Monday, May 28, 2012

Diabetes Awareness

The Diabetes Awareness Seminar was held with bloggers together with their relatives whom are diabetics.  It was sponsored by Johnson and Johnson Medical Philippines last May 26, 2012,  Saturday, 8PM at Max’s Restaurant, Gateway Mall in Cubao, Quezon City.

I was with my sister,  Sophia Cabantog and Faustina Marie Cabantog. Upon arriving on the said venue, we were asked to register on the registration area and to also have our blood sugar taken by their med tech using the Johnson and Johnson product , One Touch Glucometer. There is another registration on the blood sugar testing table as there will be a comparison between the before and after dinner blood sugar results.
Myself during the pre-dinner blood sugar testing
The med tech had a hard time getting the blood out so he had to prick me twice, of course it hurts a little and he said sorry but I was still afraid of the thought that I will be pricked.  Results show that I have 133 blood sugar, I am diabetic and it is normal for me to see numbers like that.

My blood sugar results

Next in line was my sister Sophia Cabantog. Bravely, she just do not look on the med tech staff  =)   

my sister during the pre-dinner blood sugar testing

Her results is of course as expected lower than mine as she is not diabetic, 91.  
Sometimes she even have hypoglycemia and had to eat candy just to boost her blood sugar.
my sister's blood sugar results
After the blood sugar testing, we got a vacant table and took the front seats on the extreme left area of the venue. 

The Cabantog sisters

We were served roasted nuts for the appetizer. At exactly 8PM, Max’s waiters had served iced tea and soup of the day (seems like a mushroom soup for me with cabbage).
The opening remarks was being addressed by their intern-OJT Marjorie Chan whom also organized the event
Marjorie Chan

Alex Villareal, 66 years old and one of the speakers for the night who had diabetes for 14 years shared his life story. He even said that you can still live a normal life even if you're diabetic.

Alex Villareal
 I learned some points from the speaker, which are:
  • Do not miss any of your medicines, everyday after your meals
  • Do constant monitoring of your blood sugar (because monitoring is a tool for managing the disease) He mentioned that sometimes we do not feel anything but we do not know that our blood sugar may already be high. Also he do monitoring to adjust his medicines under his doctor’s supervision and directions.
  • Do your regular check up – his doctor had advised him a test called foot screening. Persons with diabetes may be at danger of developing foot problems. Therefore it is useful to be screened, at least once a year, to identify the occurrence of neuropathy, or any foot abnormality. 
  • Always do exercise – the speaker said he does cycling
  • Do occasional researches on medicines and about diabetes

And at the same time, dinner was served. Pansit Canton, Sweet and Sour Fish Fillet, 
Plain Rice, Oriental Beef with Mushroom, and Max’s Fried Chicken. The dessert which was frozen fruit salad was served on the last part of the program.

Max's Pansit Canton

Sweet & Sour Fish Fillet and Plain Rice

Oriental Beef with Mushroom

Max’s Fried Chicken

The Customer Service Representative from Johnson and Johnson, Barbie had introduced the main speaker for the night -  Dr. John G. Flores, M.D., M.Sc., MBA which was mentioned to be an epidemiologist and is based in Singapore. The title of his talk was: An evening with Numbers; So, what? 

I learned that in digestion:
  1. Proteins  breaks down to amino acids
  2. Fats breaks down to fatty acids (which are called glycerol in technical terminology) 
  3. Carbohydrates breaks down to Glucose 
Fats breaks down to fatty acids
The pancreas contains enzyme producing cells that secrete two hormones. The two hormones are insulin and glucose. Insulin and glucose are secreted directly into the bloodstream, and together, they regulate the level of glucose in the blood.

Pancreas is a factory of insulin 

Glucose = Fuel 
Insulin= Ignition Key

Insulin= Ignition Key

Insulin lowers the blood sugar level and increases the amount of glucose (stored carbohydrate) in the liver.

Insulin is the glucose helper. Allowing glucose (and other nutrients enter the cells and provide ENERGY!

Insulin is the glucose helper

Glucose slowly increases the blood sugar level if it falls too low. If the insulin secreting cells do not work properly, diabetes occurs.  


Clinical Types of Diabetes
  1. Type 1 Diabetes Mellitus
  2. Type 2 Diabetes Mellitus
  3. Gestational Disease (during pregnancy period)  
Type 1 Diabetes Mellitus vs. Type 2 Diabetes Mellitus
Type 1 DM has destroyed pancreatic beta cells
Type 2 DM has decreased insulin secretion and insulin resistance
destroyed pancreatic beta cells

Insulin Deficiency
Insulin resistance - too much fat gets in the way of Insulin
Risk Factors causing Diabetes
  1. Stress
  2. Sedetary lifestyle (inactive, couch potato, etc)
  3. Medications (hormones, steroids)
  4. Pregnancy
  5. Open Heart Surgery 
Risk Factors

How do we know if someone has Diabetes?
  • Ancient Egyptians taste their urine 
  • If the urine has attracted ants

Normal fasting glucose should be between 70-100mg/dl

200+  Symptoms

200mg/dl + symptoms = Diabetic

  1. extreme thirst
  2. dry skin
  3. frequent urination
  4. blurred vision
  5. nausea 
  6. drowsiness
  7. hunger
Hyperglycemia - high blood glucose  
Hyperglycemia Symptoms
 An American spent his vacation here in the Philippines. He enjoyed so much of the Filipino food. When he got back in the US, he was rushed to the hospital. Why?
His dog ate his toes while he was sleeping!

News clipping
Effective diabetes control can prevent complications of:
  • Hypoglycemia (low blood glucose)
  • Hyperglycemia (high blood glucose) 
Diabetes Mellitus Complications
  Causes of Hyperglycemia 
  • Food
  • Medications (underdose)
  • No exercise 
  • Stressful condition
Causes of Hyperglycemia
  Causes of Hypoglycemia 
  • delayed meals
  • too much vigorous exercise
  • too much medicine 
Causes of Hypoglycemia
Hypoglycemia Symptoms
  • Shaking
  • Sweating
  • Anxious
  • Dizziness
  • Hunger
  • Fast Heart Beat
  • Impaired vision
  • Headache  
  • Irritable
Hypoglycemia Symptoms

What can we do about it?
  • Medical Nutrition Therapy
  • Exercise
  • Patients' education
  • Drugs/medications
  • Optimization of glucose control thru SMBG (Self Monitoring Blood Glucose)

Diabetes Theraphy

How big is the problem with Diabetes?

Diabetes has 7 million new cases per year in Asia alone according to the World Diabetes Federation. 

SMART Goals of Theraphy
Among People with Diabetes

Achieve Blood Glucose Control
Blood Pressure Control
Cholesterol Control

SMART Goals of Theraphy

SMART Goals of Theraphy Among People with Type 2 Diabetes
(American Diabetes Association)

Blood Glucose Control
Fasting glucose between 70-130mg/dl
2-hour post-prandial glucose of less than 180mg/dl
Monitoring of blood glucose sample 

SMART Goals of Theraphy with Type 2 Diabetes
When to test blood glucose?
See Sample Profile Testing photo

Sample Profile Testing

A good glucose monitor?

Factors to Consider in Glucose Meter Selection

In Summary...
  • Glucose control is one of the cornerstones of diabetes management
  • Good glucose control means 
    • Fasting Plasma Glucose of 70-130mg/dl
    • Post-prandial glucose of less than 180mg/dl

I find the seminar very informative. Although it might scare others but I believe that everyone should be open minded and also to be aware that having a healthy lifestyle and eating habits will ensure a healthy body. There was a question and answer portion after the small talk and Dr. Flores had answered all questions smartly as he had thorough knowledge about the subject. After such, a program evaluation form were distributed to us.

Before the program ended, they raffled out some prizes like Brent and Sam’s Triple Chocolate Bliss Cookies. Its good for diabetics, it is low-sugar and low in calories.  
One of the winners was my sister, Sophia Cabantog. 

And also Nita Mehta’s Cookbook for Controlling Diabetes Vegetarian Recipes in which I was also a winner. I browsed the cookbook and it is very nice as it has colorful recipe pictures inside but I am just not sure if the ingredients are all readily available locally as the author is a Hindu. There are also some ingredients in their Hindi name equivalent. 

The program ended at exactly 10PM and as agreed, there will be a blood sugar testing comparison 2 hours after eating dinner. My sister’s  blood sugar result changed from 91 to 128. 

Mine only increased to 1 point which is from 133 to 134 as I had drink my medication Metformin Glumet after my meal.

Upon exiting the venue, freebies were waiting outside for the participants.
It includes One Touch memo Pad, ballpen and flyers. 

Its true, it can have serious side effects (cardiovascular illness, kidney and liver complications, blindness, infections and even the loss of limbs), but as long as one follows one’s doctor’s advice, including religiously taking the prescribed medications, one can live a fairly normal life. Diabetes is a lifestyle disease. Millions of diabetics live a long, healthy life by taking care of their day-to-day health, and so can you!

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