Dumaguing: Neglected issues on diabetes

MUCH has been said about diabetes mellitus, whether it's the Type l or the Type 2;, that it is no longer a disease among the rich and famous but among citizens of the so-called Third world countries whose incidence has shown alarming, to say the least, increase in its incidence, an epidemiologic data gathered in Africa and Asia, so much so that whatever statistics we have today about diabetes is a wrong information in the next year or even in a few months’ time. Of course, diabetes has become a cardiovascular issue, with heart attack as one of the three macro vascular complications of the disease, the two being stroke and peripheral arterial disease. And let's not forget its micro vascular complications- the pathies; neuropathy, nephropathy and retinopathy. Despite all the trimedia discussion to increase public awareness, it is observed that there are individual signs and symptoms not addressed and paid attention to. Several variations of pain- extreme pain, pins and needles alternating with numbness in the fingers, toes and sole of our feet are signs that the blood supply to the nerve is now compromised leading to its malfunction particularly its sensitivity to pain stimuli. A lady doctor emphasized the difference between the so-called nociceptive pain-caused by wound or trauma to tissues- from neuropathic pain very common among diabetics.

Using a monofilament test, by testing ten different parts of the sole of the patient's feet, would give a fairly accurate assessment of the gravity of the diabetes. Dra Dominguez is one expert in foot care of diabetics.

Diabetes begets depression and vice versa. This is the opening salvo of Ramona Abat, and segued into an worrisome pronouncement that one in four people in the world, will have some kind of mental illness in his/her lifetime. With the disturbing statistics about diabetes, it is not surprising if a lot of them would be victims of depression. The mere diagnosis is to some, almost like a death sentence, and when confronted with the reality of taking medicine for the rest of their life adds to the emotional burden of the patient. With data from a Philippine study, the amiable lady psychiatrist, shared the findings that those with diabetes, Type l and type 2, answering carefully prepared and questionnaire, had more depressive moments affecting their sleep, appetite, interaction with people, even their loved ones, which eventually led to a careless, negative, come-what -may attitude towards taking their maintenance medicine, aggravating heir wayward blood sugar levels.

Depressed with your diabetes? Don’t despair. Dr Abat is happy to share with our readers and patients her favorable experience with medicines that would bring a calmer and possibly hopeful picture into the life of diabetics. Tongue-twisting name, it may sound, Escitalopram may have been bringing smiles on the faces of depressed people not only diabetics. Sertraline is also a choice of the lady doctor in lightening the emotional baggage of folks in distress.

And by the way, Dr. Rose, she who knows diabetic foot care well is not against pedicure per se. Being a woman herself, manicures and pedicures are part of being the lovelier half of the human species, that is gender -wise, as long as the procedure in done in aseptic, hygienic conditions.


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