Holiday heart syndrome and diabetes

The cool breeze gently reminds us that the Christmas season has started. Many families, companies and organizations are foregoing their Christmas parties in light of the dire situation in Tacloban and other typhoon-ravaged areas in the country. The saved funds are instead to be donated to help in the relief operations in these places.

This act of kindness and empathy not only helps the typhoon victims, but it  may actually be saving some lives from the donors’ group. Various scientific journals report a higher incidence of heart attacks and stroke  during the Christmas holiday due to the excessive merry-making, which usually consists of drinking unlimited booze and eating all the “good” food (aka high cholesterol food).

Add to that the mounting stress of having to go from one Christmas party to another, and to make sure one has gifts for everyone—and the elevated adrenaline in our system fuels up the engine of a cardiovascular catastrophe. It’s good if one survives a heart attack and stroke. Many are not that fortunate and they may succumb before reaching the hospital, or before they could even swallow the crispy pata.

So if one who has some risk factors like smoking, overweight, hypertension, cholesterol problems and diabetes, and he or she has not had a checkup lately, it may be for the best to have one, so as to prevent being a victim of the so-called “holiday heart syndrome.”

Alarm

Speaking of diabetes, I received an e-mail from the Philippine College of Physicians (PCP) sounding the alarm about the insidious and unrecognized increase in the prevalence of diabetes mellitus (DM) in the country. One out of five Filipino adults or about 11 million have either prediabetes or full-blown DM.

The incidence is gradually inching up and if you include those who have prediabetes or borderline diabetes,  then the figures can really be scary because diabetics and prediabetics have an increased risk of being  dialyzed for end-stage kidney problem, having their legs amputated for gangrene, or getting blind due to complications.

Dr. Monica Therese Cating-Cabral of the Philippine Society of Endocrinology and Metabolism (PSEM)—a component society of PCP—advises Filipinos to take diabetes tests as soon as they reach the age of 40. Dr. Cabral says that the lifestyle being followed by most in this age group contributes to the risk factors associated with diabetes.

“The proliferation of different gadgets of communication and entertainment causes less physical activity. Meanwhile, work-related stress can lead to overeating and result to overweight and obesity,”  Dr. Cabral explains.

Having a normal fasting blood sugar (FBS) does not rule out DM. One may have normal FBS but if the blood sugar levels after eating (postprandial blood sugar) is markedly high, it is already called impaired glucose tolerance (IGT) which is a form of prediabetes. There are other tests like the glycated hemoglobin (HbA1c) which can help detect diabetes and prediabetes among individuals who never suspect of having DM.

Recommendations

Dr. Cabral recommends that testing should be done early if other risk factors for diabetes are present such as being overweight or obese, history of  prediabetes, having first-degree relatives with diabetes; having diabetes while pregnant and giving birth to a baby weighing more than eight pounds; hypertension; history of heart attack or stroke; high triglyceride cholesterol and low HDL cholesterol levels.

Insulin resistance, which is the basic cause of DM, is also suggested if one has a condition called acanthosis nigricans which appears as brown to black, poorly defined, velvety hyperpigmentation of the skin, usually in lateral folds of the neck, armpits, groin, navel,  forehead and other areas. Those diagnosed with polycystic ovarian syndrome may also be at risk.

Prevention

“Diabetes is common but you can reduce the risk by being conscious about your weight. It is a serious illness and nothing compares the benefits of being healthier than the others if you delay or prevent diabetes as you get older,” says Dr. Maria Jocelyn Capuli-Isidro, who is an expert in treating diabetes.

Diabetes is definitely bad news, but the good news is that it could be prevented. Dr. Isidro cites the Diabetes Prevention Program study that found 30-minutes of moderate physical activity daily along with a 5- to 10-percent weight loss resulted to 58-percent reduction in diabetes.

“I advise people with diabetes to perform at least 150 minutes  of moderate intensity aerobic physical activity (50–70 percent  of maximum heart rate) per week, spread over at least three days. In the absence of contraindications, adults with type 2 diabetes should be encouraged to perform resistance training at least twice per week,” advises Dr. Isidro.

Dr. Isidro’s dietary recommendations include starchy foods, and more fruit and vegetables, less animal or saturated fat, and less sugar and salt.

Preventing diabetes by diet and regular exercise could be the best Christmas present one could give oneself and his or her loved ones.