By Jessica Asprer
In the face of a global health crisis, patients with diabetes should be more cautious and proactive, experts say.
Even before the COVID-19 pandemic, diabetes had already been notorious for taking the lives of many Filipinos, ranking 4th in the leading causes of death in the country in 2020, according to the Philippine Statistics Authority.
Latest PSA data show that there had been 39,723 deaths due to this disease, while registered deaths due to COVID-19 (confirmed and probable) were 30,140.
A comorbidity of COVID-19, diabetes increases risk of suffering from worse symptoms of the virus. “If you have diabetes and you get COVID,” the chances of becoming severely ill, Dr. Aurora Macaballug says, are high.
While it is not true that people with diabetes are at greater risk to contract the virulent disease, “there is a higher morbidity and mortality [associated with] COVID-19 infection in people with diabetes,” according to Dr. Macaballug, chair of the Advocacy Committee of the Philippine Society of Endocrinology, Diabetes, and Metabolism (PSEDM).
Dr. Macaballug notes recent studies highlighting that COVID-19 can cause diabetes when the SARS-CoV-2 virus attacks the pancreas, damaging the cells responsible for producing and regulating insulin.
Crushing myths, heeding facts
To help properly manage the disease, experts debunk myths and misconceptions concerning diabetes.
Whether eating sweets causes or exacerbates the condition is a common question.
“Sweets [are] not the cause of [diabetes]; it’s ‘yung pagkain mo nang marami,” clarifies Leyden Florido, president of the Philippine Association of Diabetes Educators (PADE).
Sugar increases blood glucose level, but specifically sweet-flavored food items are not the only source of sugar. The amount of calories and sugars in a diet should be factored in when determining one’s risk for diabetes. Other factors likewise affect blood sugar levels, such as physical activity, medication, age, and stress, among others.
Dr. Macaballug warns against using herbal supplements with no proven therapeutic benefits as alternatives in managing the disease.
Drinking alcohol is allowed but only in strict moderation, while smokers are strongly advised to stop the vice associated with insulin resistance.
Patients with diabetes who are also struggling with depression or anxiety are acutely at risk of having low blood sugar levels, Dr. Macaballug adds.
The expert cautions those with genetic predisposition to diabetes or are leading a sedentary lifestyle are at higher risk of developing the disease.
Avoid and manage
Dr. Macaballug underscores the four elements, dubbed “Apat Dapat”, that help avoid fluctuations in blood sugar levels: exercise, good diet, adherence to medication, and regular consultations with a physician.
She says muscle action from exercise will help lower insulin resistance. Experts recommend 150 minutes per week or 30 minutes per day of physical activity.
Consistency is vital, as Dr. Macaballug points out, “Once you let go of the practice of exercising, which had kept the diabetes at bay, andiyan lang ‘yon, tataaas ulit ang sugar mo.”
Adherence to the right dose and timing of prescribed medication is likewise important. “May onset ‘yan, may duration ‘yan.” Having a pillbox can help systematize medication to avoid skipping doses, she adds.
Recognizing financial constraints other patients face, Dr. Macaballug makes a case for cheaper generic antidiabetic drugs.
“We cannot insist on giving the medication that we think would be best for the patient, but we have to make do with what the patient can afford or what the patient can actually acquire,” she says, adding there is no medicine completely void of side effects while reassuring that “nobody will give you anything that will hurt your body” to quell generic drug skepticism.
Florido emphasizes the value of consulting with doctors, which can be done via teleconsultation if in-person appointment is not feasible.
Pharmacies have also adapted to the current situation by accepting e-prescription and offering other services.
To date, there are 29 “Get Well Diabetes Care Hubs” nationwide, Mercury Drug’s one-stop section for the needs of patients with diabetes, shares representative and pharmacist Nellie Calipjo.
Select Mercury Drug stores also have drive-thru services and allow booking via Viber to address mobility concerns.
“During this pandemic, pharmacists are the most accessible healthcare professionals in the community,” says Callipjo.