. Tuason is a neurologist at the Asian Hospital and Medical Center, Alabang who has been practicing for over 24 years. She graduated from the De La Salle University Medical School and took up her residency at Makati Medical Center and Medical Center Manila.

Graphics and Layout: Dan Cisneros Overall Marketing Manager: Hudson P. Pelayo Marketing Assistant: Godfrey Santos Group Sales Manager: Ma. Elna P. Jagape Senior Account Managers: Noel A. Ongkingco Charlotte Aireen Punzalan Representatives: Antonio Fajardo Jr. Florence Palapar Girlie Joy D. Jovero Leonard Anthony D. Baluyot Advertising Assistant: Irina Mae Carampatana

Dr. Maria Isabel de Leon-Duavit, MD Dr. Duavit is a clinical associate professor at the UPPGH and nephrology consultant at PGH, Asian Hospital and Medical Center, Las Pinas City Medical Center, Medical Center Parañaque, as well as Medical Director, Kobe Dialysis Unit and BBraun Avitum Dialysis Center, Alabang.

Dr. Juan Dionisio Foronda, MD Dr. Foronda is a cardiologist at the Asian Hospital and Medical Center, Alabang and Makati Medical Center.

Officer-in-Charge, Circulation Department: Armando Sandajan Executive Assistants: Angeli M. Mamaril Zenaida R. Fortes Legal Counsel: Castillo, Laman, Tan, Pantaleon and San Jose Law Firm

Dr. Maria Leonora D. Capellan, MD Dr. Capellan is an endocrinologist at the Makati Medical Center and St. Luke’s Medical Center Global City.

Jocelyn Capuli-Isidro, MD, FPCP, FPSEM Diabetes is not a one-size-fits-all disease. The information in DiabetEASE, therefore, is not meant to substitute for a health professional’s advice and readers are cautioned to consult with their healthcare provider before putting any of its contents into practice.

DiabetEASE is published by Friendly Alliances and Media Expressions, Inc. (FAME, Inc.). No part of the magazine may be reproduced in any manner without the permission of the publisher. Unsolicited manuscripts, photographs, and artwork will not be returned unless accompanied by self-addressed stamped envelopes. Address all correspondence and subscription inquiries to FAME Inc., Suite 503 Narra Building, 2276 Pasong Tamo Extension, Makati City, Philippines. Tel. Nos. 892-0723 to 24; 894-0483; 813-5433 or 36; Fax No. 892-8514; E-mail: diabetEASE.famepublishing@gmail.com. All rights reserved. Copyright 2013 by FAME, Inc.

Dr. Isidro is a Consultant Endocrinologist at Makati Medical Center and the St. Luke’s Medical Center, Global City. She is also a member of the medical bureau of Diabetes Center Philippines or the Philippine Center for Diabetes Education Foundation, Inc.

Edreilyn C. Manalo, RND Edreilyn C. Manalo is a nutrition-dietetics practitioner for clinical and hospital nutrition and weight management. She finished Bachelor of Science in Nutrition and Dietetics at Centro Escolar University; studied Bachelor of Science in Chemistry at Adamson University, and obtained a certificate of internship at the St. Luke’s Medical Center-Quezon City (SLMC). Edreilyn is a board passer in Nutrition and Dietetics, year 2013. She is currently a member of the NutritionistDietitian Association of the Philippines (NDAP) and Philippine Association of Nutrition-Delta Chapter of CEU.

OCTOBER-NOVEMBER 2013

we’vegotmail

find us on www.facebook.com/diabetEASE

Good Day! Is it ok if you include topics about glucometer? And where can we buy affordable glucose test strips? Is your company familiar with the GlucoDr™ Plus meter kit? I’m planning to use it, it has the cheapest test strips, but I don’t know if it’s accurate, I saw it in Mercury Drug.

Dear DiabetEASE, I was able to grab a copy of your August-September issue. I’ve learned so much about Kim Atienza’s story in being healthy after his stroke. Hope you will continue featuring personalities who may not have diabetes but try to live a healthy lifestyle.

–Cristina via Facebook DiabetEASE welcomes feedback from readers. Please send your comments, questions and suggestions through any of the following: Snail mail: 503 Narra Building, 2276 Pasong Tamo Extension, Makati City 1232 Philippines Email address: diabetEASE.famepublishing@ gmail.com Fax number: (+632) 8928514 Telephone numbers: (+632) 8920723 to 24; 8940843; 8135433 or 36 DiabetEASE reserves the right to edit materials for publication.

Dear Cristina, We’ve featured glucose meters a few times in our past issues.Glucose test strips can be purchased at medical supply stores, drug stores or directly from the manufacturing or distributing companies. Some companies have promo packages and accept trade-ins.GlucoDr™ Plus is a product of South Korea and was found by the US FDA to be “substantially equivalent” or at par with a reference standard. Watch for features on all things diabetes in our first annual Ultimate DiabetEASE Resource Guide which should be on bookstore shelves and newsstands by January, 2014.

– Lalaine via e-mail

Hi, DiabetEASE! Please feature not only personalities but also Diabetes Clubs since many of the groups are normally tied up to the respective organizations. -Cindy via e-mail

Thanks, Dr. Joy

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DECEMBER-JANUARY 2013

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sweetnews

Diabetes risk lower a mong Asia ns in Ca n ada

study in Canada showed that diabetes patients of Asian heritage – particularly Chinese – are less likely to develop risk of cardiovascular complications than those with European heritage. The report, which was done by researchers from the Institute for Clinical Evaluative Sciences in Toronto and published in the September issue of Diabetes Care, stated that the risk of South Asians hospitalized for coronary artery disease, stroke, or lowerextremity amputation is marginally low (HR 0.95, 95 percent CI 0.90-1.00), but this was even lower among Chinese (HR 0.50, 95 percent CI 0.46-0.53). The risk of dying within a period of 4.7 years was also 40 percent lower among South Asians (HR 0.58, 95 percent CI 0.55-0.62) and Chinese patients (HR 0.56, 95 percent CI 0.520.60).

diabetes.org

Chinese have lower risk of cardiovascular complications from diabetes

Dr. Baiju Shah and colleagues took data of 491,243 adults who were newly diagnosed with diabetes from April 2002 to March 2009 using provincial healthcare databases from Ontario. It was written whether the patients had type 1 or type 2 diabetes. Majority of them had type 2 diabetes. “We have previously shown that the utilization of and quality of care is similar between these populations, so the differences in cardiovascular disease burden and mortality may occur because new-onset diabetes in South Asian and Chinese patients is less severe [than] in European patients,” said the authors. They added: “Understanding the underlying genetic, physiologic, metabolic, or behavioral mechanisms that lead to this protection for Asian populations may help develop new strategies to reduce the risk of diabetes complications in the overall population.” With MPT report D

OCTOBER-NOVEMBER 2013

sweetnews

Fluoroquinolones m ay severely alter blood sugar levels

Antipsychotic drugs may increase type 2 DM in kids

herbal.eathealthyvitamins.com

OCTOBER-NOVEMBER 2013

a.abcnews.com

new study showed that the use of fluoroquinolone antibiotics may be the cause of dysglycemia in diabetes patients. The report, which was published in the Clinical Infectious Disease Journal, chronicled how researchers from Taiwan used national insurance claim data to check 78, 433 diabetes patients who received prescription for an oral antibiotic. Covering the period of January 2006 to November 2007, the patients who took the antibiotics showed that the absolute risk for hyperglycemia (high blood sugar) with moxifloxacin was 6.9 and 1.6 for macrolides. For hypogylcemia (low blood sugar), it was at 10.0 for moxifloxacin and 3.7 for macrolides. The researchers also discovered that hypoglycemia was also associated with patients receiving moxifloxacin concomitantly with insulin (adjusted odds ratio 2.28; 95 percent confidence interval 1.22â&#x20AC;&#x201C;4.24). The report said that the patients taking moxifloxacin, levofloxacin, or ciprofloxacin had 1.75 to 2.48 times the risk for hyperglycemia-related emergencies. The authors said that clinicians should take this study seriously and that they must prescribe fluoroquinolones cautiously in patients with diabetes. With JAMA and Clinical Infectious Disease reports D

12-year study showed that using antipsychotic drugs may dramatically increase the risk of developing type 2 diabetes in children. The study, which appeared in diabetes.co.uk listed the following drugs: aripiprazole (Abilify), which is used in older children with bipolar disorder; risperidone (Risperdal) used in children with aggressive behavior; quetiapine (Seroquel), and olanzapine (Zyprexa) both used off-label in children. According to the report, some of the medicines are not usually prescribed for children but may be given in case of schizophrenia or manic episodes of bipolar disorder. In the study, 29,000 children and young adults were observed using the medications mentioned in the list, with 14,000 of them taking alternatives such as lithium, anti-depressants and psychostimulants including methylphenidate (Ritalin). It was reported that those who used the antipsychotic medications had three times the risk of developing type 2 diabetes within the year compared to those who stuck to the alternative medicine. It also remained high, even after the use of the antipsychotic drug was stopped. The article also suggested alternate medicines that doctors can look into, taking into consideration the risk of developing insulin resistance and type 2 diabetes when prescribing antipsychotics. D

sweetnews

Apple, grapes also cut risk according to British study

on’t skip the fruits. It may reduce your risk of diabetes. In a new study release by the British Medical Journal, fruits -- particularly blueberries -- cut the risk of developing type 2 diabetes by 26 percent. Researchers from the UK, US, and Singapore looked at data from three studies of 187,000 nurses and health professional in the US to determine the link between type 2 diabetes risk and fruit consumption. In the studies, it was found that 6.5 percent of participants (12,198 out of 187,382) developed type 2 diabetes. A food frequency questionnaire was used for the study, where participants were followed up every four years on how often they consume a standard portion of each fruit. The fruits used in the study were grapes or raisins, peaches, plums or apricots, prunes, bananas, cantaloupe, apples or pears, oranges, grapefruit, strawberries, and blueberries. Data showed that three servings per week of blueberries, grapes, raisins, and apples and pears significantly reduced the risk of type 2 diabetes by as much as 26 percent, compared to the other fruits in the list. According to the researchers, this might be due to the fruits having high levels of anthocyanins, which have been shown to enhance glucose. The same fruits contain naturally-occurring polyphenols which are known to have beneficial effects. The authors wrote: “Fruits have highly variable contents of fibre, antioxidants, other nutrients, and phytochemicals that jointly may influence the risk.” But the research did not explain the glycemic load of the fruits in the study, as well as the quality and quantity. Dr.Matthew Hobbs, head of research for Diabetes UK said that the study showed the importance of fruits for diabetes patients, but should be treated with caution. “Some of the findings are based on a number of assumptions and models which may have distorted the results significantly.” “For example, the researchers used surveys to ask participants how often they ate certain foods. This type of survey can often be unreliable as people are more likely to remember certain types of food.” with BBC News report and British Medical Journal reports D

Chronic fatigue may affect adults with type 1 diabetes

report done by researchers in Holland showed that chronic fatigue is much more prevalent in adults with type 1 diabetes than those without diabetes. The study by the Expert Centre for Chronic Fatigue at Radboud University in Nijmegen observed 214 adults with type 1 diabetes, and matched them with another 214 adults without diabetes. The control group, which composed of adults without diabetes, showed that chronic fatigue was at 7 percent. Meanwhile, 40 percent of those with type 1 diabetes had chronic fatigue. Chronic fatigue was defined as severe fatigue lasting for six months or more. It was also discovered that chronic fatigue was not linked to HbA1c levels. In a subset of 66 adults with type 1 diabetes that had continuous glucose monitoring, those who had fewer hypoglycemic (low blood sugar) levels tended to be tired all the time. Chronic fatigue has also been found to affect people with diabetes-related complications, like nerve damage, kidney damage, and cardiovascular disease. It is also common in diabetes patients with depression: 88 percent of depressed diabetes patients had chronic fatigue. “Depression can cause fatigue, but…being fatigued can also lead to (often mild) depressive symptoms. More severe depression can lead to fatigue, and once the depression is treated, fatigue levels often normalize,” said Dr. Hans Knoop, lead researcher of the study. The researchers also said that psychological interventions could therefore be helpful in the management of persistent tiredness. With diabetes.co.uk D

redorbit.com

Blueberries may reduce risk of type 2 diabetes

OCTOBER-NOVEMBER 2013

sweetnews

Gestational diabetes may raise sleep apnea risk

medtronic-diabetes.co

study done in Australia showed that insulin pump therapy improved the blood glucose control among teenagers with type 1 diabetes. The study which appeared in Diabetologia focused on 700 patients from Princess Margaret Hospital for Children, in Perth. About 355 patients were on insulin pumps and 355 patients on injections, split between multiple daily injections and twice daily injections. The researchers followed the children’s progress over seven years. The researchers wrote that from the start of the first year, the pump group showed good progress with better HbA1c levels than those who did injections. The difference was even more prominent when the adolescents in the injection group saw a significant rise in HbA1c. For the injection group, HbA1c values which started at 64 mmol/mol (8.0 percent) grew steadily to 73 mmol/mol (8.8 percent) after seven years. The pump group also started with an HbA1c of 64 mmol/mol (8.0 percent) but this actually decreased to 61 mmol/mol (7.7 percent). While the researchers noted that the groups started with same average HbA1C, those who were under the insulin pump group showed a slightly better ability to control their blood glucose one year prior to the start of the treatment. The study also showed that the rate of severe hypoglycemia was significantly lower by 30 percent among those who used insulin pumps. Meanwhile, those in the injection group showed “10.2 episodes of severe hypoglycemia per 100 patient years compared with 7.2 episodes of severe hypo per 100 patient years within the insulin pump group,” according to the study. With diabetes. co.uk D

OCTOBER-NOVEMBER 2013

healthlob.com

Insulin pumps improve diabetes control in teenagers

omen with gestational diabetes may be at risk of obstructive sleep apnea according to a new report published in the Journal of Clinical Endocrinology & Metabolism (JCEM). The study saw the link between gestational diabetes and sleep apnea, a condition wherein one repeatedly stopsbreathing during sleep. If sleep apnea is left untreated, it could lead to stroke, cardiovascular disease and heart attack. In the series of controlled studies, the researchers observed 45 women with sleep apnea and with other sleep problems. They examined 15 healthy pregnant women who had gestational diabetes, 15 pregnant women who did not have the condition, and 15 women who were not pregnant and did not have diabetes. “It is common for pregnant women to experience sleep disruptions, but the risk of developing obstructive sleep apnea increases substantially in women who have gestational diabetes,” said Dr. Sirimon Reutrakul, who conducted the research at Rush University Medical Center in Chicago. “Nearly 75 percent of the participants in our study who had gestational diabetes also suffered from obstructive sleep apnea.” The researchers found strong evidence of a link between obstructive sleep apnea and diabetes in the group of obese women. Those who were not overweight and had no gestational diabetes were able to get an additional hour of sleep without disruption. “Based on these findings, women who have gestational diabetes should be considered for evaluation for obstructive sleep apnea, especially if other risk factors such as hypertension or obesity are present, and women already diagnosed with sleep apnea should be monitored for signs of gestational diabetes during pregnancy,” Dr. Reutrakul said. With Medical News Today report D

sweetnews

Cooking temperature may affect insulin resistance Low-heat cooking better, according to study

ooking food in low temperature may reduce insulin resistance, according to a new study. Based on the study published in Diabetes Care, led by Dr. Alicja B. Mark from the University of Copenhagen, Denmark, 74 overweight women were analyzed (body mass index [BMI] 25–40 kg/m, aged 20-50) and asked to cook their food in high and low temperatures. High temperature consists of baking and roasting, while low temperature is done through boiling and steaming. Food cooked in high temperature results in the formation of advanced glycation end products (AGEs), associated with inflammation and may impair glucose metabolism in patients with type 2 diabetes. Some known AGEs are cooked meat and roasted coffee. For the study, some patients were asked to eat bread with

crust, and choose high-AGE foods while others were asked to eat bread without the crust and choose low-AGE foods. During the four weeks, there were no changes from fructose or glucose on insulin resistance based on the homeostasis model assessment of insulin resistance (HOMA-IR) and the calculated insulin sensitivity index (ISI). But what made a difference in the study was their diet. Weight, BMI and waist circumference all decreased in both the high- and low-AGE groups (P < .05), but to a greater degree among those in the low-AGE group compared with the high-AGE group (P < .02). Overall, the low-AGE group consumed about 15 percent more protein, 10 percent more carbohydrates, and 22 percent less fat than did the high-AGE group (all P < .05). It was also noted that compared to those in the low-AGE diet, the high-AGE diet showed increased levels of fasting insulin and HOMA-IR (P < .001) and decreased ISI (P = .04). Although the study may have its limitations, the authors said “Low-temperature cooking methods with limited formation of AGEs may decrease the risk of developing insulin resistance, either by decreasing dietary fat intake or by restricting dietary AGE content.” Alexa Villano with Medscape report D

OCTOBER-NOVEMBER 2013

educators’corner

ou are what you perceive you are! Until the present time, we Filipinos believe in so many things that are not factual, mostly myths that have been handed down to us by our elders. Seeing a black cat crossing the street is a bad sign, an omen that means something bad is bound to happen. Taking a bath on a Tuesday or on a Friday is not advisable since these days correspond to the sorrowful mysteries and that bathing during these days makes someone sick. These superstitious beliefs, can limit our daily activities; limit the opportunities by which we can face life. The way we look at diabetes is not an exception to these beliefs. Lack of proper education creates stigma on the way we perceive this chronic disease. These myths limit the possibilities by which we can properly manage the occurrence of its complications and most importantly, prevent the disease itself. The following are some of the misconceptions that we

OCTOBER-NOVEMBER 2013

commonly encounter about diabetes: 1. “I will not become diabetic since no one in my family has the disease.” It is indeed true that diabetes is a genetic disease. It occurs in greater degree among children of a diabetic parent/parents. However, lifestyle and other environmental factors can also play a big role. Someone can have diabetes if he is obese, if he does not exercise, and if he has poor eating preferences such as high calorie and fatty meals. Diabetes type 1, or the diabetes that we see commonly in young children and adolescents occurs because of the presence of antibodies that target the pancreas leading to the deficiency of insulin. This type occurs in people even without family history of diabetes. These above facts support the concept that the occurrence of diabetes is multifactorial. 2. “I will eat all the sweets now since sooner than later I will get diabetes anyway like my parents! Once I

have diabetes, I cannot eat any of these sweets anymore.” Prevention is worth a pound of cure. Not all children born of diabetic parents may get diabetes. Early intervention through proper weight management, proper diet, and regular exercise are important tools of somehow preventing the disease. Sweets are referred to as simple sugars. These include cakes, pastries, ice creams and some local delicacies such as sapin-sapin, kalamay, halo-halo and many more. But not all carbohydrates are simple, rice and noodles are complex. It has become a misconception that diabetic individuals cannot eat rice because it can increase their blood sugar. This is indeed a myth; people with diabetes like anyone of us need complex carbohydrates as source of our energy. It is the type of carbohydrates and the amount that matter. 3. “Diabetes only affects older people.” Diabetes is a disease of the very

educators’corner young, the very old and those in between. Diabetes can be diagnosed in someone as young as 5 years old or even younger. This is manifested by progressive weight loss, frequent urination and hunger in the very young. As mentioned above, this results from pancreatic destruction due to the presence of antibodies. In a similar manner, diabetes can occur among elderly individuals and young adults accompanied by the twin sister and brother of diabetes: hypertension and high cholesterol. This common type of diabetes, diabetes type 2 results from insulin resistance, a state where the tissues become insensitive to the action of insulin, hence the sugar stays in the blood. 4. ”Insulin injection is the point of no return, once on insulin you are forever on insulin.” Only type 1 diabetics patients will be on insulin treatment for the rest of their lives. Type 2 diabetes patients may not always require insulin for blood sugar control. However, insulin therapy may be prescribed if blood sugars have been poorly controlled for quite sometime. Once glucose control is achieved, they may be put back on oral medications. Therefore, insulin therapy does not mean the end of the journey

or the point of no return but a straighter path to get to your goal of good sugar control. 5. “Insulin is the wonder drug of diabetes, once on it, I can eat everything.” Diabetes type 2 develops because of different defects in our organ systems. These defects include: insulin resistance in the muscle, liver, fats and brain, insulin deficiency, uninterrupted release of sugar in the liver. Hence, insulin therapy cannot solve these multifactorial problems in diabetes. That is one reason why most patients who are on insulin are also on oral antidiabetic medications in order to address these defects effectively. Insulin dose is adjusted according to the results of blood sugar monitoring. If diet is poor then no appropriate dose can be arrived at and the blood sugar control goes on a roller coaster ride. This poor blood sugar control leads to the development of complications. 6. “Sweating during exercise is effective exercise.” Exercise does not require enrollment in a gym for a complete exercise program. Simple aerobic exercises such as jogging, running, swimming or even brisk walking without excessive sweats are effective exercises

for those with diabetes. To start effective exercise doesn’t mean jumping into strenuous exercises right away. Daily exercise of 30 minutes a day, 5 days a week is recommended. Effective exercise is not gauged by the sweats you produce or by the feeling of tiredness after each exercise. Before starting to exercise you must know your target heart rate. Target heart rate is calculated by subtracting your age from 220 then get 60 percent to 80 percent of the difference. For example: 220- age (40 years old) X 60 percent = 126 beats per minute. If from time to time during exercise, you are able to maintain a heart rate around 126 then that’s an effective exercise even without sweats. 7. “The sugar content of my drink becomes less because I add more water.” “The sugar content of my juice is zero because on the label it says, no added sugar.” Diabetics are not allowed to drink fruit juices except during times of low blood sugars or during hypoglycemic episodes. Diluting high sugar drinks such as fruit juices or regular sodas does not change their sugar contents. This will only make the taste less

sweet. Fruit juices are made out of fruits, which are essentially sweet. Hence, they are sweet themselves even without additional sugar. Commonly, diabetic individuals are allowed one fruit exchange per day usually during breakfast only or one fruit exchange per meal as prescribed by their physicians. 8. “ Honey is better than ordinary sugar and I can use it as an artificial sweetener.” Honey is not a sugar substitute. It has no advantage over ordinary sugar in its effect on the blood sugar level. It is in fact sweeter and has more calories per teaspoon than granulated sugar. But if you prefer to try it once in awhile, you may do so but it has to be included in your diet plan for the day. The above-mentioned misconceptions are just few of the common myths we commonly hear from our patients. The best way to treat diabetes starts with proper education on the nature of the disease, its course, complications and proper management. Let us all be open to their questions no matter how simple and practical these are to avoid living diabetes in a world of misconceptions. D

OCTOBER-NOVEMBER 2013

fightin’forfitness

Achieving a n

Figure

Text By Cyrus Eleuterio Illustrations by Calvin Saquibal

ow can male or female patients get the hourglass figure? What exercises or recommended activities can they do to achieve that shapely body? Surely you are on the quest to achieve a healthy body in spite of having diabetes. So why not take it a notch higher? Do you want to achieve the body of a beauty title holder? If your answer is a resounding “yes”, here are some tips: 1. Always keep yourself physically active; 2. Eat a well-balanced diet; and 3. Do High Intensity Interval Training (HIIT). HIIT is described as any exercise/activity that alternates between high intense activity and a fixed period of less intense activity or even a short rest. Studies reveal that there are several benefits of doing HIIT workout. To name a few: a. It burns fat as compared to a steady pace exercise;

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b. It promotes a healthier heart; and c. It increases metabolism. Below is a sample of a simple HIIT workout: This workout design is called TABATA named after a Japanese scientist Izumi Tabata who created it. This interval workout is fun, a calorie blaster, and needs quick movements so it is hard to get bored. You perform this exercise and do as many reps possible for 20 seconds, followed by 10 seconds of rest. You repeat this pattern for a total of eight times, making one round for four minutes. TABATA Workout: Note: Rest for one minute before proceeding to the next exercise. 1 – Jumping jack 2 – Alternate backward lunges 3 – Burpee 4 – Side skaters 5 – Bicycle crunch 6 – Toe-Touch crunch

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Jumping jacks Perform by jumping with your legs spread wide while your hands touch over head with a clap and then return to the position with legs together and the hands on the side.

Alternating backward lunge Step your right foot back, coming into a full lunge before returning to a standing position. Repeat on the other side.

Burpee Jump straight up, landing in a squat, jump legs out into a plank, do pushup, jump leg back to squat, then jump straight up. Repeat this in one continuous sequence.

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Side skate Start in a small squat, jump sideways to the right landing on your right leg, then left, reverse direction by jumping to the left with your left leg. Keep alternating sideways jumps.

Toe-touch crunch Lie on your back and extend your arms and legs toward ceiling. Lift your head and shoulder off the ground and touch your toes.

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Bicycle crunch Lie on your back with hands behind your head. Lift your head and rotate to bring the elbow to the opposite knee. Switch sides.

Note: Before engaging in any physical activity like the above-mentioned set of exercises, always check your blood glucose level, have your medicine at your side and always hydrate yourself. Remember, you are what you eat. Muscles cannot be prominent if it is covered with fat. So the key component is to complement your exercise with a diet. By doing the two properly you are on your way in achieving that hourglass figure. D

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Wh at is theta healing? Is it good for diabetes?

Healing within…. “Emotion always has its roots in the unconscious and manifests itself in the body.” - Irene Claremont de Castillejo from within. It touches on medical intuitive sight. Its aim is not to replace medical treatment but to complement medical treatment by healing the spiritual aspect of a person. Their belief is that our genes/DNA do not control our biology but it is controlled by signals from outside the cell, including the energetic messages emanating from our positive and negative thoughts. Physical Ilness is first present on an energetic level as direct result of our beliefs, memories and emotional state. Our beliefs can influence our thoughts and our thoughts will affect our behavior both in the conscious and unconscious mind. This was clearly explained to me by Ms. Shaniayah Gurnamal, pioneer teacher of Theta healing in the Philippines. She underwent intensive training with Vianna Stibal, founder of Theta healing. Gurnamal also opened some centers in Dubai and Japan. Her usual clients are people who have chronic illnesses, as well as those with emotional disturbances.

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very disease has a negative control in our spirit. From a deep emotional disturbance will manifest a disease.This is a theory that says emotions affects one’s energy system and creates disturbance in the energy flow which affects every cell of the body and its circulation.This makes sense in the medical field when you analyze that some of the chronic diseases existing (diabetes, cancer, hypertension) are caused by stress and deep emotions. I passed by one rainy Thursday afternoon at The Third Eye Wellness Center to peek at another form of healing. The place is a haven for healing and the staff are so warm and accommodating. I am very lucky to have had the privilege of a tete-a-tete with the healer herself, Ms. Shanaiyah Gurnamal. Theta healing is a powerful technique that combines science and spirituality to identify and instantly transforms deeply held blocks, negative beliefs and trauma in the unconscious mind. It heals the body by healing deep emotions

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youaskweanswer How does theta healing work? Theta healing works to transform negative thought patterns or beliefs on all levels, including our genes /DNA, empowering us. And this technique can be shared to others so they can spread this type of healing to others. This is not a religion and not affiliated with any religious doctrines. There are five major frequencies in the human brain (Gamma, Beta, Alpha, Theta, and Delta). The Theta wave is the dominant brain wave during very deep meditation, when drifting off to sleep or whilst under hypnosis. Scientists have discovered that Theta brain frequency has been found to alleviate stress, reduce anxiety, facilitate deep relaxation, improve Ms. Shaniayah Gurnamal, theta healing teacher and healer

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mental clarity and creative thinking, reduce pain, promote euphoria, and provide access to instant healings. Healing will depend on the gravity of illness, age, diet and physical activity of the person. Healing is like peeling an onion wherein you will peel or unravel their issues from the outermost down to its core. And along the way these are the factors that can influence a person to heal at the shortest/longest time: readiness to spill out thoughts or emotions, resentment to the process , deep emotions, depression that is short or chronic. Can Theta healing be advised to diabetic patients? Ms. Gurnamal observed that people with diabetes are likely to be in control of their lives.They are very independent people and when they were told that they have this dreaded disease they undergo resentment, depression, feeling of defeat (feeling of losing a battle), anger, bitterness and if these go on for a long time there will be more emotional imbalances which in some way form stress. Stress can release hormones that can raise sugar levels. Getting to the root of these emotional imbalances is one way that somehow helps in overcoming the surges of hormones that can increase our sugar. But this technique can never be the sole treatment for diabetes, yet can complement medical treatment for it. Theta healing can heal patients through clinical intuition remedies, touching their inner minds by programming their negative thoughts into positive ones, such as they can care for their body, they can care for their families, they can control their diabetes, and they can live a healthy life. D

Dr. Maria Leonora D. Capellan, MD Dr. Capellan is an endocrinologist at the Makati Medical Center and St. Lukeâ&#x20AC;&#x2122;s Medical Center Global City.

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THE TOP By Dr. Juan Dionisio Foronda

TIPS IN THE CARE

FOR DIABETIC HEARTS

aving diabetes is almost synonymous to having heart disease and addressing diabetes is integral in the prevention of heart disease.

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1. Observe a healthy diet. Most people think that dieting is an all-or-none phenomenon. Either eating like there is no tomorrow or eating nothing at all. There is what we call a Balanced Diet. Food is not poison but should be consumed rather in the right amounts. Eat just the right amount of carbohydrates, fruits, meats, and fats. Yes, eating rice is permitted but limit it to a cup per meal and don’t overeat on fruits also! Moderation is the key.

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2. Exercise regularly. Physical activity is always beneficial. It helps regulate the blood pressure and helps the body consume excess blood glucose. Exercise need not be too strenuous. Do engage in some brisk walking exercise. A little evening walk after dinner should be all right and shouldn’t cause appendicitis. Keep in mind, some exercise is better than no exercise at all. 3. Treat hypertension. Hypertension or high

blood pressure should always be addressed. A blood pressure of 130/90 and above is already considered high in diabetic individuals and warrants taking blood pressure medication already. Hypertension does not cause symptoms in 40 percent of patients so you don’t need to feel anything to be hypertensive. Treatment includes avoiding salty food like toyo, patis, and bagoong, as well as, processed food, seasonings and the like. Remember that complications set in 15 to 20 years and are irreversible. Always have your blood pressure checked regularly. 4. Treat high cholesterol. High cholesterol or dyslipidemia is a condition that’s closely related to diabetes. It causes the gradual build up of plaques in the arteries that will cause clogging which in turn leads to the stroke (brain attack) or myocardial infarction (heart attack). Avoid food with saturated fat (fat that melts with heat but solidifes at room temperature) like butter and cheese. Most often, medications called statins are needed to keep cholesterol levels low, aiming for a target

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of 100 mg/dL at least. Again this condition will not cause symptoms like headache or dizziness. The only way to find out is thru a blood test. Remember that oven heat is needed to melt the cheese in a pizza and no amount of exercise can produce the heat to melt the cheese in your arteries. 5. Have a regular check up. If people can baby their cars and take it for periodic maintenance, we should also have regular check ups with our favorite doctor. Body weight, blood pressure, and blood tests may be done at regular intervals to make sure everything is OK.

Think Healthy. Healthy. Be healthy. D

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7. Treat complications. If you already have complications, having them treated would be the best way to go. The most serious cardiac complication of diabetes is Coronary Artery Disease or clogging of the arteries of the heart. This condition can lead to heart attack and weakening of the heart muscles. It is treated either thru an Angioplasty (using a balloon and a metal stent) to flatten out the plaque or a Coronary Artery Bypass Surgery (CABGpronounced like cabbage) to make flyovers to bypass heart blocks. Always keep in mind that even if youâ&#x20AC;&#x2122;ve had these procedures, you just have a re-conditioned heart not a brand-new one. You will still need lifetime medications.

8. Be a good patient. At the end of the day, it will still be up to you to observe a proper diet, do regular exercise, and to religiously take your medications. Have regular check ups with your doctor and regular lab examinations.

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6. Screen for complications. Diabetes makes the arteries age faster and its complications come out after sometime. It could be between 15 to 20 years after the onset of being diabetic for complications to manifest. Complications can take the form of poor eyesight, cataracts, heart attacks and stroke, clogging of the arteries of the legs leading to poor circulation, and kidney failure leading to dialysis. Just as we cannot fight ageing, the complications of diabetes is something we cannot totally avoid but certainly we can delay with proper treatment. Our bodies are just like the tires of cars, it wears out with time. And when itâ&#x20AC;&#x2122;s worn out, it will no

longer go back to a brand new state. So treat early! To screen for heart complications, your doctor can also ask for an ECG and a chest x-rays and urine tests to screen for ischemia (poor heart circulation), and heart enlargement. The doctor might also request if deemed necessary for a 2D echocardiogram (heart ultrasound) and a treadmill stress test (similar to what you do in the gym except that you are hooked to an ECG monitor). These tests are done to make sure your arteries are not clogged up yet.

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BEST CARE STRATEGIES FOR DIABETIC EYES

By Fernando Fontanilla, MD

eople with diabetes are at increased risk of developing eye problems. In the United States, diabetes is the leading cause of blindness in adults age 20-74, according to the American Diabetes Association.

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What are the complications of diabetes in the eyes? Diabetic eye disease refers to a group of eye problems that may afflict people with diabetes. Diabetic eye disease include any of the following:

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• Diabetic retinopathy – The retina is the light-sensitive tissue at the back of the eye. Diabetes can damage blood vessels in the retina, resulting in vision problems. • Cataract – Cataracts occur when the human lens inside our eyes lose their transparency, leading to decreased vision. Cataracts are commonly seen in older people but they can develop at an earlier age in people with diabetes. • Glaucoma – Glaucoma is a condition wherein the optic nerve is damaged resulting in loss of peripheral vision. There are many causes of glaucoma, one of which is diabetes. A person with diabetes is twice as likely to develop glaucoma than persons without diabetes. Diabetic retinopathy (DR) is the most common diabetic eye disease. It accounts for 2 percent

of all legally blind patients and 10 percent of those with severe visual handicap, according to the World Health Organization. In the United States, it affects about 50 percent of people with diabetes mellitus. Worldwide, the prevalence rates ranges from nine percent to 71 percent, and these rates are expected to escalate over the next 20 years. In patients with DR, blood vessels develop abnormalities resulting in fluid leakage. This leakage can lead to macular edema (swelling of the central retinal region), causing reduced vision. In severe cases, there is poor oxygenation of the retina and abnormal blood vessels can grow on the retinal surface causing further damage. In early stages of DR, a patient with diabetes may not notice any change in vision. But over time, DR can get worse and cause deterioration of vision. This usually affects both eyes. Who are at risk for diabetic eye disease? Everyone with diabetes – whether type 1 or type 2 – are at risk of developing diabetic eye disease. The longer a person has diabetes, the more likely he or she will develop eye problems. In the United States, between 40 to 45 percent of Americans diagnosed with diabetes have some stage

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of diabetic retinopathy. During pregnancy, diabetic women may also develop diabetic retinopathy so it is important for these women to have their eyes checked when they are pregnant. What are the symptoms of diabetic eye disease? Oftentimes, patients with diabetic eye disease may not notice any eye problems. A diabetic patient can still see well despite the presence of retinopathy or macular edema. Usually, by the time symptoms are experienced by these patients, diabetic eye disease is already at an advanced stage, making it more difficult to restore their vision. Blurred vision is a common complaint in patients with diabetic eye disease. Blurring may occur due to any of the following: • Macular edema – Edema or swelling of the retina is commonly seen in patients with DR. • Cataracts – Patients with cataracts complain of cloudy vision, glare and difficulty of driving at night. • Vitreous hemorrhage – Vision is blocked or obscured by blood inside the eye that leaked from abnormal blood vessels.

How can diabetic eye disease be detected? The presence of diabetic eye disease can be detected during a comprehensive eye exam conducted by an ophthalmologist. This eye exam includes the following tests: Visual acuity testing. A visual acuity test is a routine part of an eye exam and is something most patients are familiar with. This test determines the smallest letters a person can read on a standardized vision chart that is usually placed 6 meters or 20 feet in front of that person. In short, this visual acuity test measures how well a person sees distant objects. Dilated eye exam. This exam allows the eye doctor to see inside the eyes and check for signs of diabetic eye disease. Drops are placed on the patient’s eyes to widen, or dilate, the pupils. With the use of a special magnifying lens, the eye doctor can examine the optic nerve and retina and look for signs of damage, such as a large optic nerve cup (usually seen in glaucoma), leaking blood vessels (seen in DR) and retinal swelling (macular edema). Tonometry. Tonometry is a test to measure the pressure inside the eye. A high pressure inside the eye may indicate the presence of glaucoma.

How can diabetic eye disease be prevented? Studies have shown that good blood sugar control slows the onset and progression of diabetic eye disease. Diabetic patients who kept their blood sugar levels as close to normal as possible also had less kidney and nerve disease. Better blood sugar control also reduces the need for laser treatment and/ or surgery. Other studies have demonstrated that controlling the blood pressure and cholesterol can also reduce the risk of vision loss in patients with diabetes. Whether or not a patient has symptoms, early detection and intervention is the best way to prevent vision loss. People with proliferative DR can reduce their risk of blindness by up to 95 percent with timely treatment andregular follow-up care. How is diabetic eye disease treated? Diabetic retinopathy During the first three stages of DR, no procedure is necessary

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Other symptoms can be the presence of spots, specks or “floaters” in one’s vision, due to traces of blood. If spots occur, see an ophthalmologist as soon as possible before more serious bleeding occurs. Rarely, patients may complain of eye pain. This may be due to elevated eye pressures caused by

glaucoma. If left untreated, diabetic eye disease can cause severe vision loss and even blindness. The earlier a patient with diabetes receives treatment, the more likely that treatment will be effective.

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unless a patient has macular edema. More advanced stages of DR may need to be treated with lasers. Laser treatment is a relatively painless procedure that is done is an outpatient clinic setting. Two or three consecutive sessions may be necessary to complete the treatment, each session lasting about an hour. Laser treatment can reduce the risk of blindness by up to 90

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percent. However, laser surgery often cannot restore vision that has already been lost. That is why finding DR early is the best way to prevent vision loss. Research has shown that prompt treatment of macular edema with drugs that inhibit a protein called Vascular Endothelial Growth Factor (VEGF) has resulted in better vision. These drugs, when injected into the eye, may reduce fluid leakage and can interfere with the growth of abnormal blood vessels in the retina. This procedure is normally done in an operating room but the patient is able to go home immediately after the intraocular injection. If there is severe bleeding inside the eye, or if the retina is detached, laser treatment or anti-VEGF injections may not be effective. A surgical procedure called vitrectomy may be necessary. Vitrectomy is usually done in the operating room under general anesthesia and may take a few hours to perform. Cataracts - If a patient has cataracts, they have to be removed surgically in order to restore vision. An artificial lens (intraocular lens implant) is placed inside the eye immediately after cataract removal. The surgery, called phacoemulsification, usually takes less than 30 minutes. It is performed in an operating room and is frequently done on an outpatient basis. The patient is usually able to see well a few hours after the procedure. Glaucoma - People with diabetes are likely to develop an uncommon type of glaucoma, called neovascular glaucoma. In neovascular glaucoma,

new blood vessels grow on the iris, the colored part of the eye. These blood vessels block the normal flow of fluid out of the eye, resulting in increased eye pressures. Treatment of neovascularglaucoma requires lowering the eyeâ&#x20AC;&#x2122;s pressure through the use of eyedrops, laser procedures, or surgery. This form of glaucoma is difficult to treat. What are the eight best practices to care for diabetic eyes? Everyone with diabetes can take precautions to help reduce their risk of developing eye problems. Here are some important pointers: 1. Schedule regular appointments with an ophthalmologist so that any eye problem can be detected early and treated, if needed. 2. Maintain good blood sugar levels. Higher sugar levels increase the risk of developing diabetic eye disease. 3. Keep blood pressure under control. High blood pressure (hypertension) by itself can lead to eye disease. Patients with both diabetes and hypertension are at a higher risk of vision loss. 4. Get blood cholesterol levels under control. 5. Eat a healthy diet.To help protect their eyes from eye diseases, they can choose foods that have vitamin A and carotenoids like lutein and betacarotene. Beta-carotene is converted to vitamin A in the body. Sources of Vitamin A or beta-carotene include sweet potato, squash, carrots, fish and eggs. Lutein can be found in green leafy vegetables.

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6. Avoid smoking. Smoking has been associated with macular degeneration that can also cause damage to the retina. 7. Exercise regularly. This can lead to better blood sugar control, lower blood pressures and cholesterol.

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8. Consult an ophthalmologist as soon as one experiences a change in vision. If a diabetic person experiences any of the following visual problems, they should see their eye doctor immediately: • A sudden change in vision • Black spots • Flashes of light • Partial or complete loss of vision in one or both eyes Remember, vision may only be affected in the more advance stages of diabetic eye disease. By the time the patient experiences vision problems, the eye disease may be so advanced that restoration of normal vision may no longer be possible. It is thus important for diabetes patients to understand they must not wait for symptoms to occur before consulting an eye doctor. D

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BEST PRACTICES TO CARE FOR DIABETIC NERVES

By Josephine T. Tuason, MD

he nerve is vulnerable to a lot of insults be it mechanical, chemical or metabolic. Just like any part of your body it needs to be taken care of especially if you have a condition like diabetes mellitus which by itself can damage your nerve. Here are eight ways by which you can take care of your Nerves:

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1. Control of diabetes. Control of diabetes is the single most important intervention to protect your nerve. Exposure of the nerve to high sugar level can stimulate a series of reactions at the microvascular level and induce some biochemical changes which can alter and inhibit its proper functioning. It is important that tight blood sugar control be initiated early on because prolonged exposure to high blood sugar may have an irreversible effect on the nerve. Studies have shown that controlling the blood sugar level improves the symptoms of diabetic neuropathy (nerve damages). And early intervention may even totally eliminate the symptoms.

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2. Exercise (physical activity). Studies have shown that patients with diabetes can benefit from regular exercise. It may not be a standard exercise in the gym. Daily brisk walking to the grocery or to your workplace can do wonders

to your diseased nerve. What is important is you get up and enliven that nerve. The benefit may not only include prevention of early onset neuropathy, but also prevent the worsening of existing neuropathic symptoms. This is in addition to the overall benefit of lowering the blood glucose and cholesterol level, weight reduction, and muscle strengthening/improvement of balance that may keep diabetic patients from falling and prevent sustaining other injuries that may complicate the neuropathic condition. Before you start your exercise regimen it is important that you consult your doctor and ask for some precautionary measures because you might be suffering from other conditions like autonomic neuropathy, heart condition, etc. You should routinely check your blood glucose level before and after exercise. Generally, 30 minutes of low impact exercise five times a week is advisable. Brisk walking, swimming, cycling, yoga, tai-chi or selected dance routines are just some of the activities you can choose from depending on your preference and clinical condition. 3. Smoking cessation. Diabetes and smoking are a dangerous combination. You are not only at a higher risk of stroke and heart attack if you are a diabetic smoker, but you also

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have a higher predisposition to develop neuropathy, nephropathy (kidney damages) and retinopathy (eye disease). As far as the nerve is concerned, you have 2.2 times greater risk of developing diabetic neuropathy compared to other diabetics who do not smoke. Likewise, your neuropathy has 50 percent more chance of progressing within the year if you don’t stop smoking. Insulin resistance and macrovascular and microvascular changes are just some of the more important pathophysiological effects of smoking on diabetes. So, STOP SMOKING! It may be one of the most important decisions in your life. It can save your nerve and your life. There are available tools that can help you stop smoking. If you cannot do it alone, ask your doctor. Your doctor can refer you to other specialists who can assist you in attaining your desire to stop smoking.

5. Dietary supplements. We commonly encounter patients suffering from neuropathy/ diabetes who are self-medicating with Vitamin B complex and other food supplements in the hope of easing their symptoms. Vitamins and food supplements are part of “complementary and alternative medicine” or CAM. They are not generally considered part of general medicine. As of now, there is not enough scientific evidence to prove that their intake will be beneficial for diabetic patients, prevent the onset of diabetic neuropathy nor reverse its debilitating symptoms. It is important that you inform your doctor if you are planning to take any vitamins or dietary supplements because some of them may interact with your regular medicines. Dietary supplements are not completely harmless as what most patients believe. Consult your doctor and read the labels! 6. Be aware of neuropathic symptoms. Numbness and tingling sensation of the feet and lower legs, pain and burning sensation, loss of sensation in the feet, pain in the hips or buttocks, weakness of the legs, gastrointestinal symptoms (diarrhea and constipation) erectile dysfunction among males, dryness of the skin, orthostatic hypotension are just some of the more common symptoms of diabetic neuropathy. If you experience any of these symptoms it is best that you consult

your doctor so that appropriate diagnostic tests can be done. It is important to establish the presence of diabetic neuropathy as early as possible so that you can take the necessary precaution and avoid further complications. 7. Take care of your feet. Proper foot care is important for patients with diabetes because the foot is the most vulnerable to diabetic neuropathy and serious complications can lead to foot or leg amputation. This can happen to you if you ignore these simple measures. Wash and dry your feet daily, examine your feet each day, take care of your toenails, wear comfortable shoes especially when you are exercising, wear socks, and never go barefoot. 8. Calm your NERVES! Don’t be stressed, and be happy! And lastly, Stem Cell Therapy is not the answer to diabetic neuropathy. D

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4. Moderate alcohol intake. While others may be very strict in asking diabetic patients to cease from drinking alcohol, most agree that alcohol drinking in moderation may be allowed among diabetic patients. Moderate alcohol intake means no more than 2 glasses of wine or less than 10 alcoholic drinks per week. But of course, as much as possible, alcohol intake should not be encouraged at all. Both diabetes and excessive alcohol intake independently cause peripheral neuropathy. Vitamin B deficiency causes neuropathy from alcohol and metabolic disturbance for diabetes. Thus, excessive alcohol intake can add to the

risk exposure leading to diabetic neuropathy. It is like “adding insult to injury”.

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BEST CARE TACTICS FOR DIABETIC KIDNEY

By Maria Isabel de Leon Duavit, MD

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iabetes is a serious disease. It is the most common cause of kidney failure in the Philippines. High blood sugar may damage blood vessels in the kidneys, causing kidney damage, a decrease in kidney function and a buildup of waste products in your blood. Approximately one third of people with diabetes develop kidney disease. Chronic kidney disease(CKD) is a silent disease and early kidney disease rarely has symptoms. Routine screening for kidney disease therefore is important. Laboratory testing using either serum creatinine or the presence of albumin in the urine have

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been recommended screening measures. Using a creatininebased estimating formula, your doctor can compute for your GFR (glomerular filtration rate) which describes how well your kidneys are working. Once your GFR is known, your doctor can plan and modify treatment according to the stage of kidney disease you have(see the chart below). If your kidney disease is caused by diabetes, then your doctor will give a diagnosis of chronic kidney disease secondary to diabetic kidneys. Without proper treatment, the time between the start of diabetic kidney damage to end stage kidney failure is about 5 to 7 years. If I have diabetic kidney

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disease, what can be done? 1. Control blood sugar level. It is recommended that appropriate self-monitoring of blood glucose and review of blood glucose logs be part of any diabetes management. Ideally, blood glucose should be maintained at near-normal levels (premeals levels of 90-130 mg/dL and hemoglobin A1C [HbA1c] levels < 7 percent). HbA1c (glycosylated hemoglobin) is a test which will help indicate your blood sugar control in the past three months before the test was taken.

2. Keep blood pressure under control. It has been shown that higher levels of blood pressure are associated with progressive loss of kidney function. It is recommended that patients get accurate BP devices to regularly monitor their blood pressure at home instead of just relying on blood pressure checks in the doctorâ&#x20AC;&#x2122;s clinic. Use of certain types of antihypertensive drugs known as angiotensin-converting enzyme inhibitors(ACE-I) and angiotensin receptor blockers (ARB), and lowering blood pressure to approximately 140 mm Hg systolic are associated with a significant reduction in the incidence of kidney failure. However, just like sugar control, current guidelines recommend individualized blood pressure targets. A goal of less than 130/80 mm Hg,for example,may be beneficial, especially if there is more evidence of protein in the urine.Patients with CKD often will need more than 1 medication to effectively reduce their systolic blood pressure to either 140 mm Hg or even 130 mm Hg. 3. Comply with medication prescription. Take medicines regularly to help control your blood glucose and blood pressure. Although the most effective way of slowing the loss of kidney function is by

controlling your blood sugar and blood pressure, focusing on them alone does not provide adequate treatment for patients with diabetic kidneys. Treatment involves multiple goals (i.e., glycemia, lipids, blood pressure) with a major focus on comprehensive cardiovascular risk reduction as well. If the cholesterol and other fatty substances in your blood (known as lipids) are high, you may need to be given anticholesterol medications called statins to lower them. If there are already complications of kidney disease such as acidosis, increased phosphorus (hyperphosphatemia), and anemia, you will be given medications to minimize the complications and slow the rate of progression of your kidney disease. 4. Follow your diet. Diet is a very important part of the treatment of all patients with diabetes even if they do not have CKD. Recent studies have indicated that a healthy diet is

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It is possible that moreintensive blood glucose control may benefit kidney function more in people with diabetes. However, aggressive glucose lowering may not be the best strategy in all patients. Patients with kidney disease are much more likely to suffer adverse events related to low blood sugar or hypoglycemia. It is therefore recommended that bood glucose targets should be individualized. Where as earlier guidelines recommended an HbA1c of 6.5 percent or lower as the goal for most patients, recent guidelines refine this advice, recommending an HbA1c of 6.5 percent or lower for healthy patients without concurrent illness but individualized target HbA1c values greater than 6.5 percent for patients with concurrent illness and those who are at risk for hypoglycemia. For example, corresponding HbA1c targets may be less than 7.5 percent in an elderly patient with a coexisting chronic disease such as CKD or

even higher such as 8 percent or more in patients with very poor health and decreased life expectancy. Talk with your doctor regarding the blood glucose target that is right for you.

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associated with a reduced risk of developing CKD and slower progression of early kidney disease among individuals with type 2 diabetes. A diet with significant amount of fruits and vegetables, moderate amounts of saturated fat and simple sugars,low amount of salt,and reduced amounts of protein may be helpful. However, reduction in protein intake is not recommended

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for everyone and you need to discuss with your doctor regarding the diet that is best suited for you. 5. Get regular exercise. Most patients with diabetes can benefit from increased activity. It is recommended to have exercise training of more than 150 minutes per week. Aerobic exercise alone or in combination with resistance training has been shown to improve blood glucose control as well as circulating triglycerides, systolic blood pressure, and waist circumference. Previously sedentary patients, however, should start activities slowly. Older patients or patients with multiple risk factors and evidence of atherosclerotic disease should have a cardiovascular evaluation and clearance prior to initiating an exercise regimen. 6. Lose weight. In 2013, the American Association of Clinical Endocrinologists (AACE) included obesity management in diabetes treatment because it is now clear that weight loss also reduces blood glucose. It is recommended for overweight patients to lose weight because modest weight losses of 5-10 percent have been associated with significant improvements in cardiovascular disease risk factors (ie, decreased HbA1c levels, reduced blood pressure, increase in HDL cholesterol, decreased plasma triglycerides) in patients with type 2 diabetes mellitus. Risk factor reduction was even greater with losses of 10-15 percent of body weight.

7. Avoid nephrotoxins. Nephrotoxins are substances that may further damage kidneys in patients who already have kidney disease. Once you have kidney disease, it is recommended that you check with your doctor first before taking any medicines or herbal supplements because a lot of these are metabolized by your kidneys.The most common pain relieving medicines known as nonsteroidal anti-inflammatory drugs(NSAIDS) in particular can make your renal function much worse and should be avoided. Dosages of most medications(e.g. antibiotics) need to be adjusted according to the level of kidney function. You should also avoid smoking and alcohol. 8. See your doctor as often as you are told. With each encounter, your doctor can discuss with you goals of management including blood glucose and blood pressure targets, as well as modify your medications, diet, and exercise regimen. Regular monitoring for complications, presence of infections, and laboratory assessment are also done at this time. You may be referred to a kidney doctor (nephrologist) and a dietitian who will work along with you to make your kidneys last longer. If steps are not taken to slow the worsening of kidney function, the kidneys may eventually fail and either dialysis or kidney transplant would be needed to live. It is important to choose a doctor that you trust and are most comfortable with and who can plan your treatment with you. D

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Glucerna launches Ph’s first diabetes mobile app

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definitely helped increase my productivity. Another benefit Glucerna gives me is that I am able to maintain my weight which is a constant concern of diabetics. Overall, my life has returned to almost normal and I have a lot more of energy to work with. I would recommend Glucerna to other diabetics to achieve good health.” So what are you waiting for? Sign up now at www. glucerna123challenge.com.ph and be in full control in managing your diabetes: • Learn to eat for improved blood sugar control with healthy meal plans to support blood sugar control. • Get the tools you need to help you reach your goals—your schedule, videos, tracking, recipes, and support. • Manage your diabetes anywhere. Access anywhere: Stream workouts, access your plan, and track progress from your smartphone, tablet, computer, or web-enabled TV. Managing your diabetes can be a challenge. Glucerna is here to help. Glucerna is the only brand with over 20 years of clinical results supporting management of blood glucose response. Talk to your physician before beginning any new diet or exercise plan. D

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iabetes is a lifelong problem requiring lifelong treatment. It requires a holistic method of management requiring discipline and determination. Keeping track of one’s diabetes condition and taking full control in controlling and managing it can be a major challenge. Now, thanks to a mobile application for smartphones, keeping track of one’s diabetes and being in full control are now made easier. Abbott, one of the leading health companies is pleased to announce that they have developed the first mobile application for diabetes in the Philippines through the Glucerna 1-2-3 Challenge. The Glucerna 1-2-3 Challenge is a 12-week customized program wherein one follows three scientific steps: 1) Help manage blood sugar levels; 2) help reduce weight and waistline; and 3) support heart health. The 1-2-3 challenge also offers participants meals plans wherein one can browse through specialized meals with vegetarian options that are balanced and taste good. It also includes drinking Glucerna Triple Care, which will help in one’s diet. The application also includes exercises recommended for diabetes patients and other tools such as a food monitor and glucose tracker where you log the food you eat. This way, it will help you check your glucose test and calories if you are sticking to the goal and reducing weight. Most of all, the 1-2-3 challenge mobile application is handy. You can bring it with you wherever you are – at work, at the gym, or even while running your errands. The Glucerna 1-2-3 Challenge really works. Dr.Sasa Chua Lee, herself a diabetic, has this to say: “I have been living with Type 2 diabetes for 30 years now and started taking Glucerna for the past 6 years. I take 4 glasses per week every night while my husband, Quirino Lee, takes one glass per day. Diabetes has affected my energy the most. I had to adjust to being tired and having very low energy almost all the time. However, after I tried Glucerna, I noticed that I became more energetic. Instead of just preferring to rest, I can now work properly. Glucerna has

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Phil and James Younghusband talk about their personal lives,losing their parents, following their passion, living healthy, and their advocacy to teach kids to play the sport

alf Brit, half Filipino football poster boys, brothers Phil and James Younghusband seem to have it all â&#x20AC;&#x201C; good looks, athletic skills, popularity and fame, bodies to-die-for, and gorgeous girlfriends. Basically, perfect lives. But not everything is as it seems. The two boys have already lost their

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parents. Their mother, Susan PlacerYounghusband died in 2011 due to complications of diabetes, while their father, Philip Younghusband Sr. died in 2004 of lung cancer, making the two brothers orphans and the sole guardians to their 12-year-old sister, Keri. DiabetEASE sits down with Phil and James who revealed how they are coping with the loss of their parents (particularly their mother), being brother-parents to Keri, their love for football and plans for the sport, living healthy, and more.

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ver story ] Red & Blue tops, stylist’s pants by Guess Caps by Team Manila

LEARNING FROM OUR MOM,

IT SHOWS HOW IMPORTANT EXERCISE IS AND HAVING THE RIGHT DIET.

BEING AWARE OF HOW MUCH

SUGAR YOU HAVE TAKEN

- Phil

Phil and James reveals that their dad died when they were 16 and 17, respectively, from lung cancer due to smoking. But being football players and athletes, they cannot afford to smoke, especially since the game is fast-paced. “Little things make big differences. I think smoking, drinking or taking drugs — they can have a big effect on your performance,” says Phil, the younger of the two. “We’ve been raised not to smoke or have bad vices, so

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we know not to do it for our performance, for our profession and our career.” “I think playing football and seeing our father die from lung cancer and smoking — [showed us that] we can’t do that sort of thing,” says Phil. He continues: “With our mom, she had diabetes. But they say you don’t die from diabetes, you die from complications of diabetes. Our mom was very stubborn. We do always ask our mom to keep exercising, keep eating healthy,

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but our mom never listens to us. “Learning from our mom, it shows how important exercise is and having the right diet. Being aware of how much sugar you have taken,” he adds. Now that they became instant parents to Keri, James realizes how expensive it is to raise a kid. “We just got our sister’s birthday coming. We got the bill for her party [laughs]. [But] we grew stronger and became wiser in seeing how things are.” “Now we know what our mom and dad meant when we were younger. We’re so naïve and we didn’t see why things are the way they are.” “She’s [Keri] like a daughter to us – she’s still our sister. She’s a very sweet girl and she does well.” Phil is grateful though to have close family friends to help them with Keri and balance their schedules. “Keri is a girl so we’re not used to it – we’re boys! [laughs]. So it’s different having girls and boys, we haven’t had any experience, so we are learning,” says Phil.

Phil and James tried lots of sports when they were younger, but football is like a religion in England. Growing up in England exposed them to the sport. It is everywhere: the streets, the malls, on television. Even ads have

Black & white oufit by Guess

WE DON’T EXACTLY LIKE BEING TOLD WHAT TO DO.

IN FOOTBALL, YOU GET TO MAKE DECISIONS, BE CREATIVE, AND EXPRESS YOURSELF. THAT’S WHY WE CHOSE IT

- James

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Red & Blue tops, stylistâ&#x20AC;&#x2122;s pants by Guess Caps by Team Manila

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football players as models. “We don’t exactly like being told what to do. In football, you get to make decisions, be creative, and express yourself that’s why we chose it,” says James. “James and I are quite energetic and active people and football was a chance to run around and be with our friends. Our dad was our biggest influence – he encouraged us to play football and supported us. He took us to the park every weekend to learn and play football,” says Phil. James says that their day typically starts at 7 am. They train from 8 to 10 am, then have lunch to get their calories back. In the afternoon, they work at the academy, teach kids, or attend to their endorsements. It varies each day but that is how it usually goes. For James, football is mentally challenging, as he sometimes can’t control his frustration. But after a while, he has learned to deal with the stress and his temperament. “Football is quite new here. There is no set established football season. Things are still being learned.” Phil, on the other hand, finds difficulty in scheduling. “We have Keri, we have football, we have coaching, and we have events. So physically, it’s quite a challenge. It’s difficult but we have very great people around to help us.”

“It’s mentally taxing. We need to make sure when we’ll have our day-off and when our football sessions are.” But football is not all about living healthy and well. The brothers admitted they have cheat days. Phil tries to stick to the “8020 rule” where he spends 80 percent of the time eating healthy and 20 percent relaxing and taking in sugars or his guilty pleasures. “There’s always cheat days. We grew up professionally at Chelsea and one thing that is instilled in us was to have a balanced diet and to exercise,” says Phil, adding that he tends to eat healthier when the games come closer. “Of course, we have holidays as well. When you travel, you want to enjoy the food,” says James who reveals that his favorite cheat food is chocolate. Phil’s is chocolate and potato chips.

Phil reveals that people often try to compare and contrast the different sports but they’re not trying to win this competition. They just want football to grow as a sport in general. “It is not about being the number one sport, or about being the number 10 sport. It is about having everyone live healthily,” says Phil.

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However, the brothers didn’t expect football to become so popular, so fast. That is why they are trying to find ways to learn what can be done in terms of football promotion and culture. “The tricky part now is sustaining interest. The pressure is always on the national team. People say even with just one loss, that ‘football is going down’.” “I think it’s how you sustain it and look for other options. For example, you take a local football team, and [you have] more opportunity for the kids to play – we are looking at developing the grassroots here. It’s a long way to go, lots of missing pieces. That’s why we’re trying to help,” says James. He adds: “I always said before that sports is a thing that unites countries together. Look at all the major sporting events around the world – World Cup, the Olympics. People always get together and they follow it. There is always a positive thing[to counter the negative stuff] like the war.” “I was watching the TV news earlier and saw Afghanistan. A lot of the news you hear about Afghanistan involves wars and conflicts. Just this morning, they won their first football trophy. The fans are going crazy in Afghanistan. To see that news of Afghanistan, celebrating and

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WITH OUR PROFESSION,

WE NEED TO MAKE SURE WE’RE IN THE RIGHT SHAPE.

SO WE BOTH HAVE COMMON GOALS AND THAT HELPS WITH OUR RELATIONSHIP.

rejoicing the fact that they’ve won a football competition, it shows unity and bringing people together,” Phil adds.

Phil admits that he and James are both very competitive but this also helps each other grow. “There is sibling rivalry but it’s very healthy. James and I are old enough now, and mature enough to the point where we know how far to go with it. When we were younger, we used to get violent. We’re always fighting. But now, we’re more mature and we know how to use that rivalry as a positive ,” he says. He adds: “If James is successful, it gives me the motivation to do better and be successful and vice versa. If I’m more successful, it gives James the motivation to become successful. We use each other to excel, to engage in programs. I think through that competition, it has helped us succeed.” “We’re like a couple [laughs]. None us will be where we are without each other,” says James.

Phil has been in a relationship with Filipina actress, Angel Locsin for about two years now; while James is in a relationship with fashion designer, Sari Lazaro. Phil admits to spending time with Angel while working out. “With

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our profession, we need to make sure we’re in the right shape. So we both have common goals and that helps with our relationship.” While James said he and Sari don’t work out together, they still hangout, shop, or watch a movie“ because we feel like we have to make valuable time, plus my training. She does boxing, yoga and Plana Forma on her own.” On what attracts them to a woman, Phil says: “Before you get to know someone, there is a physical attraction. They should have confidence on how they look. I won’t say I have a specific type. But, I think it’s important for a girl to have confidence in the way she looks – that’s sexy and appealing. So for me, I think I’ll see first the physical attraction, but once you get to know a person, it’s more about the personality and how you connect and get on.” For James: “Same interests help. It just starts developing. You just click. Her ambition, attitude, the way she carries her confidence, or cares for other people. It’s not all about the looks, of course. It really does matter a lot what’s inside the person, how the person is and how she treats other people.” Five to 10 years from now, the brothers see themselves still coaching but having a family and kids of their own. However, as of the moment, there are no wedding plans yet.

“Still good looking [laughs]. Hopefully, I’ll have a family. I’ll be married. See how football would have grown. I’ll still be playing with the Azkals. Hopefully, we see the progression of football on a playing and financial level.” “For me, in terms of my professional career, keep playing for the Azkals. On my personal life, have a growing family,” says Phil. “I think I’ll have more kids than Phil [laughs]. If the person spends this amount on his wedding, the next person will spend more,” says James. “I’ll have cuter babies,” banters Phil. “We’ll see,” James says and laughs. “I think I still want to be based in the Philippines. Five to 10 years from now, you’ve got kids and perhaps still playing. You might want to have a kid where they can see you play and see what you love doing. It really inspires your children.”

James said the Philippines has a lot of potential when it comes to football. “Yes, of course. S’yempre, s’yempre. We look at the young kids, they’re really young and they’ve got the same ability as kids in Europe. The only thing lacking is the opportunity.” “There are no facilities and

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competitions – they need that. Coaching needs to be looked at as well. Right planning, right elements need to be put in place – that would take quite a long time. As for the World Cup, you have to climb the ladder. You cannot go straight to the top.” Phil relates a story in Japan: “In 1991, they were all baseball. Now, they have the football team. They’re one of the strongest teams in Asia. And around 20 years, with the right investment, more programs, it is achievable and feasible[for them to be at the top].” “As James says, a lot of investments have to be put in place – facilities, competitions,

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etc. [It] depends on how quickly the structures, grassroots, and infrastructures are put into place. Phil advises parents whose kids want to play football to let their kids enjoy the sport. Don’t force them to do things they don’t want to, no matter what it is. “For us it’s easy because it’s our passion, it’s our love. It’s important that the kids follow their passion and they enjoy what they do. It’s easy to play football because we love doing it and we want to do it every day. Even if we miss football training, we’d be at home playing football because we loved it so much. So I think it’s important that the parents

just encourage their kids to follow their passions. And no matter what obstacles there are, they just help them face those challenges.” James, on the other hand, says one has to “pick a good coach.” “Call me and Phil [laughs]. Just get the kids to play football as much as they can. It shouldn’t be limiting.” “Some systems here are very territorial. The kids cannot play for the school or are not allowed to play outside the school. That’s not fair to the kid and not fair for football here.” “Just let them play as much as they can. Don’t take it too seriously. It’s all about having fun. It’s all

[c about enjoyment. Sometimes, they forget why they got into the sport in the first place, why they started at a young age, or why they play. Let’s not forget it is all about having fun,” says James.

“We love football. I want to still be able to coach. We want to look into business ventures, just try other things, just want to be involved in football and help develop [it],” answers James, adding that he also wants to travel the world and see how football

goes in other countries. For Phil, he wants to have free time to learn different skills, like learning a new language, playing a new instrument, or learning how to cook. “I really want to coach and put structures into place. Having a personal life and a family – that is what’s really after football.” Phil advises kids to keep it simple and balance everything. “One can’t be healthy all the time. One can’t exercise or study all the time. I think it is important to balance and do everything in moderation. There’s a time to play, a time to study, a time to be serious

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and have fun. It’s important that kids learn the priorities – what’s necessary for them to do. One thing I’ve learned from my mom is too much of anything is bad.” For James: “Always enjoy it. Don’t take it too seriously. Keep the right balance. Make sure you have the right time for everything. Have time for your family, and for hard work. Balance, balance.” When asked if the brothers are more Pinoy or Brit, Phil answers, “I think I’m more Pinoy”; while James says, “Pinoy ako (I’m Filipino).” D

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Our 8 top covers Compiled by Jose Martin Punzalan

tâ&#x20AC;&#x2122;s been eight years since DiabetEASE magazine first circulated, and it has since been educating diabetes patients and their caregivers in various ways to cope with and manage the condition. Of all the issues weâ&#x20AC;&#x2122;ve created so far, here are eight of our best sellers:

Diabetes management in kids starts at home, but it is in school where the real challenge takes place.

Broadcast journalists Julius and Christine Bersola Babao, together with thier daughter Antonia share how they celebrate the holidays while still maintaining a healthy diet.

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Diabetes is a condition that is all-encompassing. Not that it should overwhelm anyone, but its maintenance and treatment should be handled with utmost care. And care is often forgotten when it comes to dealing with the brain. Indeed, the link between the endocrine and nervous systems is one that ought to be given considerable attention or at least some mindfulness.

No doubt, diabetes mellitus is a worldwide epidemic. The numbers of people afflicted are skyrocketing year after year. And there is no better time than NOW to put a STOP to it.

It seems a lot of folks are troubled by sleepless nights. Getting enough slumber truly does wonders for the body and soul. And unbeknownst to many, sleep deprivation, disruption, and even irregular sleep patterns like jet lag or working the night shift can lead to or worsen diabetes.

Losing weight is easier said than done. And the rates of diabesity (a term coined for the dastardly duo of diabetes and obesity) are rapidly escalating. This issue served up several smart slimming solutions for those struggling with diabesity.

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Summer provides the perfect opportunity to travel. But if you have diabetes, does that mean giving up on your out-of-town plans? Not at all. This issue delves on ways for diabetic persons to enjoy their trip despite the condition.

Diabetes is a disease that can take a toll particularly on the elderly. This issue addressed how the senior diabetes patient could age gracefully and triumphantly. Moreover, this sold-out issue, reprinted by special request featured one of the pillars of diabetes care and education in the Philippines, the Father of Philippine Endocrinology, Dr. Augusto D. Litonjua.

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World Diabetes Day 2012: How the World Celebrated Diabetes as a global phenomenon found in its wake people worldwide taking the battle one World Diabetes Day at a time The Triabetics group held a forum last year with speakers giving tips to fight diabetes by losing weight.

efore we celebrate the last day of the theme Diabetes: Protect our Future, we look back on the world’s activities in 2012. What was the rest of the world up to on November 14, 2012, World Diabetes Day (WDD)? Americas: Epidemic proportions Some 62.9 million people in America are living with diabetes based on 2011 data. If the number grows at a continuous rate, the number could go up to 91.1 million by 2030. “Diabetes has reached epidemic proportion in the Americas. Latin America especially the Caribbean now have among the highest diabetes rates in the world, and if we don’t take action now – especially to slow rising rates of obesity – the trend will only get worse,” said Dr. James Hospedales of the Pan American Health Organization and the World Health Organization in the Washington celebrations of WDD

By Michaela Sarah De Leon

2012. Keeping the theme of WDD 2012, America celebrated WDD 2012 through education and prevention messages for children and young people to encourage early awareness of the risks and dangers of diabetes and the importance of healthy eating and physical activity. In California, “Learn your Risk”diabetes campaign was launched by the California Diabetes Program and the American Diabetes Association. It aimed to increase awareness about diabetes risk through worksite wellness and community programs, specifically populations most at risk of diabetes. The campaign had a total of 2075 participants and 10,000 homeowners. Africa: Education and prevention It is estimated that the SubSaharan Africa will witness a 98 percent increase from 12.1 million cases in 2010 to 23.9 million by 2030

should the increasing trend for the disease continue at its present rate. “Death due to diabetes is common today even among people aged 20-39 years, the most economically productive segment of the populations,” said Dr. Luis Gomes Sambo, regional director for the World Health Organization-Africa. He adds that in the region, they committed themselves to strengthening, prevention, and control of diabetes and other non-communicable diseases (NCD) by signing and adopting the Mauritius Call for Action, the Brazzaville Declaration on NCDs, and the UN high level meeting’s Political Declaration on NCDs. He further called for a more intensified development and implementation of comprehensive and integrated diabetes prevention and control program. WDD 2012 in South Africa gave 120 people free screenings. OCTOBER-NOVEMBER 2013

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By Joy C. Fontanilla, MD

he blue circle is the universal symbol for diabetes. The International Diabetes Federation first used it to campaign for a United Nations (UN) resolution on diabetes. On December 20th 2006, the UN passed Resolution 61/225 celebrating every 14th of November as ‘World Diabetes Day’. In many cultures, the circle symbolizes life and health. More importantly for the campaign, the circle embodies unity. Solidarity in the global community can really make a differencein stemming the tide of this skyrocketing pandemic. The blue color mirrors the color of the sky and the UN flag. With the UN’s influence, governments worldwide can be motivated to fight diabetes, one of the leading causes for suffering and premature death as well as economic drain in many countries.

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sports. It had over 50 participants. Meanwhile, to prove wrong beliefs on sugar and diabetes, the organizers distributed close to 1,000 fruit cakes and fruit inside the EU parliament. The campaign reached several thousands of people and distributed 2,840 “vitality dishes”. Middle East: Diabetes in conflict areas One adult in 10 are reported to have diabetes in the Middle East, according to data by the IDF. By the end of 2012, it is estimated that 34 million people in the region will have diabetes while IDF figures also show that 357,000 people in the region died in 2012. Only 280,000 deaths due to diabetes were recorded in 2011. Kuwait and Saudi have the highest prevalence of diabetes but Egypt has the highest number at 7.5 million. “We are in the middle of a public health emergency,” said Dr AmirKamran NikousokhanTayar, Chair of IDF’s Middle East and North Africa region. “We must focus our health resources on prevention where

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The Blue Circle

Europe: Healthy eating, healthy living According to the World Health Organization, there are about 60 million people with diabetes in Europe. In the event of the World Diabetes Day celebration in 2012, the Europe chapter of the International Diabetes Federation (IDF) organized a weeklong set of activities that aimed to raise awareness around the theme “Healthy Eating, Healthy Living” in three locations, Brussels, Luxembourg, and Strasbourg. The campaign included adding a healthy, balanced dish dubbed “vitality dish” in the menu of restaurants of European Parliament restaurants and special placemats with recommendations on healthy lifestyles. It also organized a booth where visitors can receive information on diabetes, the extent of the epidemic in Europe, and the link with EU food policy. Visitors included dietitians, nutritionists, and professional athletes living with diabetes. IDF-Europe also hosted a breakfast debate on the theme with experts on diets, food policy, and

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Southeast Asia: The right education for all The Western Pacific Region of the world is considered one of the most highly affected by diabetes, with diabetes affecting one out of three adults. The IDF specified that most afflicted is Southeast Asia, which records one death out of four diabetes cases. There are 70 million diabetes patients in Southeast Asia and the number is expected to shoot up to 121 million by 2030. The number represents 1/5 of the world’s diabetes cases. India, Bangladesh, and Sri Lanka top the list with India having the second highest number at 63 million people. China still has the most cases in the world. In Singapore, WDD was celebrated with the 13th National Eye Care Day by the Singapore National Eye centre by answering the IDF’s calls to “Educate, Engage, and Empower Youth and the General Public on Diabetes”. In addition, the country’s Community Health Assistance Scheme was enhanced in 2012 to enable middle and low income Singaporeans to benefit from the subsidized care. It also provided complimentary eye health check, dental and foot screenings, educational talks, exhibitions, and product sales by pharmaceutical and industry partners as well as educational and fun activities by the Diabetic Society of Singapore. Philippines: Scenes from home WDD 2012 in the Philippines saw events organized by local diabetes advocates. The Diabetes Care Team and BuCor Inmates Diabetes Association (BIDA) proudly won for the country the 2012 Global Diabetes Walk (GDW) Award given by the World Diabetes Foundation in Category 1 for Best Awareness and Advocacy Campaign. Among some very strong contenders for the 2012 GDW award, the jury found the walk organized by Dr. Melanie Duran with the Diabetes Care Team and BIDA stood out above the rest as being original in a very difficult context: “Mobilising 1,000 inmates and uniting 14 gangs to lift the blue circle is a beautiful way of carrying the global message of uniting for diabetes. The nurses and organisations behind this campaign show an example

worth replicating throughout the world and they deserve our sincere appreciation,” said jury member and Chairman of the WDF Board of DirectorsProf. Pierre Lefèbvre. Team Triabetic also set up an event in Glorietta 5 featuring talks by experts in the field like Dr. Teresa Macato, who talked about “Exercise for Diabetics”, Harvie De Baron, sports nutritionist who talked about “The Baron Method”, Kaye Lopez, running coach who talked about Running Basics, Dr. Edgar Eufemio, sports medicine and orthopedic surgeon who talked about “The Diabetic Athlete: A Different Kind of Animal”, Dr. Glenn Ramons, who talked about “Useful Strategies in the Management of Competitive Athletes with Diabetes”, and Dr. Germiliano Algui, professor and research epidemiologist who talked about “Choosing Food that Can Help with Weight Loss and Supplement Diabetic Control Regimen”. Diabetes Philippines (DP) also mounted its own celebrations by organizing scientific conventions for healthcare professionals as well as the annual Gimik Diabetes for the lay to learn more about the disease, its prevention and control in an atmosphere of fun. DP also encouraged some buildings to be lit up in blue such as the Mandaluyong City Hall and those where some DP Chapters hold office. D

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possible and education around this disease to prevent even more deaths in the region…On World Diabetes Day, we want to raise awareness that with the right education and care this disease can be controlled and in some cases prevented.” In the United Arab Emirates, free health checks for residents were offered in the event of WDD 2012 in 10 locations around Dubai.

The International Diabetes Federation - Europe distributed fruitcakes and fruit during last year’s Diabetes Celebration.

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Diabetes: Things I Wish I Knew About You By Nicole Limlengco Reviewed by Joy Arabelle C. Fontanilla, MD

iabetes is called the silent killer because many only discover that they have the disease after seeing their doctors for a thorough check-up. Once afflicted, the condition is for life. But despite the information and education given, many are still in the dark about diabetes, along with the ways to prevent it. DiabetEASE conducted a survey with individuals – from the young, to the young at heart - from various sectors to ask what they wish they knew about diabetes. Here is what we found out. Vince Dacallos, banker and rower for Alab Sagwan Pilipinas Vince enjoys sports and loves going to the movies with his wife, Cynthia • What to eat? You can eat anything but in moderation. Reduce your sugar intake which means avoiding sweet drinks such as colas and juice. According to the Mayo Clinic’s The Essential Diabetes Guide, a diet which consists of vegetables, fruits and whole grain, and small portions of lean meat is suitable. • How does insulin work? Insulin is normally released by the pancreas in small amounts throughout the day and produced in larger amounts at meal times to

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maintain blood sugar levels. Insulin may also be injected into the subcutaneous fat (the fatty layer beneath the skin) by a nurse or the patient with diabetes. Once in the circulation, insulin acts like a key that opens the doors of the cells to let glucose (blood sugar) in to be used for energy. • How do you treat the wounds of a diabetic person? Wash the wound under clean running water. Avoid soap, hydrogen peroxide and iodine, which can irritate the skin. Show the wound to your doctor, so he can check and treat it before it gets serious. The best treatment for wounds is still prevention. Avoid walking barefoot or wearing tight footwear; trim toenails carefully.; moisturize to avoid skin cracks that could be entry points for bacteria. • Would one still have a sex life after diabetes? Yes. But better consult your partner and physician to find out the source of any sexual dysfunction and plan out the remedies. Neuropathy (nerve damage) may affect both men and women during intimacy. Controlling blood glucose, taking medications such as sildenafil and applying water-based lubrication to lessen the friction during intercourse may be helpful. Francesca Sotto, junior copywriter Chesca enjoys the company of good friends and can’t wait for the arrival of the new PS4

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• Is it curable? Once you have diabetes, it is a lifelong condition, but it can be controlled with proper medication, diet and lifestyle change. People can lead long, full and active lives despite diabetes. • What are the medications available? Many oral and injectable medications are now available by prescription to lower blood sugar. Drugs to treat blood pressure, cholesterol and thin the blood may also be prescribed to prevent complications of diabetes. • How much will the medications cost? It depends on the drug prescribed. However, many of them now come in generic form, slashing costs to below 50 percent of the original price. • Has anyone died from diabetes? According to the International Diabetes Federation, 4.8 million people worldwide died due to diabetes in 2012. Diabetes-related deaths include those from severely high and low blood sugar such as diabetic ketoacidosis and hypoglycemic coma, respectively, as well as complications like heart attack, stroke and kidney disease. • At what age does diabetes start? Diabetes does not choose any age. In fact, a rare form of diabetes can be diagnosed in babies under 6 months of age, and the most common form - type 2 diabetes has been found in kids as young as five years old. Genes play a factor as well as the lifestyle of a person. • Is it true that family history plays a huge role when acquiring diabetes? Yes, but nowadays, lifestyle is a huge culprit. More people are now obese and living an inactive lifestyle, thus the rising number of noncommunicable diseases. K-ann Marpuri, real estate broker Aside from spending time with her loved-ones, K-Ann loves to travel • How can you prevent diabetes? You can prevent diabetes by eating food rich in fiber and low in saturated

fat and refined sugars, exercising at least 30 minutes a day, 5 days a week, maintaining a healthy weight, and living a healthy lifestyle. Studies have shown that lifestyle intervention can cut the risk of diabetes by as much as 58 percent. Some medications may also be prescribed. • How is this related to fertility? Infertility rates are higher in both men and women with diabetes. Diabetes can cause DNA damage in the sperm and menstrual cycle irregularities. Insulin resistance, a precursor to diabetes, is linked to polycysticovary syndrome, a common cause for female infertility. Women with diabetes must have well-controlled blood sugars before planning pregnancy as uncontrolled diabetes can lead to congenital defects in the fetus. • What are the other natural sugar alternatives out there (like stevia)? Examples of artificial sweeteners are acesulfame potassium, aspartame, neotame, saccharin and sucralose. Natural sugar substitutes besides stevia include xylitol (a sugar alcohol found in beets, berries and corn) and agave nectar (from the plant used to make tequila). Side effects from xylitol include stomachaches, gas and diarrhea, while concerns about agave nectar are related to its higher calorie count and high fructose content which may lead to obesity. Toots Maravilla, mountaineer The great outdoors are much more fun whenever Toots is around • What are the lifestyle changes we should make/follow to avoid diabetes? The first is to eat a balanced diet. Reduce (not cut out completely) the fat and sugar on your plate. Eat more vegetables which are good sources of fiber. Be active by engaging in activities like brisk walking, running, swimming, and even dancing. Avoid consuming too much alcohol, smoking and stress. Also, consult your doctor if you have a history of diabetes in the family. D OCTOBER-NOVEMBER 2013

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Breaking the Limits of Sports Medicine By Alexa Villano

“The focus is on treatment and prevention of injuries. That’s why subspecialties such as orthopedic medicine, rehab medicine and physical therapy, and the sports sciences have been more popular now based out of the need to provide better care,” he added. Dr. Michael Francis Obispo of the Physical Medicine and Rehabilitation Department at the Asian Hospital and Medical Center, Alabang, said that while sports rehabilitation medicine has been in the country for quite some time, those who choose to specialize in it still needs to seek training abroad.

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Or, hospitals have to invite experts to train those interested in the field. “These trainings for sports rehabilitation as well as sport medicine – they usually get it abroad. We have Armand (Bajacan) who is trained in the United States. Asian Hospital had to get him so we can have really honest to goodness trained individuals to be able to help these people,” Dr. Obispo said. ACL, occupational injuries and mental conditioning Injuries experienced by an athlete or a regular fitness buff can be

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n the last five years, the number of people getting into sports has increased rapidly, with more people enrolling in gyms or joining weekly marathons. But with physical activities also comes the risk of injuries. Enter Sports Medicine, a specialty that is becoming more in-demand, as people continue to push the boundaries of their bodies. “It’s been around for several decades but there is more emphasis in the past five years, simply because new sports and new fitness programs have come out. The more active people become, the more risk they have of getting injured,” said Dr. Edgar Eufemio, orthopedic surgeon of Peak Form, a sports and rehabilitation center located in Bonifacio Global City.

classified into two: surgical and nonsurgical. Athletes often suffer anterior cruciate ligament injury (ACL) but Dr. Obispo said many of those who go to sports doctors often complain of nonsurgical problems. “The most common (injuries treated) would be neck and back pains. As we allow technology to work for us rather than us working for technology, it is putting a bad effect in our bodies. It’s good we are trying to bring people back into being active. If you make them more active, they are doing what is supposed to be natural

feature for the human body,” Dr. Obispo said. Getting back in shape is also different for an athlete compared to a regular health buff. “If you’re dealing with sports rehabilitation, the goals change. It’s more competitive and performance based. You have to be faster, stronger. You have to have more endurance.” “All of those components factor into sports rehab when you play,” said Bajacan, a physical therapist and sports conditioning consultant. Bajacan said that mental attitude is crucial for someone injured especially an athlete who has been active all his life. “Athletes have the perception that they can do everything despite whatever experts say. There is what we call the iceberg phenomenon, where athletes would show a little bit of injury but it’s actually big. All their lives they’ve undergone physical and mental stress to win. That’s a big goal for them. All the more we (sport medical specialists) should exist especially in the Philippines because I think the common trait of the Filipinos is matiisin.”

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Back to basics and rehab process While rehabilitation is essential in getting back the person’s fighting form, it is also important that from the start, athletes or those who want to get into shape should have the basic knowledge of training and the sport they are planning to get into. “They think the sport is the exercise. They go into a complicated movement for a very long period of time and their bodies are not prepared for it. The exercise component and the sports component are (separate) skills (to be learned),” Bajacan said. A lot of patients also come to them when they are already injured, and this shouldn’t be the case.

“Unfortunately they come to us when they are already injured. The Dept. of Rehab Medicine [in Asian] is trying to change the paradigm shift. [You need] to improve fitness, fixing the problem before it comes into play because obviously if you want to play, then you need to condition yourself. You need to educate them with the right techniques and what are the right practices,” Dr. Obispo said. He also compared rehabilitation to a cookbook. “You need to access the individual itself. You need to access their lifestyle, and if they’re going into a sport, know what sport they are in. There is a lot of assessment to be done.” Dr. Eufemio on the other said: “You put them into two broad categories; home exercises or programs they tend to do on their own. There is formal therapy wherein they have to be monitored and seen at regular intervals by a therapist. Most usually [go] three times a week for two weeks of which you are monitored on exercise supervised by a therapist and you have the luxury of modalities including ultrasound therapy, laser, electrical stimulation, cyrotherapy and attraction machine.” The future of sports medicine in Ph As running and other form of sports continue to become popular, the demand for people in the sports medicine is steadily increasing, but there’s not enough yet according to Dr. Eufemio. “Dumadami na (It’s increasing). The fact that they’re not enough causes problems because it seems to be a little too competitive. Although the supply of patients is many, it becomes a problem because only a few sports doctors are known. The rivalry tends to be more intense.” “The problem with sports medicine is that it only improves as the sports program of the country improves. It doesn’t matter how high the skills are of the athletes if those we see are not of a high caliber. I think sports medicine can only move to the next level if the general sports program improves,” Dr. Eufemio added. “There should be a more comprehensive program for every athlete and he has to start very young. You don’t start taking care of an athlete when they are old. You take care of them during the formative years– the younger years,” he advised. Dr. Obispo, on the other hand, said that education is still vital and that the people are now aware of the effects of a sedentary lifestyle. “We want to create awareness and we were introducing the science but we also have to look into the market. We can’t do it alone. Education is still the evangelical scheme of things.”D OCTOBER-NOVEMBER 2013

righteousrecipes

Brown Rice Burger

Brown Rice Salad

3 Must-try Brown Rice Recipes

Vegetable & Brown Rice Porridge

By Chef Junjun de Guzman Photos By Jose Martin Punzalan

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rown rice has been described as a “healthier option” to white rice. It is even recommended for patients with diabetes. Here are three recipes you can try and taste toward a healthy life.

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righteousrecipes Nutrition facts per serving: 216. 5 calories 7 g fat 97.7 g carbohydrates 26.8 g protein

Brown Rice Burger Good for: 6 persons Preparation time: 30 minutes Cooking time: less than 10 minutes Ingredients: 1 cup cooked brown rice 1 cup cooked mongo beans ½ cup finely chopped onions ¼ cup finely chopped carrots ½ cup finely chopped mushrooms ½ cup mashed potatoes ¼ cup finely chopped celery ½ tsp ground pepper Pinch salt or no salt 1 tsp Worcestershire sauce 10-12 pieces mini burger buns Lettuce leaves Tomato slices Olive oil

Procedure: 1. In a bowl, mix rice, mongo beans, onions, carrots, mushrooms, potatoes, and celery 2. Add Worcestershire sauce for taste. 3. Shape into patties around 2 tablespoons each. Freeze for 10 minutes 4. Pan fry for two minutes per side to achieve some crusting Assemble: 1. Prepare mini-buns by slicing into two pieces. Brush each side with olive oil, lay lettuce leaves, and tomatoes 2. Top with rice burger patty and serve OCTOBER-NOVEMBER 2013

righteousrecipes Nutrition facts per serving: 82 calories 3.8 g fat 2 g carbohydrates 0.6 g protein

Vegetable a nd Brown Rice Porridge Serves 8 persons Preparation time: 20 minutes Cooking time: 30 minutes Ingredients: 2 tbsp canola oil 1 tbsp minced garlic 1 cup finely chopped onions ½ tsp finely chopped ginger ½ cup finely chopped leeks 1 piece sayote, cubed 2 stalks tagalog pechay, chopped 1 tsp low sodium Kikkoman sauce 1 tbsp oyster sauce 1 ½ cups brown rice

OCTOBER-NOVEMBER 2013

Procedure: 1. Sauté garlic in canola oil. Add in onions, ginger, and leeks 2. Sweat vegetables until soft. Add sayote cubes, and pechay leaves 3. Continue cooking, then add Kikkoman and oyster sauce 4. Put brown rice and two cups of water. Let it boil and simmer, serve it hot

righteousrecipes Nutrition facts per serving: 216. 5 calories 7 g fat 97.7 g carbohydrates 26.8 g protein

Brown Rice Salad Serves 4 persons Preparation time: 30 – 40 minutes Cooking time: for rice– 20-25 minutes Ingredients: 1 ½ cups cooked brown rice ½ cup finely cubed cucumber unpeeled 1 piece roasted red bell pepper, cubed 1 piece roasted egg plant, sliced 4 pieces tomatoes, cubed 100 gms fresh asparagus spears, blanched ¼ cup corn oil 2 tsps mustard 1 tbsps lemon juice

Procedure: 1. Make vinaigrette by mixing mustard and lemon juice. Slowly pour oil, and whisk until well combined. Season with salt and pepper 2. Toss all ingredients into a salad bowl, and blend mixture together. Serve cold

OCTOBER-NOVEMBER 2013

goodfoodguide

Clea nsing diet a nyone? By Edreilyn C. Manalo, RND

leansing diets or detox diets are used for the detoxification process of the body. Detoxification is the process of eliminating toxins and other unhealthy compounds from the body, specifically from the liver. The liver itself performs detoxification functions as it serves as the body’s filter, the organ in which every substance of our body finds its way to and through. Over time, this “filter” can become clogged, and the filtration system compensates by functioning in a sluggish and inefficient way. A cleansing diet is meant to clean out the liver, which in turn purifies, revitalizes, and energizes the entire body. There are many diet plans to choose from when looking for a cleansing routine. Practices range from the very intense to the very mild. Here are some types according to Cheryl Zielke, a Nutrition Consultant: The Lemonade Diet - Intensity level varies depending on length of practice. Although not recommended, it can be followed for up to 40 days. The main energy source is an elixir of fresh lemon juice, a dash of cayenne pepper, a tablespoon of pure maple syrup, and purified hot water. This diet is also known as the Master

Cleanse Diet. The Grapefruit Diet - This is a very mild approach to purifying the body. As most citrus foods offer the benefit of detoxifying, grapefruit is a main food source. Basically, the fruit is added to the beginning of each meal. It can be followed for any length of time without causing side effect.* The Cabbage Soup Diet Cabbage, cabbage, cabbage. If you can tolerate cabbage, this cleansing regime is worth a try. While the cabbage diet is not highly recommended, those who undergo the diet should stick to it

for seven days, with at least two weeks of interval in between as written in the cabbage-soup-diet. com. 24-Hour Cleanse - a very common cleansing diet with few major side effects. While there are many menu plans available, most include whole, unprocessed, raw (or lightly steamed) fruits and vegetables, slow-cooked brown rice, a source of protein and fat such as tofu or almonds, and lots and lots of water. Three-Day Cleanse - Also rather popular, the three day detox can offer many benefits without

*Grapefruits, though have been known to interact with certain medications such as those for blood thinning, blood pressure and cholesterol. ~Ed.

OCTOBER-NOVEMBER 2013

goodfoodguide

the harsh side effects of longer programs. The foundation of meals is very similar to the 24-hour protocol. Two-Week Cleanse - The longer time period of such diets will certainly cause extreme side effects. There is no evidence that the length of time is beneficial. Please research and ask your doctor about this type of diet carefully and thoroughly before engaging in it. There are several plans available. The Moon Diet - A cleansing diet based on the phases of the moon, which could result in losing at least 6 lbs. According to moonconnection.com, the moon diet is classified into two types: the Basic, and the Extended one. The Basic is a 24-hour fasting wherein you only consume water or juice. It must take place during a full moon or a new moon. The Extended, on the other hand,has one fasting during the new moon as described in the basic moon diet plan. It provides additional guidelines for weight loss and healthy eating during the phases of the moon. Food and substances to abstain from during this

period are caffeine in coffee, tea, soda, chocolate, tobacco, processed and refined foods, sugar, and alcohol. In addition, nearly every diet of this type requires drinking a high volume of purified water. Cleansing diet sought to be short-term management for disease and for weight loss. This kind of diet may be applicable to some individuals, while not suited for others. It definitely should be avoided if you are pregnant or trying to conceive, or if you are taking any medication. A recommended diet is one that is balanced, has variety, and is done in moderation. Every food group plays a vital role in maintaining “equilibrium”, so elimination of one or more will cause some health problems. The key is to control the amount of food we eat without starving, and to choose foods from a wide variety daily. The main point to remember when considering a cleansing diet is to be gentle with yourself. Never think that fasting entirely is the only way to clean your body. If you’ve been sick, have a health condition or take medications that require you to eat regularly, make sure to get your doctor’s approval before undertaking even a gentle cleansing program. D

Edreilyn C. Manalo, RND Edreilyn C. Manalo is a nutrition-dietetics practitioner for clinical and hospital nutrition and weight management. She finished Bachelor of Science in Nutrition and Dietetics at Centro Escolar University; studied Bachelor of Science in Chemistry at Adamson University, and obtained a certificate of internship at the St. Luke’s Medical Center-Quezon City (SLMC). Edreilyn is a board passer in Nutrition and Dietetics, year 2013. She is currently a member of the Nutritionist-Dietitian Association of the Philippines (NDAP) and Philippine Association of Nutrition-Delta Chapter of CEU.

OCTOBER-NOVEMBER 2013

productspotlight

Diabetes Must-Haves for the Busy Bee By Aencille A. Santos

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panacea is yet to be discovered by modern science for diabetes, but the condition should not dictate your life â&#x20AC;&#x201C; instead, learn to work around it. Here are some of DiabetEASEâ&#x20AC;&#x2122;s product must-haves to enjoy work and enjoy life, hassle-free.

OCTOBER-NOVEMBER 2013

productspotlight INSULATED CARRY-ON BAG Insulin, in order to keep its efficacy, must be stored in room temperature or in the refrigerator, but never frozen. If youâ&#x20AC;&#x2122;re going on a long trip, letâ&#x20AC;&#x2122;s say, a long drive to Pagudpud from Manila amidst the scorching summer heat (which is a 14-hour drive), its best to protect your meds from harsh temperatures. Various containers are readily available in the market based on the amount of insulin you need to bring and your preference.

INSULATED INSULIN PEN AND WALLET CASES For those who make short trips to work or to a meeting, a mini diabetes bag would do. Consider having wallets or carry cases as handy as pencil cases that would easily fit in your purse for your daily insulin needs. EMERGENCY SNACKS Hypoglycemia occurs when the patient deviates from maintenance schedules. Still, there are ways to stabilize sugar levels. Only about 15g to 20g of carbohydrates would be enough to save a patient from a hypoglycemia episode, according to the American Diabetes Association.

Skidaddle Polka Dot Bag USD 25.00 The Messenger travel bag is a bigger and more spacious choice, making more room for your insulin and medical supplies. It is a good choice those who will be traveling for a longer period of time.

Medicool Dia-Pak Classic USD 24.50 without shipping The Messenger travel bag is a bigger and more spacious choice, making more room for your insulin and medical supplies. It is a good choice those who will be traveling for a longer period of time.

8 ounces of milk Nestle Non-Fat Milk Hi-Calcium

The Berry Juices 4 oz. or 1/2 cup Available at SugarLeaf G-2F MEDICard Lifestyle Center 51 Paseo de Roxas corner Senator Gil Puyat Avenue, Makati City Messenger Diabetic Bag USD 89.95

OCTOBER-NOVEMBER 2013

productspotlight SMARTPHONE WITH DIABETES CARE APPS Communication and information comes in one tiny package in smartphones. Any model containing any of the most popular operating systems in mobile phones today (take your pick: Apple iOS, Android, and Windows) is enough to download applications which will help you manage your fitness, nutrition, and even your glucose levels. If tech jargon is way beyond your league, ask the younger member of the family to help you with these.

dLife Diabetes Companion (Free for download on Apple iOS) This application is a comprehensive diabetes aid all available for download, for free. From lifestyle choices, recipes, restaurant recommendations, and even health tips from the experts, have your personal holistic diabetes partner, right at your fingertips.

OCTOBER-NOVEMBER 2013

Glucose Buddy (Free for download on Apple iOS and Android) Easily track and record your glucose levels, carb consumption, insulin dosages, and activities with Glucose Buddy, an app available for free in Apple iOS and Android. It has bonus features which allow you to print your results, estimate your A1c, and a notification which reminds you about your maintenance schedules. D

livingwell

Two Different Faces of Diabetes By Excel Dyquiangco

iabetes doesn’t choose its target. Single or married, young or old, anyone can be afflicted with this condition. Two men, one in his 40’s and the other in his 60’s, share their story. Gerry dela Cruz: Learning his lesson the hardway His was somewhat an active lifestyle. Having worked as a bill collector, 49-year old Gerry dela Cruz would go from one company to another or from one home to another to collect bills and debts. He would eat anything: usual, ordinary – and sometimes a little bit extraordinary just to reward himself. He claimed he did a little bit of exercise just to tone his body. Fifteen years ago, however, all of these activities began to change drastically when he discovered that his sugar levels were shooting up to the stars. It wasn’t much of a shock when he finally learned he had diabetes. He was adamant at first “I was young, so I thought that it couldn’t be that

[bad],” he said. “I was hard-headed and stubborn, and I had no discipline. For instance, when I got invited by my friends to parties, nothing really changed much with my eating habits. I actually didn’t show to my friends that I’m a diabetic so I ate anything I wanted.” He learned his lesson the hard way when he turned 40 years old. His vision became blurry and he would feel dizzy from time to time. It was this time when he began to take things a little more seriously by following his doctor’s advice. “I would take just one spoonful of rice,” he shared. “But there were times when I would eat more than the usual only to regret what I had done later on. Because of this I wouldn’t want to do it ever again.” He also takes vitamins and other supplements to combat diabetes. On the other hand, he admits that he still has a lot of things to learn. For one, he should practice the habit of exercising daily. For another, he needs to take in more hours of sleep.

Gerry dela Cruz

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livingwell “I get tired easily even when I only walk only a few miles,” Gerry replied on the challenge of having diabetes. He decided to join the Diabetes Support Group at The Medical City. Even when the group meets once a month, he said he was not a regular attendee before because of the pressures of work. But now that he knows he is being helped and supported by the group and the organizers, he finds time to join the events and meetings. In fact, he is currently the public relations officer of the organization. His responsibilities include helping out the other officers with their responsibilities and assisting in the information drive campaign. “When I joined the group, I became more well-informed,” he said. “They teach us how to manage diabetes by giving us information on what we need to eat or what we shouldn’t, what kind of workouts we should do and others. There are also other topics which include diabetes complications and first aid. Spiritual encounters are also offered to the members.” Angel Siawingco Jr.: Everything in moderation Sixty six-year-old Angel Siawingco was overweight and drank a heavy. Because of the pressures and stress from work, he only slept for four hours a day, only to wake up to the same routine each day. When his previous company ran an annual physical exam for all of its employees in the 1990s, he found out that his blood sugar level was way beyond the desired amount. “I was quite happy when they informed me that I was diabetic because finally, they detected my illness,” Angel said. “It was a blessing in disguise because if it had not been detected this early, I would have suffered more severe complications.” From there, his lifestyle completely changed. He cut down on his drinking

OCTOBER-NOVEMBER 2013

of heavy liquor. He became more disciplined in his sleeping patterns by following the eight-hour rule. He also takes vitamins and supplements since he almost turned blind, but thankfully the whole thing was reversed. He has become conscious of the food that he eats. “The whole lifestyle change was difficult because I had to cut down on sweets and my taste buds had to adjust to the new flavor,” he said. “I also had to reduce my rice intake to just one spoonful. Although I eat small portions six times a day, it wasn’t as flavorful as before when I can eat anything.” He admits it was very difficult to adjust since he was still longing for those meals. In fact, during the first month of his program, he immensely lost a lot of weight. The amount of rice he had to take for snacks turned into just one piece of cracker. “It took a lot of self-determination,” he recalled. “When you are stubborn and hardheaded, what can be expected out of you? I’ve seen my father who was a diabetic deteriorate and I don’t want that to happen to me, too.” Eventually his diet soon changed. Instead of getting rid of rice completely, for instance, he gradually ate everything in moderation. As advised by his doctor, he adjusted his food intake. He also tries to improve his immune system by taking vitamins, sleeping at least eight hours a day and by having an active and healthy lifestyle by walking around his neighborhood, doing household chores, and others. This took a total of six months before he became fully adjusted. How did he influence his family? “It’s with the diet,” he says. “They also had to eat what I had to eat, too.” Like Gerry, Angel is also a member of the Diabetes Support Group of The Medical City, and he’s pleased with his decision to join.

“I keep on learning from the series of lectures,” he said. “My mind always gets refreshed and I also give testimonials on how to manage diabetes properly.” Gerry believed that discipline and perseverance are the greatest values he’s learned in his journey. “Prevention is still better than cure,” he said. “So even now try to keep your lifestyle healthy. If you already have diabetes, attend seminars and meetings so that you are well-informed too.” For first timers joining support groups, Angel has this to say: “It’s a way of knowing what you should and shouldn’t do and the benefits you get out of this,” he says. “Diabetes support groups provide a wealth of information from other participants about what they have learned and gained from their successes as well as from the mistakes they’ve made. People with diabetes have various experiences but the common goal of a support group is for these people to encourage each other. There are also free consultations since medicines and treatments are really way expensive.” D

Angel Siawingco Jr.

stressbuster

By Ma. Cristina C. Arayata

ith our current lifestyle, itâ&#x20AC;&#x2122;s easy to be overwhelmed by stress. Not to worry â&#x20AC;&#x201C; there are a lot of things you can do to overcome this and return to your sunny disposition. Below are just some of the ways.

OCTOBER-NOVEMBER 2013

stressbuster

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Pray. Yes, the easiest yet most powerful thing one can do is to pray the stress away. Face the fact that you cannot do anything without Him. Leave all your worries; cast all your cares on the Big Guy above. Find the peace of mind you’ve been longing for by saying a prayer and having a conversation with God. Visit a spa. These days, spas offer a very cozy environment for de-stressing. Go out with your mom or with your friends and enjoy the health benefits of a full body massage or a body scrub. Visiting a spa is a great reward, too, for a hard day’s work. Laugh. Sometimes, because people tend to focus too much on their problems, they tend to forget to laugh. Watch a comedy movie or visit a comedy bar. Forget your problems and start learning to enjoy life. Laugh more! According to experts, laughing is good for the heart and has health benefits. Call a friend. Haven’t you noticed that catching up with your family, friends and positive influences in your life makes you feel relieved and happy? Just having a great conversation with them would help you destress, without spending anything.

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Volunteer. Offering a hand to charity, helping those in need – these are acts that can make one feel so light. Assisting others also does you a favor, as it takes your mind off your troubles and makes these seem less significant compared to other people’s plight. Play. Sometimes, we need to be young at heart. YOLO (You only live once) as they say. We must learn to savor every moment. Play with your kids, nephews or nieces, or with your grandchildren. Enjoy being young again. Engage in sports, too, if and you’re able to do both your body and spirit some good. Travel. You can opt to go to a resort (Panglao in Bohol is a really nice place to unwind). Travel with your family. Visit the places on your checklist.

Relax. Unwind with activities or interests that give you joy. Curl up with a good book, watch a show, sing your heart out, play that instrument, listen to your favorite music, paint your masterpiece, dance with a partner, fill in that scrapbook or journal, and so on and so forth. D

dosanddon’ts

8 Tips for the Newly Diagnosed By Emil Karlo Dela Cruz Reviewed By Joy Arabelle Castillo Fontanilla, MD

etting diagnosed with diabetes is no easy thing to hurdle. But don’t panic. Despite how scary diabetes may be, you can still manage your condition from the get-go, so that it doesn’t overwhelm you. Everything starts with a first step – you just have to be brave enough to take it. So steel your heart, steady your resolve, and take heed of these things that you should and shouldn’t do, upon being diagnosed with diabetes.

DO’S Learn more. Ask your doctor where you could get reliable information about the disease and to fully rein in your condition, the newly diagnosed may need the help of a team of physicians, a diabetes educator, and dietitian. Familiarize yourself with the condition and how to avoid its complications. Learn how to check your blood sugar, plan your meals and/or administer your medications such as insulin if recommended.

IIlustration by Calvin Saquibal

Make meal changes. People with diabetes are generally advised to stay away from fatty food, or those with too much carbohydrates. These items often cause blood sugar spikes and raise cholesterol. But if you think about it, these are diet recommendations even for people without diabetes, to stay healthy. Of course, this doesn’t mean you have to deprive yourself. Just make sure to lessen the quantity. Also, opt for healthier food alternatives, like black or brown rice (instead of white rice) and whole-wheat bread. Move. Obesity and diabetes often go hand in hand. Be physically active to

trim those extra pounds. Exercising not only helps manage your weight; it also improves blood sugar and cholesterol levels. In case you don’t have time to exercise, then at least commit to moving as much as you can to get fit.Be careful also not to get injured. You might be subject to wounds that take long to heal or get infected. Get tested. People with diabetes should specifically watch out for eye and foot problems, which can lead to blindness and limb amputation. See the eye doc at least once a year even if you have no symptoms; examine your feet daily, watching for cracks, wounds or signs of infection. Kidney, nerve, and heart disease are also prevalent among patients with this condition. Control of blood pressure, sugar, and cholesterol are a must. Heart, urine, and quarterly blood exams are routine.

Keep it a secret. Keeping the condition a secret from others may not be a good idea. Summon the courage to tell a trusted friend, family member, co-worker and/ or fellow patient about your diagnosis.

Confiding can help you unburden your fears and may even save your life. Your confidante may be able to recognize when you’re displaying signs of hypoglycemia (low blood sugar) and help you out of it. Starve yourself. For some, they see their diabetes as a consequence of eating too much. They think that the remedy for this is to do the opposite, which is to eat in very little amounts or not at all! Never go on an extreme diet without consulting your physician and dietitian. Severe diets may drastically affect your blood levels, causing hypoglycemia. Skip meds. Do your best to take your medications as prescribed, and let your doctor know if you are taking any supplements, over-the-counter drugs, or other substances. Schedule regular checkups. This will give you and your healthcare team a good gauge of your condition. Be negative. Getting over diabetes may be a daunting task, even for the strongest of us. But getting swallowed by negativity makes the condition ten times worse. Counter the bad vibe by talking to your support group, or to your physician. Pretty soon, you won’t feel alone in handling your condition. Remember: there is a silver lining to even the darkest cloud. D

OCTOBER-NOVEMBER 2013

dosanddonâ&#x20AC;&#x2122;ts

8 Payo Para sa Bagong Tuklas ng Diyabetes Isinulat ni Emil Karlo Dela Cruz Pinamatnugutan ni Joy Arabelle Castillo Fontanilla, MD

Mag-aral tungkol sa diyabetes. Itanong sa iyong doktor kung saan maaaring kumuha ng impormasyon tungkol sa iyong kondisyon. Upang manalo kontra diyabetes, kinakailangan ng bagong pasyente ang tulong ng isang doktor, diabetes educator, at isang dietitian. Kilalanin nang maigi ang iyong sakit para maiwasan ang paglaganap ng komplikasyon. Mag-aral kung paano kunin ang iyong blood sugar, kumain nang tama, at mag-insulin kung kailangan. Baguhin ang diyeta. Pinapayuhan ang mga may diyabetes na umiwas sa taba, o kaya sa ubod ng daming carbohydrates. Ang mga ito ay kilalang nagpapataas ng blood sugar at kolesterol. Kung tutuusin, ito din ang rekomendadong diyeta kahit na walang diyabetes. Kung nahihirapan mag-adjust sa ganito, bawasan na lamang ang iyong kinakain. Pumili din ng mga pagkain na mas makakabuti sa iyong kalusugan, tulad ng brown rice at whole-wheat na tinapay. Gumalaw. Ang katabaan at diyabetes ay madalas na magkakabit . Para maiwasan

OCTOBER-NOVEMBER 2013

ito, ugaliin na mag-ehersisyo. Ang pageehersiyo ay hindi lamang nakakatulong sa pagpapapayat; pinapaganda din nito ang iyong blood sugar at kolesterol. Kung sakaling wala kang oras magehersisyo, ugaliin na gumalaw kung kailan maaari. Ingatan lamang na huwag masugatan, dahil maaaring mahirap gumaling ang sugat ng may diyabetes. Magpasuri. Maging alisto sa problema sa mata o kaya sa mga sugat sa paa, dahil maaari itong humantong sa pagkabulag o pagkaputol ng paa. Ugaliing bumisita sa ophthalmologist taun-taon kahit walang sintomas. Tingnan din kada araw ang iyong mga paa kung meron itong mga sugat o pasa. Ang sakit sa bato at puso ay malimit din sa may diyabetes. Siguraduhing maging alisto sa iyong blood pressure, sugar, at kolesterol. Karaniwaâ&#x20AC;&#x2122;y kailangang suriin ang puso, ihi, at dugo.

Itago ang iyong kondisyon. Ang pagtago ng iyong kondisyon ay maaari ring makasama sa iyo. Kung kaya, sabihin sa mapagkakatitiwalaang kaibigan, kapamilya, o kapwa pasyente ang tungkol sa

iyong diyabetes. Nakagagaan ng loob ang pakikipag-usap. Ang iyong mapagsasabihan ay siya ring maaaring sumaklolo sa oras na magpakita ka ng sintomas ng hypoglycemia (sobrang pagbaba ng asukal sa dugo). Magpakagutom. Para sa ilan, ang sobrang pagkain ang tinuturing sanhi ng kanilang diyabetes. Kaya naman naiisip nila na ang solusyon dito ay ang pagdidiyeta nang todo. Huwag mag-diyeta nang hindi kumokonsulta sa iyong doktor at dietitian. Ang labis na pag-diyeta ay maaaring makaapekto sa iyong asukal sa dugo, at magdulot ng hypoglycemia. Kalimutan ang gamot. Gawin ang lahat upang masunod ang resetang iyong doktor. Ipaalam sa doktor kung ikaw ay may iniinom na mga supplements, o mga over-thecounter na gamot. Magpatingin din nang regular, upang makatulong sa pagsuri ng iyong kondisyon. Maging negatibo. Minsan nakakalungkot ang diyabetes. Matatag ka man ay posibleng mabagabag ka pa rin sa iyong kalagayan. Subalit ang pagiging negatibo ay maaaring magpapalala sa lahat. Kontrahin ang pagiging negatibo sa pamamagitan ng pakikipag-usap sa mga kaibigan, o kaya naman sa doktor. Hindi magtatagal ay mararamdaman mo na hindi ka nag-iisa sa iyong pinagdaraanan. D

IIlustration by Calvin Saquibal

ng masuri ng pagkakaroon ng diyabetes ay mahirap tanggapin. Pero huwag matakot. Kaya mong malagpasan ang diyabetes at pigilan na lumala ito. Lahat ay nagsisimula sa unang hakbang â&#x20AC;&#x201C; tibayan mo lang ang iyong loob. Magpakatatag, at sundin ang mga payong ito.

affairstoremember

OCTOBER-NOVEMBER 2013

affairstoremember

Kim Atienza launched as Omron’s heart ambassador

lejandro Atienza or more popularly known as Kuya Kim,was launched as the Heart Ambassador of blood pressure monitor, OMRON, in view of his advocacy against stroke. “Omron is a top brand in blood pressure monitoring. Why ‘Kuya Kim’? It’s because Kuya Kim is a stroke survivor,” Atienza said at the launch event held at Makati Shangri-La in July. “At one point in my life, I was reliant on my blood pressure information whether my blood pressure is high or low because it indicated whether I live or I die.” At the event, Atienza explained the need to constantly monitor blood pressure especially after a stroke. “When you suffer from stroke and it is not fixed yet, the probability of getting another stroke is more than 60 percent,” he explained and later demonstrated the proper use of a blood pressure monitor with Julie Lim, OMRON’s Senior Brand Marketing Manager for healthcare. Atienza suffered a stroke in 2010, which almost took his life. Atienza also explained that OMRON’s range of digital monitors give very accurate readings. The most common problem arises with human error, which is why education on its proper use is very important. “Home monitoring of the BP is helpful in guiding titration of one’s medicines for hypertension, and maintaining optimal BP levels,” said Dr. Rafael Castillo, past president of the Philippine Society of Hypertension and current president of the Asian Pacific Society of Hypertension. However, he emphasized that although BP devices like Omron are quite easy to use, patients have to be taught the proper technique to take one’s BP so faulty readings may be avoided. Omron is the only brand validated by the Philippine Society of Hypertension and is trusted by millions of people around the globe. Omron’s line of home-use blood pressure monitors allow and encourage Filipinos of all ages to take a more hands-on role in managing their health. The BP monitors are equipped with the patented Intellisense Technology that applies the exact amount

OCTOBER-NOVEMBER 2013

Kim Atienza talks about the story of his heart at his launch as OMRON’s heart ambassador

OMRON’s line of blood pressure monitors displayed at the event

of pressure to attain quick, comfortable, and precise measurements. Some products even have Heartbeat Detection, which indicates irregular heartbeats while the BP is being monitored. Monitors like the HEM 7211 and HEM 7221 models have features like the Dual Check System, which monitors itself if it’s working correctly; and a cuff wrap, which indicates whether the cuff is wrapped properly around the arm. Both Atienza and Dr. Castillo promote regular monitoring of their blood pressures to prevent known cardiovascular complications of hypertension like stroke, heart attack, and heart failure. “Each hypertensive patient owes it to himself to monitor his blood pressure. Patients should also keep up-to-date records of his BP, noting any symptoms that might be related to the BP. Accurate records can help their physician evaluate them and the efficacy of their anti-hypertensive medications during follow up examinations,” said Dr. Castillo. Michaela Sarah de Leon D

affairstoremember

Glucerna launches 1-2-3 Challenge

D Coach Jim Saret of the Biggest Loser Philippines

Nutritionist Nadine Tengco

iabetes has grown rapidly in the country. It is estimated that 11 million Filipinos are reported to have diabetes and prediabetes. Alarmed by the numbers, Abbott Philippines launched the Glucerna 1-2-3 Challenge last August 1 at Shangri-La Edsa Hotel. “Proper diabetes management can be overwhelming for people with diabetes, but is essential for them to maintain a healthy and active life,” said Dr. Jose Rodolfo Dimaano, medical director, Abbott Nutrition. “That’s why we developed the Glucerna 1-2-3 Challenge to provide people with diabetes an easy-to-use resource that helps them take charge of managing their condition and feel confident they can lead a healthier lifestyle. Also in attendance to share their expertise in preventing diabetes were The Biggest Loser Philippines Coach Jim Saret and nutritionist Nadine Tengco. “Diabetics are prescribed to exercise by most doctors. The thing is, we have to be careful with them because they can get either a hypo- or hyperglycemia,” Saret said. “The role of exercise in diabetes is very big. Most of them [Biggest Loser participants] had prediabetes. In the show, our major thrust was for them to lose weight.” Tengco meanwhile discourages diabetes patients from making food as their enemy, which is often reflected in the diet and food intake they have. “Food is the solution and not the problem. In diets however we focus on the two B’s – bawal (not allowed) and bawas (reduced),” Tengco said that the two D’s – dagdag (added) and dapat (recommended) should be followed. She recommends eating food with the big four: fiber, calcium, Vitamin D, and Omega 3. By registering through the website www. glucerna123challenge.com.ph, participants can access healthy meal plans and recipes, exercise plans, and recommendation portions of Glucerna to help monitor the body. A loyalty program is also part of the 12-week challenge. Alexa Villano D

Abbott Medical director Dr. Jose Rodolfo Dimaano

OCTOBER-NOVEMBER 2013

affairstoremember

PADE-ADNEP holds 11th joint convention

embers of the Philippine Association of Diabetes Educators (PADE) and the Association of Diabetes Nurses Educators of the Philippines (ADNEP) held their 11th joint convention last August 23-24 at the Crowne Plaza Hotel, Ortigas. This year’s theme tackled diabetes trends in the community. “There is a young population already suffering from cardiovascular diseases. Sometimes, they already have diabetes at the age of 20-25,” said Jay Raymond Mazo, RN from the National Center for Disease Prevention and Control. He added: “Non-communicable diseases are manmade. They are caused by a person’s unhealthy lifestyle.”Mazo also mentioned that programs such as Pilipinas Go 4 Health and Belly Gud Program are just ways to help Filipinos fight diabetes. Estelita Cadiente, a health education and promotion officer in the municipal health office of Carmona, Cavite

Estelita Cadiente

Nutritionist Jennina Duatin

Jay Raymond Mazo, RN

told attendees at the forum that they have a program called D.A.H.L.I.A (Direct Access to Healthy Lifestyle Intervention and Advocacy). The program has been on-going for the past few years thanks to their present mayor Dahlia Loyola, a practicing doctor by profession. Carmona has been awarded as one of the cities with a good health program by the Department of Health. Meanwhile, Jennina Duatin, a nutritionist, enumerated foods diabetic patients can eat. Alexa Villano D

St. Luke’s Medical Center QC holds healthy lifestyle talk

s part of its 27th anniversary, the St. Luke’s Medical Center’s Heart Institute in Quezon City held a lay forum entitled “Please be Careful with My Heart,” tackling hypertension, diabetes, and health habits last August 7 at the CHBC Auditorium. Speakers for the forum were Dr. Sue Ann Locnen who discussed hypertension in the talk Hypertension: Are you High?...Are you Low?followed by a discussion on exercises by Dr. Irma Yape together with a demonstration from some of the St. Luke’s staff. Dr. Allan Dampil meanwhile discussed diabetes in his talk Diabetes Mellitus: Candy Crush…Sugar

OCTOBER-NOVEMBER 2013

Chart showing if diabetes can be inherited

Rush! Dr. Dampil answered questions from the audience, reminding them on how to manage their condition. NUIU (New YOU)cuisine’s Arabelle Jungco and Brian Kitane also gave a talk on healthy diet and cooking tips. A healthy guide was also distributed to participants to enlighten them about NUIU’s recipes and eating plans. Alexa Villano D

affairstoremember

PASOO joins ‘Exercise is Medicine’ network

xercise is Medicine™ (EIM) a global non-profit organization whose vision is to make physical activity and exercise a standard part of disease prevention and medical treatment, was formally launched last September 7 at the 19th Philippine Association for the Study of Overweight and Obesity (PASOO) convention at ShangriLa Edsa Hotel. “We’re very happy that we will join the world wide network of EIM. We consider EIM Philippines as a coalition of like-minded members with the vision of considering physical activity and exercise as a vital tool for the prevention and management of disease,” said Dr. Rodolfo Florentino, vicepresident of PASOO. “The mission of EIM Philippines will be to spread the word to physicians and allied practitioners all over the Philippines that we can start prescribing or advising or counseling their patients and inform them of the proper physical activity and exercise you do in order to avoid worsening the condition or help in the management of the disease they are treating.” Present during the signing of the partnership were Dr. Florentino, PASOO president Dr. Gabriel Jasul, Dr. Benedict Tan of EIM Singapore, and Mr. Guillermo Aponte, president and general manager of Coca-Cola Philippines.

From left - Dr. Benedict Tan, Dr. Rodolfo Florentino, chair EIM Phils, Caloy (Happiness President, Coke) Mr. Guillermo Aponte, President & General Manager, Coca-Cola Phils and Dr. Gabriel Jasul Jr. PASOO President

“We are honored to be part of the EIM program in the Philippines. Together with our partners and our stakeholders we believe that this initiative is an important way to increase physical activity and improve wellness which is critical to public health,” Aponte said. Health societies led by the Philippine College of Physicians, Diabetes Philippines and Philippine Society of Endocrinology and Metabolism were also present at the signing to show their support for the program. The EIM global initiative was created by the American College of Sports Medicine and the American Medical Association in 2007. Since then, several countries around the globe have formed their own national Task Forces – such as Australia, Canada, Colombia, Mexico, Singapore and Thailand. Alexa Villano D

7th AACE-Ph il meeting held New president vows to have a more patient-centered AACE-Phil THE 7th Annual Meeting and Clinical Congress of the Philippine Chapter of the American Association of Clinical Endocrinologists (AACE) and 5th Joint Meeting with AACE,was successfully held in Radisson Bleu Hotel in Mandaue, Cebu. With the theme Advocacies, Advances, and Challenges in Endocrinology, it boasted a host of key opinion leaders from here and abroad, sharing their expertise. Topics ranged from diabetes, thyroid, and osteoporosis to nutrition, cardiology, sports medicine, and even IQ+EQ in clinical practice. Aside from the lectures and symposia, AACE Philippine

Chapter inducted a new set of officers for the year 20132014. Dr. Florence Amorado-Santos, former chair of the Power of Prevention Through Fitness and Nutrition (POPTFN), took the helm of the AACE Philippines as president after immediate past president Dr. Marsha Tolentino, the last of the association’s founding Fellows (of the American College of Endocrinology). “For the year 2013, AACE-Philippines will be patientcentered. I will be initiating the rule of 10s advocacy, basically covering diabetes, thyroid, and nutrition,” said Dr. Santos in her acceptance speech on the second night of the OCTOBER-NOVEMBER 2013

affairstoremember three-day congress. The rule of 10s refers to the association’s thrust to add 10 more beneficiaries to AACE-Philippines’ various programs. The other officers inducted by AACE-Philippines president emeritus, Dr. Augusto D. Litonjua, were: Dr. Leilani Gail Magtolis, President-Elect; Dr. Jose Carlos Miranda, Vice-President; Dr. Reynaldo Rosales, Secretary; Dr. Robert Michael Gan, Treasurer; and Dr. Marie Yvette Rosales-Amante, Assistant Secretary. Board members included: Drs. Marie Gertrude Santos, Raymond Oribio, Jubilia Balderas-De Guzman, Theresa Marie Valdez-Faller, Melanie Grace Valdez, Rosario Bongco, and Francis Lee Ho. Past presidents of AACE-Philippines were Drs. Gerry Tan, Joy Arabelle Castillo-Fontanilla, Estrellita AACE - Philippines elects it’s new officers as it ushers in a more “patient-centered” 2014 Fernando-Lopez, Ma. Honolina Gomez,, and founding president Dr. George Tan. The next congress will be brought back to Manila with the theme Pursuing Hindrances, Issues, Learnings & Skills in Endocrinology. Micahaela Sarah de Leon D

Paano ba sumeksi gaya mo?

OCTOBER-NOVEMBER 2013

Galaw-galaw din ‘pag may time!

IIlustration by Calvin Saquibal | Script by Mylene C. Orillo

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