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hypoglycemiaLow blood sugar or hypoglycemia is one of the most common acute complications of Diabetes especially in individuals on insulin therapy or medications. Symptoms include shakiness, sweating, palpitations, anxiety, and hunger. Some people describe it as “parang nauupos na kandila” and may experience “blacking out” or “feeling like I’m gonna collapse or pass out.” When the blood sugar drops further, it might lead to confusion and disorientation, slurred or rambling speech, irrational or unusual behaviors, extreme fatigue, and lethargy (sleepiness), seizures and unconsciousness which could become fatal for some individuals with other comorbidities. Thus, awareness of the early signs of hypoglycemia would trigger early intervention with emergency foods or drinks and prevention of dangerous low blood sugar levels.

What are the common causes of Hypoglycemia?

IMAGE 1 Diabetes ComplicationsDiabetes mellitus is a non-communicable disease characterized by prolonged high blood sugar concentrations or hyperglycemia. This could be due to problems in: (1) insulin production - the hormone that is needed for the body to be able to use sugars for energy or (2) insulin resistance - where the body is less responsive to insulin even at high levels due to prolonged high blood sugar. Other risk factors include genetic and environmental factors, family history of diabetes, older age, physical inactivity, prior history of gestational diabetes, prediabetes, hypertension, or dyslipidemia (high LDL or Cholesterol), race and ethnicity.

During the early prediabetes phase, insulin resistance happens within the muscle, liver, and fat cells. The pancreas compensates by producing more insulin to keep the blood sugar levels normal. However, when prolonged, the pancreas starts to get damaged and fails in producing enough insulin and blood sugar continues to increase - leading to Diabetes. When left untreated or if a Diabetic person does not consistently drink his or her antidiabetic medications - high blood sugars start to stick to red blood cells which is measured by the HBa1c test. Continuously high blood sugars will also start to trigger the development of the following complications:

1. Dyslipidemia (High LDL or Cholesterol)

High blood LDL or Cholesterol levels is one of the common comorbidities for individuals with Diabetes. This excess cholesterol may deposit in large and small arteries which may contribute to the development of hypertension and increased risk for stroke and blood clots. Thus, it is also important to control your blood cholesterol through a diet rich in healthy fats from fish, nuts, and seeds and to regularly take your cholesterol lowering medications until you reach the healthy range.

acne and dietProclamation No. 110 declares the second week of November of every year as “National Skin Disease Detection and Prevention Week” under the auspices of the Philippine Dermatological Society which aims to educate the public on the importance of self-examination, adequate skin care, early consultation with dermatologists for proper management of skin diseases. This article focuses on the relationship between nutrition and skin health in terms of acne prevention.

Acne is one of the most common skin conditions experienced by adolescents and young adults. They could be in the form of mild few pimples on the face or body or to severe forms with redness and swelling. Acne lesions form when the hair follicles become blocked with skin cells and excess oil (sebum). This usually happens during adolescence when hormonal imbalances may stimulate excess oil production in the face, neck, chest, upper back and upper arms. This excess oil also allows the overgrowth of the bacteria Cutibacterium acnes that causes inflammation - thus the formation of a red or painful pimple.

What Causes Acne?

1. Hormonal changes. Hormonal changes during puberty stimulate excess oil production which may aggravate acne. Women with Polycystic Ovary Syndrome (PCOS) are also prone to acne and even hirsutism or the formation of male like pattern hair in the face, chest and back due to high levels of androgen hormone. If you suspect that you have an underlying medical condition that is causing your acne, consult your doctor.

balanced dietDiet is an important component of Diabetes management to keep the blood sugar within normal levels or to improve long term blood sugar control. Achieving good blood sugar control will help prevent or delay long term complications such as Hypertension, Chronic Kidney Disease, Neuropathy (problem with the nerves) and Retinopathy (blurring of vision due to damage in small blood vessels in the eye).

For Pre-diabetic Individuals

The initial intervention for pre-diabetic individuals is a Balanced Diet with plenty of fruits and vegetables and high-fiber foods. Regular physical activity of at least 30 minutes per day can help improve the body’s response to insulin and help in weight loss for overweight or obese individuals. Weight reduction may help reduce risk factors that contribute to the progression of Diabetes and its other complications.

Food Fortification

This November 7, we are observing the National Food Fortification Day as mandated by Executive Order 382 which aims to advocate and promote food fortification to address micronutrient deficiency. Food fortification is defined by the Codex Alimentarius as “the addition of one or more essential nutrients to food, whether or not it is normally contained in the food, for the purpose of preventing or correcting a demonstrated deficiency of one or more nutrients in the population or specific population groups. A famous example is Iodized salt which is table salt fortified with Iodine to address Iodine deficiency that causes goiter, cretinism and mental retardation. Salt Iodization is mandated by the ASIN LAW or Republic Act 8172: “An Act Promoting Salt Iodization Nationwide and for other purposes”, signed into law on 20 December 1995.

world diabetes dayThis November 14, we observed World Diabetes Day with the theme: “Access to Diabetes Care: If Not Now, When?” which aims to promote awareness about Diabetes risks, prevention and treatment and to improve access to Diabetes care around the world. In the Philippines, Diabetes is the 4th leading cause of death as of 2020 with heart disease as the top 1. This could be attributed to many health and environmental factors that can be prevented or addressed.

What is Diabetes?

Diabetes is a disorder in the way the body uses glucose or sugar that cells need for energy. Sugar in the blood is absorbed by the cells through the hormone insulin. When there is not enough insulin, sugar builds up in the blood and may lead to elevated blood sugar which may cause complications when left untreated. There are 2 types of Diabetes:

1. Type 1 Diabetes - The problem is in the pancreas or the organ in the abdomen that normally produces insulin. Autoimmune disorders may target this organ and prevent it from producing insulin.

2. Type 2 Diabetes - An acquired diabetes due to poor diet and lifestyle that causes the body to stop responding to normal or high levels of insulin. This may overwork the pancreas in the long run and may lead to damage that would cause it to produce little to no insulin.

Who is at-risk of developing Diabetes?