How to Live with Diabetes and Take Control

How to Live with Diabetes and Take Control | This article was initially published in Philippine Daily Inquirer – 2016

Dr. Elizabeth Paz-Pacheco Tells Us All on Detecting and Self-Managing Diabetes 

The Philippines is among the world’s emergent diabetes hotbeds. We can blame it on the diet, lifestyle, or environmental factors, but the sad truth is, thousands of Filipinos are dying on what could’ve been a preventable and manageable disease.  

Dr. Elizabeth Paz-Pacheco, one of the leading endocrinologists in the country, tells all about diabetes–early signs, prevention and control. 

Diabetes in a Nutshell 

There are two types of diabetes, type 1 and type 2. “The two types are differentiated by  cause and characteristics,” states Dr. Paz-Pacheco. 

“Type 2 Diabetes Mellitus (T2DM) is the more common type of diabetes among Filipinos, affecting about 90-95 %. Defects occur in the pancreas where there is a deficiency in insulin production. Insulin is an important hormone that promotes anabolism or growth.” T2DM usually presents in older, overweight individuals with a strong family history of diabetes. T2DM may be prevented if at-risk individuals maintain a healthy lifestyle. 

“Type 1 Diabetes (T1DM) usually occurs in younger individuals. Less than 5% of  Filipinos are afflicted, and occurs in the setting of a genetic susceptibility, autoimmunity and other factors that result in destruction of the pancreas, therefore ceases production  of insulin. Such patients often need full dose insulin for life.” 

Diabetes – Early Signs and Diagnosis

“Early detection through screening and diagnosis is essential, the earlier the control, the  better is the outcome.” Dr. Paz-Pacheco advises. If you think you’re at risk for diabetes,  look out for signs and symptoms. 

T1DM is easier to determine as it often presents a classic presentation in a younger  patient: significant weight loss, increased urination and thirst.  

T2DM is generally asymptomatic, until blood sugars run too high, at which time they present the following symptoms: increased urination and thirst, infections, blurring vision; or in the setting of major events such as a heart attack or stroke. 

High/Low Blood Sugar Levels and Management 

Blood sugars should be kept within acceptable range. Keep Fasting blood sugars at around 120 mg/dl; 2 hour post-meals at around 150 mg/dl and Hemoglobin A1C less  than 7%.  

Hypoglycemia refers to low blood sugars, generally lower than 70 mg/dl. The low blood sugar is accompanied by feelings of an attack: feeling hungry, cold clammy sensation increased sweating and palpitations. Taking in sugar calories, e.g. soft drink, orange juice or caloric meal can relieve these symptoms. Hypoglycemia can be prevented by regular intake of meals, with the proper matching of physical activity and diabetes medications. 

Hyperglycemia refers to high blood sugars, higher than normal in both fasting and after eating. If blood sugar levels are above acceptable it comes with the following complications: affected vision, kidney disease, numb and tingling hands & feet, etc. Poor  control of blood pressure, cholesterol and weight can lead to further complications such  as heart disease and stroke. When having hyperglycemia, seek medical attention  promptly. 

Diabetes – Self-Management and Control 

Diabetes is a lifetime disease. It cannot be cured but can be managed.  Early detection through screening and diagnosis is essential– the earlier the control, the better is the outcome.  

Dr. Pacheco held, “Once an individual is diagnosed with diabetes, I tell the patient: ‘it’s not the end of the world. Think of it as a blessing– the earlier you know, the easier you  can manage the disease and prevent problems’.” 

“Acceptance is key, followed by an active role in modifying lifestyle. Some introspection is required to change for the better. Dr. Pacheco advises to prepare your daily meal plans and formulate an exercise plan. The basics are non-negotiable—it’s a lifetime lifestyle,  not just for one week or one month. Discuss with your physician a program of regular  follow-up, which tests to monitor and consultations to assist you with proper  medications.” 

For a balanced meal plan, Dr. Pacheco recommends a balanced caloric meal with the aim  of achieving an optimal weight. “Food plate should include vegetables and fish or lean  meat as source of protein and fat. Carbohydrates may comprise 50-60% of the diet.  Avoid sugary foods such as cakes, ice cream, juices, wine or beer.” 

Check with your physician an exercise program that’s acceptable for you. If not contraindicated, 45-minute exercise thrice a week is recommended. This may be as simple as brisk walking, zumba, badminton, swimming, and others. Choose a physical activity you’re interested in doing.  

“Diabetes is in your hands,” reminds Dr. Pacheco. “Control the risk factors, use your fingers to remember:

  1. blood sugars,
  2. blood pressure,
  3. cholesterol,
  4. weight, and
  5. smoking cessation.

“It’s not easy, but not impossible. Proper management will give you  the best chance of long life without much problems.” (Dr. Pacheco, How to Live with Diabetes and Take Control, Philippine Daily Inquirer 2016)

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