It starts off innocently.

Open a bag of chips, bake cookies, turn the TV on and before you know it, you have spent another quarantine day at home binge-eating and binge-watching—with no form of exercise at all. For the past few months, it has become a daily routine.

With home quarantine measures in place to deal with the COVID-19 pandemic, many have acquired unhealthy habits that may possibly increase risks for diabetes and many other illnesses. 

ISDF (Institute for Studies on Diabetes Foundation Inc.) faculty member and diabetes nurse Leyden Florido shares her thoughts on quarantine habits people have developed. ISDF is an official partner of “For Your SweetHeart,” a campaign spearheaded by Boehringer Ingelheim and medical societies that aims to promote awareness among Filipinos about the deadly link between diabetes and cardiovascular disease.

“Habit ngayon ng mga tao ang binge-eating lalo na ngayon available lahat online and pwedeng magpa-deliver. Hindi pa nage-exercise. Kapag naka-online na ng Netflix and throwback films, inuulit-ulit. Eh kapag nanonood, ano ang ginagawa natin? Nakahiga na, may katabi pang kinakain,” Florido notes.

“Those are the unhealthy habits that we developed during quarantine. Willpower kasi yan eh. It’s the discipline. Kapag nawala iyon at naisip mong wala namang magawa kahit maraming pwedeng gawin sa loob ng bahay, iyon ang balikan natin. [May kinalaman sa] mga pananaw natin sa buhay,” she explains.

We all have to remember: Diabetes is one of the comorbidities that can increase the risk of severe illness for COVID-19. 

‘Do You Have Diabetes?’

A cursory glance at Google would let you know the common symptoms of diabetes such as frequent urination (often at night), feeling very thirsty and hungry, extreme fatigue, weight loss, sores are not healing and blurry vision.

With her vast experience as a diabetes nurse, Florido also shares some of the “uncommon” symptoms of possible diabetes she came across with like frequent bouts with UTI (urinary tract infection), acanthosis nigricans (a skin condition that causes dark discoloration in body folds and creases), itchiness all over the body and for women—vaginal itchiness.

If you have symptoms of diabetes, it is best to brave it and consult a doctor. 

With  telemedicine, one can consult with a general practitioner or an endocrinologist safely. Electronic prescriptions are accepted and there are options to avail of home service laboratory testing. One of the first confirmatory tests for diabetes is FBS (Fasting Blood Sugar) which involves eight-hour fasting.

Once a patient is diagnosed with diabetes, Florido provides a preview of the next steps.

“Usually ganito ang nangyayari since enumerated and structured na—medication, exercise and nutrition,” she says.

In addition, equipping one’s self with knowledge about diabetes is not only helpful but also deemed key to success. Elliott P. Joslin, an American specialist on diabetes declared, “The diabetic who knows the most, lives the longest.”

Processing the Diabetes Diagnosis

There is a hidden and neglected part of dealing with diabetes that deserves the spotlight: taking care of its emotional impact.

“Tanungin natin ang pasyente: How do you feel right now? Ano iyong nararamdaman mo noong nalaman mo na may diabetes ka? Sino ang kasama mo sa bahay na mapagsasabihan mo ng nararamdaman mo ngayon? Ano ang alam mo tungkol sa diabetes? First is about the feeling of the patient and what he knows about diabetes because non-compliance on medication, exercise and nutrition stem from the lack of knowledge. Bakit ako pini-prescribe ng mga bagay na ito? Para saan ito? Ano ang gagawin ko?” she says, emphasizing the need to check up on the patient’s feelings and thoughts upon diagnosis.

Deng, a patient with diabetes, shares her initial thoughts when the doctor confirmed she has the illness. To her, it felt like a death sentence and she can only think of the things she can no longer eat and the deprivation that comes with it. She says it mentally affected her and she feels low and depressed at times.

“You have to address first kung ano ang nasa isip ng patient, what they feel and what they know about diabetes. From there, it will be easier to educate them and correct misconceptions like ‘Wala na akong kakainin? Mamamatay na ako.’ So you have to tell them na wala pong bawal. Magkakaroon lang po ng dagdag-bawas or diet and lifestyle modification,” Florido explains.

She says that for long-time diabetes patients, feeling depressed about the situation can be a sign of what they call “diabetes burnout.” According to her, “diabetes burnout” is part of every patient’s journey which also affects the carer and family of the patient.

“Diabetes is a chronic disease—pangmatagalan sya and sometimes if you won’t be able to control it, it’s progressive. How do you think the family of the person with diabetes could cope with this disease for a long period of time? Marami silang gagastusin sa medication lalo na kung may complications na,” the diabetes nurse says.

Florido stresses the importance of communication between the person with diabetes and the carer.

“May nag-aalaga ba doon sa nag-aalaga? How do they feel? What if may burnout sa pag-aalaga? Paano kapag nag-iisip sya ng ipapakain sa patient or saan kukuha ng panggamot? Sino mag-aalaga sa patient kapag kailangan niyang magtrabaho? There are burdens to be tackled not just by the patient but also by a carer. There should be a healthy communication among the patient, the carer and the healthcare provider,” she remarks.

When burnout happens, Florido says this is where the support system should come in, and for people involved to communicate their needs and emotions as well as the kind of help each one needs. It would also help to take a breather like going out (protected from the virus, of course!) or doing an activity to divert one’s negative emotion like cleaning up the house or doing something productive. She also says faith and prayers play important roles in coping with the condition.

The ISDF educator encourages the patients to think beyond diabetes by not letting the illness take hold of their lives.

“Focus on yourself and not on your condition. We do not say ‘diabetic person’ because it’s a noun about the sickness. We refer to it as ‘person with diabetes.’ Person ka muna before your condition. You are a person, kabuuan mo muna as a total and unique person. Diabetes is just a tweak in your life and you can control it. Do not let diabetes control you,” Florido declares.

And what a beautiful reminder to all those dealing with diabetes right now: your identity as a person shouldn’t be defined by your illness. There are a lot more aspects of your life that are worthy of focusing on without neglecting your health.

For more information on diabetes and its connection to cardiovascular disease, its management and how to care for a patient, visit https://foryoursweetheart.ph/. The website includes an assessment tool based on the Framingham 10-year Heart Disease Risk Test, which requires details of the patient’s total cholesterol, HDL cholesterol, and systolic blood pressure. 

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• ¹ Krall, Leo C. 2th edition, Philadelphia: Lea and Febiger, 1985. Joslin’s Diabetes Mellitus, ch. 23, p. 465
• ² The Framingham risk score estimates the risk of developing heart disease within a 10-year period and is seen to help individuals determine if the presence of any risk factor would require appropriate medical attention. The results are not meant to take the place of a medical examination.

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