Taking a step further in fighting diabetes

FACT: If your wound heals over time, it does not mean you are diabetes-free.

This was pointed out by Dr. Nemencio Nicodemus Jr., co-investigator of the Advance and Advance On (Action in Diabetes and Vascular Disease: Preteraax and Diamicron MR Controlled Evaluation Posttrial Observational study), during the media forum in observance of the World Diabetes Day on Nov. 12.

“Here in the Philippines, a lot of people tell the doctor that they are not diabetic because their wounds recover easily,” Nicodemus said. “It’s not a guarantee that if a wound heals, you don’t have diabetes.”

Wound healing, according to him, does not depend on blood sugar alone but depends on the flow of blood and other factors. He noted that even if it heals fast, it does not guarantee that a person is nondiabetic.

The best way to know if a person is diabetic is to have his/her blood sugar tested via fasting or postprandial (blood sugar after a meal), Nicodemus said.

Posttrial study

In line with the observance of World Diabetes Day last Nov. 14, Nicodemus, along with his team of specialists presented the Advance On posttrial observational study that resulted in helping lower risks of death and complications to patients.

The Advance research, one of the largest morbidity-mortality trials conducted for type 2 diabetes patients, is aimed at assessing the effects of intensive glucose and blood pressure control on major vascular outcomes in a broad cross-section of patients.

Advance and Advance On director and first author Sophia Zoungas, a professor at the George Institute for Global Health at the University of Sydney, said the findings will highlight the importance of active and effective blood glucose management for renal protection in type 2 diabetes patients.

The posttrial study, Advance On, revealed that with a long-term intensive glucose control based on gliclazide-modified release strategy given to patients, there might be a significant effect on the reduction of kidney failure. This will produce long-term benefits for the diabetic patients’ kidneys.

The research was funded by Australia’s National Health and Medical Research Council (NHMRC), the British Heart Foundation, Diabetes UK and Servier. More than 11,000 type 2 diabetes patients from 20 countries were enrolled in the Advance study.

Filipino patients also participated in the said study. And four centers led by resident doctors were chosen to conduct the study, namely: University of the Philippines-Philippine General Hospital (Dr. Mary Anne Lim-Abraham), Institute for Studies on Diabetes Foundation (Dr. Araceli Panelo), Makati Medical Center (Dr. Augusto D. Litonjua) and East Avenue Medical Center (Dr. Ma. Teresa Plata-Que).”

Meanwhile, Nicodemus said that the diabetes problem should be addressed because it is a looming epidemic not only worldwide but also in the country. He said that though diabetes may be only ninth on the list of mortality causes in the country, it can lead to complications such as heart and other vascular diseases.

He said: “So what does diabetes do to individuals? It gives them a lot of problems, particularly complications.”

Statistics

Furthermore, in 2003 there were 4.6 million people recorded with diabetes. In 2008, the number grew to 7.2 million (including patients who have a history of diabetes drugs intake or treatment), and in the most recent survey, it is projected that it will increase to 10.2 million.

The Department of Health, on the other hand, estimated that 60 people die from diabetes every day.

Advance investigator Dr. Augusto Litonjua, also the founding president of the Philippine Center for Diabetes Education Foundation, said that though prevention of diabetes may not be possible, a patient can delay the onset of the disease.

“Certain studies say that you can delay the onset of diabetes mellitus by adapting a healthy lifestyle, avoiding high-density calorie foods, exercising regularly, not drinking too much alcohol, among other things,” he said.