It's Complicated

SUGAR FREE

By MALOU E. ROSAL

April 24, 2012, 11:12am

MANILA, Philippines — If you’re a diabetic, you’ve probably heard it said that no one actually dies of diabetes itself.  Instead, patients can succumb due to the complications that arise from this dreaded disease. But why do these complications even occur?

Perhaps a basic explanation can help. According to www.netwellness.org, “Diabetes is the inability of glucose to enter the cells. The result is that the bloodstream has a high amount of glucose and cells are not able to produce energy for the body. When diabetes is not carefully managed by keeping the amount of sugar in the blood at the right level, the resulting high glucose amounts wreak havoc on nearly every organ system in the body.”

While the whole body is affected by diabetes, the more common complications are “heart disease and stroke, vision loss and blindness (diabetic retinopathy), kidney failure (diabetic nephropathy), amputation (diabetic neuropathy), diabetic ketoacidosis and diabetic coma (non-ketotic coma).” Also because damage to nerves occur, males can suffer erectile dysfunction, while women can experience decreased lubrication. Another complication caused by nerve damage is gastroparesis, which, according to the National Digestive Diseases Information Clearinghouse (NDDIC) is “also called delayed gastric emptying, a disorder in which the stomach takes too long to empty its contents.” Then, there are also urological concerns that can cause bladder problems and urinary tract infections.

Netwellness.org continues: “One of the main contributing factors in some of the complications mentioned are issues arising from problems with the smallest of blood vessels. High concentrations of glucose lead to weakness in their walls, and the combination of bursts in these vessels and the scar tissue created in the healing process can damage the organs which these vessels serve.”

That is exactly why I undergo a series of laser photocoagulation sessions to seal the abnormal leaking of the blood vessels in the small area of my retina near the macula. That is also the reason why I was prescribed gabapentin for the pain I have on my arms, hands, fingers, legs and feet. At this point, I am already feeling a lot of the effects of these complications.  Being pasyenteng pasaway for so long has produced dire consquences. Fortunately, diabetes management and lifestyle adjustments have been addressing some of these issues.

Dr. Beaver Tamesis, FPCP, FPCC, Business Unit Director of Merck Sharp & Dohme (MSD) remarks: “Some of the risk factors potentially are reversible. If you’re able to slow down, say, protein spillage in the urine, if you’re able to reduce blood pressure, if you’re able to reduce the cholesterol level to achieve the target goal, you reduce the chances of having complications.”

This was what Dr. Tamesis and his group had in mind when they set up Asia Diabetes Foundation in the Philippines. They discovered that “with a structured treatment approach where people are reminded constantly about where they need to be, what they need to achieve, what they need to give to the patients... we are able to actually reduce mortality.”

Dr. Tamesis continues: “So we set up the Joint Asia Diabetes Evaluation (JADE) program and this includes primarily a software where doctors can enlist a diabetic patient.  They do a comprehensive assessment upon the first visit; after that, they are able to assign where the patient is in terms of his risks for developing complications. They can now use that to help the conversation go on between the doctor and the patient.  And in between patient visits, the nurse can call the patient and ask if there are questions and concerns.”

According to Dr. Tamesis, the program has exhibited quite an amount of success in the three years that it has been running in the country.  The 200-plus doctors that have participated since the launch have generated about 9,000 patients. And their data has shown that because of the program, some patients in risk level care 4 have gone down to level 2; and even patients in level 2 are down to level 1. Clearly, the key to living with diabetes is patient compliance. And regular visits to doctors who show care, concern and compassion are vital.

For more information about the JADE program, visit https://test.jade-adf.org. Questions and comments can be sent to mbsugarfree@gmail.com.

http://www.mb.com.ph/articles/357868/its-complicated

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