A sweet heart is not a good thing

MANILA, Philippines – Consider this: Cardiovascular disease (CVD) is the most common complication associated with type 1 and type 2-diabetes, and the leading cause of death. People with diabetes are two to four times more likely to develop CVD than healthy individuals without diabetes. Taken in this context, a “sweet heart,” or a heart that is affected and impaired by the elevation of blood sugar levels, is definitely not a good thing to have.

“Diabetes mellitus is a chronic disease or lifelong illness that results in metabolic abnormalities in protein, fat, and carbohydrate processing,” explains one of the country’s top endocrinologists, Dr. Rosa Allyn Sy, past president of the Philippine Diabetes Association. “It is characterized by elevation of blood sugar in the circulation, and if uncontrolled, leads to multi-organ complications.” Deaths from heart disease have significantly risen over the last decade in proportion to a parallel rise in the incidence of diabetes.

In light of the statistics showing that diabetes affects 246 million adults worldwide, with 80 percent living in developing countries like the Philippines, the disease has serious repercussions on public health and the economy. The International Diabetes Federation estimates that in 2007, at least US$232 billion was spent to treat and prevent diabetes and its complications. By 2025, the estimate is expected to exceed US$302.5 billion. Figures from the same organization show that in industrialized countries, around 25 percent of medical expenditures go into long-term complications, mainly cardiovascular disease, while the rest is spent on additional medical care. Thus, it is easy to comprehend that the burden of the disease becomes even more difficult for patients in underdeveloped or developing countries where resources are sparse.

The factors that lead to diabetes mellitus are varied. Dr. Sy cites family history, obesity, stress, physical inactivity, and abnormal maternal or infantile nutrition. “Babies who are born with a weight higher than eight pounds have higher risk for diabetes.”

Ethnicity also influences diabetic risk. “Filipinos show higher risk for diabetes,” warns Dr. Sy. “And if left untreated and uncontrolled for a long time, diabetes is dangerous. Diabetes is the fourth leading cause of death by disease; the seventh leading cause of death in the US. In the Philippines, it is the ninth leading cause of mortality.”

Around 160,000 people die of diabetes and its complications and of these, cardiovascular disease accounts for 75 percent. Moreover, the risk for stroke is 2.5 times higher among diabetics; their risk for hypertension is 60-65 percent, and 19-34 percent of diabetics are also complicated by kidney disease. In addition, blindness afflicts 14-40 percent of the population, while 50 percent undergo amputation. Undoubtedly, diabetes is both devastating and deadly.

What are the common signs and symptoms of diabetes mellitus that one should watch out for? Fatigue, weight loss despite a good appetite, frequent urination and thirst, genital itching, change in behavior, Acanthosis nigricans or hyperpigmentation/ darkening of the nape or armpit areas, numbness, and blurring of vision will indicate high blood sugar levels.

However, early detection is still the best way to prevent complications, and this is achieved by tests to determine pre-diabetes or impaired glucose tolerance (IGT). Pre-diabetes is characterized by blood glucose levels that are higher than normal, but not high enough to be diagnosed as diabetes.

“Early diagnosis of pre-diabetes, and treatment, along with lifestyle change can delay, if not prevent, the development of type 2 diabetes,” says Dr. Sy. If untreated, studies show that 46 percent of pre-diabetics become diabetics in nine years.

The test to determine pre-diabetes is called the Post- Prandial Blood Glucose Test (PPBG). Simply, it is a blood glucose test administered two hours after a meal. A glucose level above 140mg/dl may signal less-than-desired control and the need for further tests.

To create awareness about diabetes and pre-diabetes, Bayer has launched a campaign called “I’m in control with my healthcare.” Dr Luis Abola, medical director of Bayer Philippines, explains that myHealthcare is an “umbrella patient care program in the areas of cardiovascular risk management (diabetes, hypertension), acute care, and men’s health.” The aim is to improve patients’ management of their condition through patient awareness campaigns on early detection and prevention of diabetes, free blood sugar screenings, blood pressure screenings, urinalysis, and myHealthcare discount cards, where patients can save up to 40 percent on the cost of medication.

“By partnering with the medical community to help educate the public about diabetes prevention, the program promotes an early intervention strategy that involves screening and treatment of pre-diabetics,” says Dr. Abola. “More importantly, Bayer is providing opportunities for the public to have greater access to tests and medication.” PPBG screening is free in participating hospitals and clinics nationwide.