Health World News and Features

Our theme for this year’s Diabetes Awareness Week activities, “Diabetes in Motion,” seeks to convey two messages.

The first message is a simple and practical one. Motion, such as exercise or physical activity, is essential to good diabetes management.

Exercise includes anything that gets moving. It could be walking, dancing, or even doing household chores. You don’t have to go to the gym or use fancy equipment to be physically active. There are many opportunities for you to be active throughout the day. For instance, walk instead of drive. Park your car at the far end of the parking lot then walk to your office. Or take the stairs instead of the elevator. Walk in the garden, or do some house-cleaning every day.

The benefits of exercise are numerous. Exercise can lower your blood glucose, blood pressure, and cholesterol. It can also reduce your risk for heart disease and stroke, relieve stress, and strengthen your heart, muscles, and bones. In addition, regular activity helps your insulin work better, improves your blood circulation, and keeps your joints flexible.

Exercise should always be a part of any diabetes treatment regimen.
The second message is more abstract but hopeful. Diabetes (management) is in Motion: That is, the treatment of diabetes is rapidly evolving. In fact, in the last few years, we have seen major shifts in the treatment approach to diabetes.

Earlier use of combination therapy (two or more oral antidiabetic drugs, even in newly diagnosed patients) allows us to address both pathophysiologic defects in diabetes. Plus the recent availability of fixed-dose combinations decreases the pill count for most patients.

Earlier institution of insulin therapy allows us to decrease the harmful effects of high blood glucose (glucotoxicity) and augment pancreatic function. Insulin is no longer considered the “last resort” but an effective therapeutic option that should be offered to the patient early in his treatment.

More aggressive control of glucose levels should be the norm in all patients, to target prevention not only of microvascular (small blood vessels such as the retina, kidneys, nerves) but macrovascular (large blood vessels) complications. In addition, multiple risk factor intervention should be undertaken, looking not only at blood sugar levels, but also blood pressure, lipids (cholesterol and triglycerides), obesity (especially abdominal obesity or beer belly), smoking, and other cardiac risk factors such as prothrombotic state.

DR. AUGUSTO D. LITONJUA, July 24, 2004 Manila Bulletin

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