How diabetes can impact your body from head to toe

 

Manage diabetes well

Experts refer to diabetes as a “silent killer”—an ominous label, for sure, but definitely not an exaggeration. Caused by chronic high blood sugar due to the inability of the body to use or produce insulin (the hormone that converts food to energy), diabetes can have no obvious symptoms for many years. When signs do appear, however, they put you at risk for certain diseases or leave you with irreparable damage.

“Diabetes impacts our body literally from head to toe,” says Jimmy B. Aragon, MD from the Diabetes Care Center of top hospital in the Philippines Makati Medical Center (MakatiMed). “That’s why we always advocate for early detection, so treatment can begin before the effects become irreversible.”

Long-term exposure to blood sugar damages our blood vessels, which leads to a host of complications, some of them life-threatening:

Cardiovascular disease. “People with diabetes are more at risk of getting a stroke and heart attack,” reveals Dr. Aragon. “Damaged blood vessels become stiff and develop plaque, hampering oxygen and blood flow to vital organs like the brain and heart.”

Visual problems. “Damaged blood vessels in the eyes can lead to diabetic retinopathy, a condition that blurs vision and could progress to blindness,” shares Dr. Aragon. “Cataracts or a cloudiness in your eye’s lens and glaucoma or the damage of an optic nerve are also traced to diabetes.”

Kidney disease. “When high blood sugar damages the tiny blood vessels and filters of the kidneys, it impairs the kidneys’ ability to filter out toxic waste from our system,” says Dr. Aragon. “The kidneys’ impaired function may eventually lead to dialysis or a kidney transplant.”

Neuropathy. Nerve damage due to high blood sugar usually presents itself in the legs and feet. “The sensation is one of pins and needles,” explains Dr. Aragon. “It could also manifest as numbness, and the loss of feeling makes you unaware of injuries on your feet.” People with diabetes are also known for their slow-healing wounds in the feet—a result, yet again, of damaged blood vessels and poor circulation.

A frequent need to pee, dry skin, fatigue, and unquenchable thirst are other signs of diabetes.

Managing blood sugar is the first step to controlling diabetes. “The two most common tests to check for diabetes are Fasting Blood Sugar and HbA1c,” says Dr. Aragon. “The former measures blood sugar after eight hours of fasting, the latter measures your average blood sugar levels in the last 2-3 months.” Type 2 diabetes (wherein the body cannot make insulin or is resistant to it) is the more common form of disease, while type 1 diabetes (an autoimmune disorder that attacks the cells that make insulin) is usually diagnosed in children and young adults.

Aim for a normal fasting blood sugar between 70 and 100 mg/dl (or (3.9 and 5.6 mmol/L). “You’re considered prediabetes if your blood sugar runs from 100 to 125 mg/dL (5.6 to 6.9 mmol/L). A result of 126 mg/dL (7 mmol/L) or higher means you have diabetes,” reminds Dr. Aragon.

Medications are available to either lower blood sugar levels or aid the body in using insulin more effectively. MakatiMed also shares some simple lifestyle changes to keep blood sugar within normal levels.

Dr. Aragon advises replacing carbs with low-glycemic whole grains and fiber, and hydrating with water, not sugary drinks, to manage blood sugar. The doctor also recommends staying active. Even a 30-minute walk after meals helps lower blood sugar and aids weight loss for better overall health.

Given that people with diabetes have an increased risk of developing serious foot problems, Dr. Aragon stresses moisturizing and cleaning feet, and wearing socks to prevent sores. Diabetes also affects many of our organs, so the expert emphasizes the importance of monitoring any changes not only with your blood sugar but with your eyes, kidneys, blood pressure, and cholesterol.

“Diabetes doesn’t have to be your ‘silent killer,’” asserts Dr. Aragon. “With your doctor’s guidance and your compliance, you can live a full and active life and do what non-diabetics can do, within healthy limits, of course.”

For more information, please contact MakatiMed On-Call at +632.88888 999, email mmc@makatimed.net.ph, or visit www.makatimed.net.ph. Follow @IamMakatiMed on Facebook and Twitter.

Why are millennials getting middle-age diseases?

 

Hypertension, cardiovascular disease, obesity, type II diabetes, cancer, and depression are typical health conditions associated with middle age—the result of genetics and years of poor lifestyle choices finally catching up on those in their 50s and 60s.

But such diseases are no longer exclusive to Boomers and Generation X according to top hospital in the Philippines, Makati Medical Center (MakatiMed). Of late, doctors have been diagnosing these diseases in millennials, or those born between 1981 and 1996, making them in their late 20s to early 40s as of this writing.

Per a 2022 report from the Department of Health (DOH), 36 percent of Filipinos 20 years old and above are obese, 20 percent are smokers, 50 to 53 percent are binge drinkers, and 40 percent are physically inactive. Breast and colorectal cancer among patients who are less than 45 years old is also on the rise, says the Philippine Society of Oncologists.

Most alarming is the mental health crisis plaguing not just millennials but Generation Z, whose ages range from early teens to 20s. Global consultancy firm Deloitte revealed in a study that 63 percent of millennials and 50 percent of Gen Zs are experiencing burnout due to the demands of work. There’s also a spike in the number of Filipino youths who have tried to end their life. According to a 2021 Young Adult Fertility and Sexuality Study initiated by the University of the Philippines Population Institute and funded by the DOH, nearly 1.5 million Filipino youth have attempted suicide in 2021. That’s more than double the number of youths who have tried in 2013.

Confluence of factors. Juan Armando D. Diaz, M.D., from the Section of Cardiology, attributes

millennials’ midlife health woes to a confluence of factors. “Work- and money-related stress can lead to high blood pressure, which puts you at risk for stroke or heart attack. Those experiencing chronic stress also tend to cope with bad habits like smoking, drinking, and choosing processed foods over balanced meals.”

Millennial behavior likewise contributes to the early onset of middle-age diseases. “Millennials are very reliant on technology,” says Dr. Diaz. “More time staring at their gadgets for work, entertainment, communication, and online gaming means less time for sleep, physical exercise, exposure to sunlight and fresh air, and other practices that boost health and well-being.”

Act early. Fortunately, you’re never too old—or young—to regain control of your health. “Especially if you act early,” Dr. Diaz points out. “For millennials, I like to remind them that they still have their best years ahead of them. There are places to go, people to meet, goals to conquer—and they need to be in good health to achieve them. Once they realize that, they become more responsible and mindful of their actions.”

Interestingly, Dr. Diaz’s health tips for millennials are the same for mid-lifers. His first recommendation? “Secure your doctor’s approval first before beginning any lifestyle changes to improve your health.”

It’s always good to get some exercise. “Aim for at least 15-30 minutes of cardiovascular activity three to five times a week. Walking is the easiest because it only requires a comfortable pair of shoes,” says the MakatiMed doctor. “You can also get into sports, dance, or putter around the house. Tech-savvy millennials can use a smart watch or app to monitor your number of steps, calories burned, and miles covered—and try to better your stats in the next workout.” Pressed for time? Follow an instructor on YouTube when your schedule permits.

Dr. Diaz also recommends eating a balanced diet that includes fruits and vegetables in every meal. “Choose lean protein like fish and chicken instead of pork and beef. Cut down on processed foods and junk food. Eliminate alcohol, if you can. And drink water. Investing in one of those stainless-steel water bottles can encourage you to hydrate more often.”

Sleep is very important! “Sleep promotes repair and recovery. It’s also associated with weight loss, improved brain function, better mood, and a fresh appearance.” For millennials, Dr. Diaz says getting 7-9 hours of shut eye is ideal. “Gadgets tend to stimulate the mind. Read a book or listen to calming music instead.”

Meet up IRL. Sure, you have thousands of Facebook friends and followers on Instagram but cultivating relationships in person, and not always online, is still the way to go for many reasons. “Seeing friends staves off loneliness, gives you a feeling of belonging, lifts your spirits, and may even prevent dementia and Alzheimer’s disease,” says Dr. Diaz. “Sometimes, just sharing a laugh or a sincere conversation with people who love and care for you is the best medicine there is.”

For more information, please contact MakatiMed On-Call at +632.88888 999, email mmc@makatimed.net.ph, or visit www.makatimed.net.ph. Follow @IamMakatiMed on Facebook and Twitter.

How constipation causes back pain?

 

MakatiMed shares ways to treat it and enjoy pain-free and “regular” holidays

Slipped disc, pinched nerve, poor posture, osteoporosis, old age, obesity, lifting heavy weights, or the dreaded undetected tumor. When your lower back hurts, you’re likely to attribute your pain to one or more of these common causes.

Nobody ever suspects constipation—and why would they? The difficult and infrequent bowel movement can leave you feeling uncomfortably bloated and with a distended tummy. But a dull and aching sensation on your lower back? Don’t discount it, says Carlo M. Cornejo, MD of the Section of Gastroenterology of the top hospital in the Philippines Makati Medical Center (MakatiMed).

“An accumulation of stool in the intestines can manifest as lower back pain. The buildup of stool can put extra pressure on the back muscles, which causes soreness and discomfort,” says the MakatiMed gastroenterologist. “So too can fecal impaction, or dry stool that gets stuck in the column or rectum. This is a complication caused by chronic constipation. It usually happens among older adults.”

Common causes of constipation include inadequate fiber, dehydration, too much alcohol, and a sedentary lifestyle. Dr. Cornejo explains that certain medications such as antihistamines, blood pressure medicines, antidepressants, and diuretics can also cause constipation.

“How often you pass stool varies from person to person. Some do it twice a day, others are fine with a thrice-weekly bowel movement,” Dr. Cornejo points out. “You’ll know you’re constipated if you experience fullness in the stomach, gassiness, straining when you sit on the toilet, and that dull lower backache.”

For the simplest case of constipation, over-the-counter laxatives and stool softeners are always available for a quick fix. But for constipation and backache that persist and recur, it’s a must to visit a doctor as it could be a serious case of fecal impaction and would require additional treatments.

“Doctors will perform a digital rectum examination where they insert a gloved and lubricated finger into the anus to check for stool buildup. In some cases, a CT scan may be required if impaction happens deep into the colon,” shares Dr. Cornejo. “Once fecal impaction is confirmed, they will manually remove the impacted stool using their finger. They may also perform enema and inject fluid into the rectum to loosen dry stool.”

To prevent constipation and fecal impaction, Dr. Cornejo advises adding more fiber-rich foods like leafy green vegetables, oatmeal, beans and legumes, papaya, prunes, and avocado to your meals; keeping hydrated or adding natural laxatives like tea or coffee for some; and working out regularly. “Some even achieve regularity by adding probiotics to their diet and minimizing their alcohol intake. These tips are especially helpful now we’re in the season of drinking and feasting,” the expert adds.

It may also help to follow a regular bowel movement schedule. Dr. Cornejo says the best time to do it is around 20-40 minutes after eating, ideally after breakfast.

“Remember, constipation or lower back pain, especially the chronic type that seems to worsen with time, is not natural, especially if you’ve already taken steps to address them. It’s your body’s way of telling you something,” says Dr. Cornejo. “Don’t tolerate it or mask it with laxatives and pain relievers. See your doctor soonest.”

For more information, please contact MakatiMed On-Call at +632.88888 999, email

mmc@makatimed.net.ph, or visit www.makatimed.net.ph. Follow @IamMakatiMed on Facebook and

Twitter.

Are you losing your balance?

 

Have you ever ridden a rollercoaster, had a bit too much to drink, or sailed over rough and choppy seas? Then you may have experienced a temporary loss of balance, that woozy, room-is-spinning feeling that leaves you staggering and holding on to support until you’ve regained your steadiness.

A loss of balance and its accompanying symptoms can also be the result of a medical issue. “Your ability to sit, stand, and walk without falling or swaying from side to side involves more than your muscles and bones,” says Franco Louie L.B. Abes, MD, of the Department of Otorhinolaryngology of top hospital in the Philippines, Makati Medical Center (MakatiMed). “These actions also involve your eyes, inner ear, nerves, heart, brain, muscles, and blood vessels. Once one of these key organs doesn’t function as it should, it can impact your balance.”

According to MakatiMed, health-related balance problems can stem from one of three sources:

The vestibular system “is usually related to the inner ear. Certain medications, ear infections, calcium crystals that move to the wrong side of the inner ear, too much fluid in the inner ear (Meniere’s disease), or a benign tumor in the ear (acoustic neuroma) can affect your balance,” says Dr. Abes. “Common symptoms to look out for are dizziness, vertigo, unsteadiness, blurred vision, and even falling.”

The vascular system “controls the flow of blood to the brain. Poor circulation, standing up or sitting down too quickly (orthostatic hypotension), and stroke can manifest in the form of dizziness, lightheadedness, and the feeling of fainting,” Dr. Abes explains.

The nervous system, “which is made up of the brain, spinal cord, and other nerves, can also be the cause of your imbalance issues,” Dr. Abes points out. “Parkinson’s disease, Alzheimer’s disease, cervical spondylosis, multiple sclerosis, as well as the presence of an infarct or a concussion are conditions that can result in a loss of balance.”

A thorough clinical examination and further diagnostic tests aid a physician in getting to the bottom of your balance problem. “You should likely see an otolaryngologist, who specializes in diseases and disorders of the ear, nose, neck, and throat,” says Dr. Abes. “If your loss of balance is due to dislodged crystals in your inner ear, then the doctor may do the Epley maneuver, which moves the calcium crystals back into their proper place. Steroids and vestibular rehabilitation therapy can address an inner ear infection and Meniere’s disease.”

Proper vestibular evaluation and imaging tests of your head and brain are recommended if initial examinations and treatments do not resolve the problem.

“The point is not to delay a consultation,” advises Dr. Abes. “An unsteady gait doesn’t just interfere with your daily activities. It could lead to more problems like falls that could result in fractures or head trauma. By addressing your loss of balance issue early, you save yourself from complications that could be more detrimental to your health.”

For more information, please contact MakatiMed On-Call at +632.88888 999, email

mmc@makatimed.net.ph, or visit www.makatimed.net.ph. Follow @IamMakatiMed on Facebook and

Twitter.

From itchy skin to heart disease: How kidney disease causes a chain reaction of health woes

 

The kidneys are small, bean-shaped organs only about 5 inches big, but don’t let their small size fool you. Sitting just below the rib cage, they are a complex filter system that processes around 200 liters of blood, removes impurities, regulates blood pressure, maintains electrolyte balance, and produces hormones crucial for red blood cell production and bone health. Whew, what a fantastic job they do every single day.

In other words, these fist-sized hardworking organs play a powerful role in maintaining our well-being, that having kidney problems can set off a domino effect of other health problems. “Given all the work the kidneys must do, developing kidney issues like chronic kidney disease or CKD which affects one Filipino every hour puts you at risk of complications that affect other areas of your body like your skin and your heart,” explains Eladio Miguel M. Peñaranda Jr., MD Chief of the Section of Nephrology of the top hospital in the Philippines Makati Medical Center (MakatiMed).

Some people with malfunctioning kidneys do complain about itchy skin that can range from mildly bothersome to unbearably life-disrupting, and gout too. “There are many possible reasons why people with kidney problems experience this, and it could be because there’s an accumulation of toxins in the body,” shares Dr. Peñaranda. “The same excess waste buildup also leads to uric acid building up in your blood that triggers gout. Having too much uric acid creates small urate crystals, which settle in your joints and cause sudden attacks of pain and swelling.”

With the kidney controlling the balance of minerals like phosphorus, calcium, and potassium in the body, problems in these organs may also affect bone and heart health. “Healthy kidneys can easily get rid of excess phosphorus. Otherwise, high levels of this mineral can also decrease the calcium levels in bone, making you more at risk of fractures and osteoporosis,” says Dr. Peñaranda. “Moreover, potassium controls the electrical signals of your myocardium or the muscular layer of the heart controlling your heartbeat. When there’s too much potassium it can result in an irregular heartbeat.”

Similarly, kidney damage increases risk for more serious health issues like heart disease, which remains the leading cause of death among Filipinos. “This is because kidney disease can lead to increased strain on the heart as it works harder to supply blood to the kidneys,” notes Dr. Peñaranda.

Considering their impact and influence on the rest of the body, these small organs should always be factored into our proactive approach to maintaining health, MakatiMed reminds. Some people with kidney disease don’t feel its effects until the condition reaches an advanced stage, when treatment only involves alleviating symptoms and slowing down the progression of the disease.

“To keep kidneys healthy, it’s crucial to add more veggies and fruits to your plate, stay hydrated, work out regularly, limit cholesterol and salt intake, reduce alcohol consumption, quit smoking, and control blood sugar and blood pressure,” underlines Dr. Peñaranda. “If you suspect kidney issues, see a doctor immediately and ask if you can get tested. Diagnosis requires blood and urine tests. Taking these steps can preserve your kidneys and prevent a surge of health issues that’ll keep you from living life to the fullest.”

For more information, please contact MakatiMed On-Call at +632.88888 999, email

mmc@makatimed.net.ph,

Hypertension for Adults, Teens and Kids: An alarming pandemic among Filipinos

 

Dr. Don Robespierre C. Reyes hosted the 4th Presyon edition webinar organized by the Philippine Heart Association with Corrbridge as sponsor

I recently found out I am hypertensive stage 2, meaning I am at high risk for coronary heart disease, which can lead to a heart attack or stroke. I will need to have my blood pressure checked regularly and follow a strict regimen that will likely include dietary changes, exercise, and lifestyle changes.

I never even thought I had it because I wasn’t even aware of its symptoms. I knew I had diabetes mellitus type 2, but I didn’t know it could also lead to hypertension. Had it not been for my desire to get vaccinated against COVID-19, I wouldn’t have visited my cardiologist. And thus, I’ve found out I was hypertensive and I was given maintenance medicines to keep my blood pressure down.  I was given meds that have the powerful combination of amlodiphine + losartan in one tablet. 

That’s why I was glad when I had been invited along with other bloggers to listen, learn and attend the recent Presyon 4 Webinar organized by the Philippine Heart Association [PHA]. The webinar proved to be very informative especially with resource speakers led by Dr. Jorge A. Sison, past president of the PHA, had discussed the prevalence of hypertension in the country. He also emphasized the importance of awareness, treatment, compliance, and BP control rates. Dr. Sison mentioned that most of the time, we Filipinos would take things for granted, hence, we’d find out about our heart’s condition with 58% end-organ damage. What we often overlook is that stroke is highly related to uncontrolled hypertension, microvasculopathy, risk factors, and poor compliance. According to Dr. Sison, hypertension-related stroke was the most common cause of mortality among the hospital-based population [READ: Uncontrolled BP and poor compliance]

It was alarming to note that amongst the adult population above 18 years old, there were 1,399 males and 1,398 females surveyed. While pediatric population [those from 12-18 years old] has 329 males and 312 females suffering from hypertension. Among the hypertensives, about 25% answered that they have their blood pressure checked only at the comforts of their own homes. Thus, the prevalence of hypertension in the Philippines among adults is 37% [M:52% F: 48%] where 19% are very much aware of their condition and 18% are unaware. The prevalence of hypertension among adolescents is 5% [M: 68% F: 32%] And sadly, none is receiving any treatment. Among adult hypertensives, the treatment rate is 67%, compliance is 87% and BP control rate is 36%. The most common drug used in the country is ARB. And 78% of hypertensives are on monotherapy with the highest compliance among beta-blocker users. Adult hypertensives have higher BMI, waist circumference, and central obesity rate. End organ surveillance showed abnormal ECG in 57%, abnormal ABI in 36%, and microalbuminuria in 11.5% in adult hypertensives.