Dumaguing: A closer look at diabetes

THE WORLD Diabetes Day passed by without much fanfare and the usual festive atmosphere expected in special occasions. The truth is, there is not much reason to celebrate rather it is a sad reality diabetes mellitus has encroached and invaded, so to speak, the household of every nation in the planet, not only in the so-called industrialized rich countries but more so in struggling poor nations. Despite the alarming incidence and prevalence rate- supposedly 240 million currently and counting- diabetes is not yet well understood by the majority of the populace, which might explain why, most newly-diagnosed diabetics are already in their advanced state.

Diabetes came from a Greek word which translated literally means “siphon" in obvious reference to the copious amounts of urine of diabetics. Type 1 diabetes mellitus is insulin dependent, in the sense the patient's pancreas, more specifically the beta cells of the Islets of Langerhans - have been destroyed ad demolished by microbes- virus, more specifically the mumps virus when the person has reached pubertal years. It must be emphasized that if a child has the usual childhood diseases- mumps, chicken pox, measles before puberty, there would be uneventful recovery, meaning no serious complications. That's why parents are advised that somehow, not to be so over-protective of their children, that it would be wise to expose them to these viral diseases early on in their early years.

Diabetes type 2 or the so-called adult onset diabetes has a strong genetic predisposition, meaning if a relative, whether it is straight vertical transmission- mother to daughter- or diagonal transmission- auntie to niece or uncle to a nephew- it appears that the gene for Type 2 DM - which is supposedly in chromosome No.6 close to the gene that encodes obesity, is an inducible gene, meaning that not all the siblings of diabetic parents would have the disease. Like for example, if a brother is aware of the sad, dismal state of a parent, who now has to undergo periodic dialysis because of end stage renal disease (ESRD) or CKD (chronic kidney disease), and this brother is careful with what he eats, drinks and follows a regimented system of exercise, then, he may not suffer from diabetes for the rest of his life. On the other hand, if a sister eats with gay abandon all that whets her appetite and to make things worse, an avowed coach potato, then in all likelihood, she would start manifesting the signs and symptoms late 20s or early 30s.

The public now is aware of the so-called 3 P's of diabetes mellitus. Polyuria is frequent urination; despite the frequency of urination, the patient puts out voluminous amounts of urine, whose specific gravity would be high,( normal is 1.004-1.024) because of its heavy load of sugar-glycosuria. Polydipsia is frequency of thirst or the urge to drink a lot of water. In the past, many argued that the reason the patient is always urinating is because he/she has been drinking. A study was conducted in which the patients were not allowed to drink water or any liquid for four hours. Result, despite the water restriction, the patients still was urinating profusely. Message is, diabetics could easily be dehydrated.

The 3rd be is polyphagia or the sensation of always feeling hungry. Indeed it has been observed that even if the patient has eaten, in a few moments he/she feels the pangs of hunger, accompanied by weakness and easy fatigability. Your columnist has added another P, which is the persistence of a non-healing wound. Everybody in the medical world- nurses, doctors, med technologists, hospital orderlies and other health care givers- are aware of the fact that, it takes a much longer time to treat a diabetic wound until it heals to a sturdy strong scar tissue.

We have heard of stories of dehiscence- opening of a previous surgical scar- among diabetics who had undergone operations- especially abdominal surgery.

Lastly, please allow us to inform our dear readers, friends and patients that, it is not only sugar or sweets that the diabetic must minimize- look we are not saying 'avoid' because we want our diabetics to also enjoy life- but carbohydrates in general- rice, wheat, potatoes and all foods that are derivatives of starch. Of course, easy also on fats and same with proteins. in short, a reasonably balanced diet should be always the daily fare of the diabetic, that way Life may not always be sweeter but definitely healthier! Cheers!


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