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COVID 19 and Diabetes: a lethal partnership? How do we overcome this?

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by Dr. Kayathri Periasamy

With the latest wave of COVID-19 infections sweeping steadily across Sri Lanka, attention has been directed towards persons with uncontrolled, pre-existing conditions, particularly diabetes; as a sect most vulnerable to get severely ill or die because of complications caused by the virus. This has shed light on another growing concern among healthcare providers and patients, which is that patients suffering from diabetes or other chronic conditions are finding it increasingly difficult or are unable to access the medical care they require due to mandatory albeit essential curfew measures combined with a deep fear of contracting the virus in communal healthcare settings.

With a staggering 463 million adult diabetic patients present worldwide, World Diabetes Day 2020 – falling on the 14th of November- is a critical time for diabetes support communities and healthcare advocates to rally together to create awareness about this debilitating medical condition and push for progress in the standards of care and the better management of diabetic patients during a pandemic. In Sri Lanka alone, 1 in 10 adults are approximated to suffer from the disease. It is also then vital to look at ways to help stop more people from getting this disease, particularly at a time when ‘lockdown’ lifestyles are more often than not likely to be sedentary, unhealthy and stressful; an ideal background for a diabetes diagnosis.

Why is uncontrolled diabetes such a potent accelerant for COVID-19?

A recent study conducted by Lancet on Diabetes & Endocrinology screened over 61 million medical records in the U.K. to find that 30% of COVID-19 deaths can be attributed to people with diabetes. After accounting for factors such as demography and chronic medical conditions, the risk of succumbing to the virus was shown to be about three times higher for people with Type 1 diabetes and almost twice as high for Type 2, versus those without the disease. 

There appears to be two primary reasons driving this predicament. Over a lifetime, poor glucose control inflicts widespread damage in our systems which can lead to strokes, heart attacks, kidney failure, eye disease, and limb amputations. The linings of blood vessels throughout the body weaken to an extent where they can’t ferry necessary nutrients adequately. Inflammation is another byproduct of poor diabetes control, which makes the body ill-prepared for the onslaught of the viral disease. Secondly, the rich environment of elevated blood glucose present in diabetic patients, makes them prone to superadded bacterial complications during the viral infection. Many diabetics also tend to have other co-morbidities such as obesity, hypertension, and heart disease, which are all factors that aggravate complications during viral illneses. These problems are seen in any infections in the setting of diabetes and not only with COVID 19. The pandemic has just highlighted the difficulties of having diabetes

What precautions can diabetic patients take?

So during this pandemic, apart from strict adherence to general COVID-19 personal safety protocols such as strict social distancing and sanitization, it is important for patients to regularly monitor their glucose levels to avoid complications caused by fluctuating blood glucose. Proper hydration is essential for good health. It is also crucial to have access to a good supply of the prescribed diabetes medications and healthy food so that patients are able to correct the situation if blood glucose levels fluctuate. Finally, sticking to a comfortable daily routine, maintaining an exercise program even within the confines of your home, reducing excessive work and having a good night’s sleep can go a long way in keeping you strong. In essence, maintaining good blood sugar levels may be their best defense against severe COVID-19.

Disruption to continuity of care for diabetes patients

A rapid assessment survey conducted by WHO among Ministries of Health across many countries, focusing on the service delivery for NCDs during the COVID-19 pandemic, revealed deepening concerns that many people living with NCDs are no longer receiving appropriate treatment or access to medicines during the COVID-19 pandemic. The more severe the transmission phase of the COVID-19 pandemic, the more NCD care services were disrupted.

With our country currently in the cluster transmission phase and heading towards the community transmission phase due to the large and distant spread of the first-line contacts, the threat to NCD care and especially routine and emergency care of diabetes patients worries us physicians. As healthcare providers, we too are torn between the dilemma of not wanting to expose our patients to unnecessary hospital visits and the need to ensure that all our patients have continued access to their healthcare team along with a steady supply of medicines and other diabetes care products such as glucometer strips and insulin. Unfortunately, the delay in visiting their healthcare provider when they have symptoms of complications has caused many people to present late to the hospital with heart attacks or infections. A delayed presentation, weakens the patient further.

This disruption to healthcare services is foreseen to be a huge dilemma for patients and healthcare providers alike, especially when it comes to the care of patients with diabetes and other non-communicable diseases. In Sri Lanka, the Ministry of Health, is currently providing a number of telemedicine services and has opened avenues to deliver medicines to houses without diabetic persons having to visit crowded settings

How do we counter this?

At Healthy Life Clinic, we adhere strictly to COVID-19 safety operational health protocols established according to Ministry of Health (MOH), Epidemiology Unit. All incoming patients are screened by our nurses as soon as appointments are made over the phone, to understand the nature of their illness. If there is a worry that they could have contracted COVID-19 or have been in contact with such patients, they are given the opportunity to speak to the doctor first over the phone for a detailed history. Every patient will be consulted and no one is turned away from our care.

In order to help patients overcome barriers such as curfews or even the fear of entering communal healthcare settings, our experienced, highly-regarded team of consultants conducts telehealth consultations via established, trusted telemedicine partners such as oDoc and Mydoctor.lk to maintain continuity of care throughout this pandemic. We have also moved many of our long-standing diabetes care and weight management programs online, which have proven to be effective even in the absence of a physical meeting and examination. Additionally, our social media platforms and website are constantly updated to increase awareness about this condition, along with content that informs people about the proper management and prevention of diabetes – particularly when it is thus connected to COVID-19.

(Dr. Kayathri Periasamy is a consultant physician MBBS (UK), MRCP (UK), Board Certified in Int. Medicine (U.S.A). She is the founder of Healthy Life Clinic, Colombo 07.)

 

 



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Mix of nostalgia and modernity among the young

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As a fashion studies major,the greatest interest has been seeing how younger generations are slowly changing the fashion world without really noticing. Many fandoms, as well as influencers, have created many important changes in fashion such as starting new trends through popular social media platforms.

Meanwhile how Younger Generations Have Influenced Fashion

Many people have considered that interests brought by younger generations such as fandoms and fashion are two different worlds, that younger generations and fandoms focus a lot on pop culture and other entertainment interests, and that fashion enthusiasts focus on the latest garment and color trends.

However, many don’t really realize how much pop culture, fandoms liked by younger generations have influenced fashion and vice versa simply because there has been a line made to divide these two into two worlds that most likely will never intersect, though this line has slowly disappeared within the most recent years, creating a fashion aesthetic strictly inspired by popular fandoms and pop culture.

Not only that but many people began creating and designing clothing that features strawberry designs inspired by the popular trending dress. This was a huge influence that younger generations have had in the fashion world, but this fashion trend also inspired many anime fandom artists to unleash their imaginations and create a wonderful world with their favorite characters wearing this magnificent dress.

This influence is only one of the many influences that pop culture, fandoms, and the younger generations have had in the fashion world. There have been many other fashion aesthetics that have trended and inspired many new garments and colour combinations. One of the popular aesthetics or commonly known as “core” was the cottagecore trend.

What is cottagecore? It is the aesthetic surrounding life in a rural and peaceful environment. This aesthetic has left an important impact on fashion because garments such as flowy and delicate dresses, sun hats and more headgear, sweater vests, among other styles of clothing have become quite popular as well due to the influence younger generations have had in the fashion world. Another important pop-culture interest has been the many entertainment sections such as many different series, anime, dramas, music and band groups, comics and manga, influencers etc which has led to the creation of many fandoms that have influenced the fashion world heavily.

But how has this been done? Well, with the rising popularity of pop culture and every entertainment loved by younger generations, designers and brands have decided to change their fashion path into a more laid back and casual but just as a trend and exquisite specifically made to appeal to Millennials and Gen-Z which are the cause in this sudden change in the fashion industry.

Popular stores have been the spotlight of fashion influenced by these generations and pop culture. Stores like these have a wide range of many innovative and creative fashion garments which were either inspired by a tv show, a band, an anime, a comic or manga, or even Disney and Nickelodeon classics and have been designed specifically to appeal to Millenials and Gen-Z by creating unique and playful accessories as well as garments. These stores have managed to make pop culture fashionable and made fashion more hip and exclusive for those lovers of pop culture. Another way of how younger generations have influenced fashion has been by making past trends come back to our modern times. For some reason, Millennials and Gen-Z have actually been so interested in old fashion trends, or more commonly known as retro fashion aesthetic. Many past fashion garments have made a very strong comeback, and young generations have even recreated its original style into a mix of nostalgia and modernity, giving this certain fashion trend a complete and new innovative aspect. Another interesting aspect of retro fashion was the incorporation of retro sources of entertainment into popular fashion aesthetics.

Many younger generations have been very innovative and unique in creating trends, sometimes they do not notice the impact that they are making for an entire industry and the inspirational fashion garments created due to the trends created by these generations but it is undeniable that the fashion industry has entered a world where the younger generations are determining how the game is played and introducing new and exciting trends that are fun, fashionable, and fresh. Embracing tradition, as well as modernity, has been the tool that the younger generations have made great use of when establishing new, wonderful, catchy and popular trends.

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How Young People Are Changing the Fashion Industry

New York Fashion Week is here and there is a growing fashion movement that has the potential to fundamentally change the industry: sustainable fashion. If designers want to endear themselves to Gen Z, they’ll take note of this important shift.

The last ten years have seen a dramatic rise in the educated consumer, one who thinks not just about the quality and value of the finished product, but how it got on the shelf — where the materials come from, who made it and under what conditions. This desire to understand the backstory of consumer goods has spread to fashion, and young people are forcing brands to take a look at what they do and how they do it. Gen Z, in particular, wants to align themselves with brands that stand for something (hello, Nike). Sustainability and ethical fashion are quickly becoming a part of this generation’s values set, as the negative impacts of fast fashion come to light (think environmental hazards and human rights issues).

But while there is a cohort of front-row influencers, celebrities and brands such as Allbirds, United by Blue, Girlfriend Collective, Reformation, Outerknown and Everlane that devote themselves to sustainable fashion, the movement still has a long way to go before it’s mainstream. Most young people today would consider sustainable fashion more of an ethical bonus or nice-to-have, not a requirement. The primary reason: The cost.

Most sustainable fashion naturally comes with a higher price point because of the devotion to ethically sourced fabrics, thoughtful construction methods, improved factory conditions, and improved pay for workers. When the average cost of one eco-friendly item is about $80 (at the low end), young people often have no choice but to shop elsewhere. Especially when you can buy several outfits at stores such as Forever 21 or Old Navy for that same amount. Young people are still in that fashion phase of wanting to wear the latest looks — and changing up their outfits daily. They don’t yet have that mindset to buy more higher-quality clothes and keep them for a long time.

–Vogue

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How Celebrities Influence Fashions

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Celebrities have always shaped and influenced the ongoing fashion trend.

Celebrities both Hollywood and Bollywood influence fashion by wearing whatever is in fashion and also sometimes they create their fashion trend by wearing something enormous, created by the world’s leading fashion designers.

Some of them are known to having better knowledge with fashion than other celebrities, we look to them as fashion icons. They are numerous ways celebrities can influence fashion.

Celebrities set the rule on how to dress to a certain event or how you should dress at a certain age. A lot of times celebrities will promote certain fashion trends. People dress a certain way because their favorite celebrity that they stalk on social media is wearing the same thing.

Fashion can be influenced by social media, the person wearing a certain type of designer or a piece of clothing from that designer.

Research says the some individuals who are referred to as opinion leaders has a major impact on what society thinks of a certain type of fashion. With having celebrities as a fashion opinion leader it leads to higher percentage of market sales. It is agreed that they tend to have more knowledge about fashion than a regular person would, even though if they do not dress accordingly to society at the time. The key aspect of fashion on celebrities is to be seen in the public eye which helps the consumer/designer get more clients or fame.

When it comes to celebrities and trends, clothing is one of the easiest ones to follow. It doesn’t matter what article of clothing celebs have on, if it’s in a magazine or on an Instagram feed, the next day stores are selling the same piece of clothing that said celebrity wore in a photo. It is easier to keep up with the changing trends because of Instagram and TikTok where many celebrities will post videos of their outfits when going out for an event or just spending the day at home. Everyone has their own unique sense of style but how do celebrities influence our style, and are we really dressing in the clothes we choose because we like them, or are we doing it to follow a trend?Celebrities have been known to popularize trends even after they go out of style. One of the reasons why people are so drawn to the styles celebrities wear is because many will choose to dress in a style that brings back nostalgia.

For example, some fashion trend that has been in and out of style for the last couple of years. Various stores and clothing brands have been selling items from tthis fashion collection for a while such as Hot Topic, Forever 21, and Urban Outfitters. But the downside to clothing trends is that we realize “I’m never gonna wear this again,” or “I don’t even like this style, why did I buy this?”

Celebrities are good at advertising the clothing items they’re given because it’s part of their job, but sometimes they don’t even like the items they wear. So, why do we continue to follow clothing trends? They have been given lots of beautiful pieces of clothing to wear and when we see them in it and how people respond to them, we want the same reaction they get, so we choose to follow the trend people say

These celibritiescan also influence where clothing is sourced from. Some of the clothes that we wear are made from animals and harmful products that we don’t even realize are made from insects (silk), goats (cashmere), and sheep (shearling). Numerous celebrities have taken a stand against animal products in clothing, and have chosen to wear clothing that is vegan and animal-free.

For example, Ariana Grande’s wedding dress was made from stating vegan which, according to VeganFashionWeek, has “the soft and lustrous texture of satin to create the perfect wedding gown for Arianna Grande. Satin is made from synthetic materials (polyester, nylon, rayon fibers…)” The choice to buy ethically can influence fans’ styles because they may be inspired to purchase clothing that is made from vegan materials and animal-free products.

Another reason could be because many items that celebrities wear can be used on various occasions. Because celebrities have millions of fans who follow everything that they do, some celebrities have their own clothing lines designed to fit every size and every occasion so that they’re fans can dress comfortably and stylish. Cardi B partnered with Fashion Nova, Kendall and Kylie Jenner have a namesake clothing line, as do many other celebrities. It gives fans the confidence to expand their wardrobe, and it has made people feel comfortable in their own skin.

More positively, celebrities can influence our style by advertising to their fans to dress as themselves and not for anyone else. Angelina Jolie shared her views on fashion in an article last year, saying, “I think we all know boldness when we see it. Nothing makes me smile more than when I see someone being fully themselves, with their own individual style and character, whatever that is.”

Remember: celebrities have their own individual styles that match their own unique personalities and so do you. They can influence our styles because we might like how they look in movies, TV shows, and Tiktoks. It is worth mentioning that celebrities have stylists who dress them for special occasions, and designers who want them to wear their clothes. Style and clothing should be about self expression and instead it has become about trends and influence. Clothes are the reflection of the person you are on the inside so instead of following a clothing trend that’ll be over in a few weeks, dress for yourself.

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Sade Greenwood Miss Sri Lanka world 2022, speaks about Fitness and lifestyle 

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by Zanita Careem

The reigning Miss Sri Lanka world Sade Greenwood gives insight into the importance of a balanced and healthy lifestyle for achieving goals and overall wellbeing.

Sade is currently a student at Tokyo International University in Japan where She studies International Relations. She hopes to make a difference in her country using her degree, where she hopes to be involved in youth programmes and education. When Sade is not studying she is usually doing her charity work which involves environmental services and animal welfare. .

Sade with her sparkling personality and penchant for positivity personifies ‘beauty with a purpose’. She has brought immense pride to us all with her ‘walking the talk’ through her numerous charitable endeavors.

Q• Sade tell us about your journey from modelling to competing nationally, and winning the coveted Miss Sri Lanka World 2022 title?

A•

It’s been a surreal journey! Definitely a lot of adjusting as it was a huge shift in my life but all the same I’m so grateful and blessed to be able to represent my country on the  international stage. 

Q• You have always been in model shape. Have You had to change your workout routines when focusing on the beauty industry? 

A• I think I more so needed fitness to help me balance my busy schedules. It was always great to have a release from everything through fitness, it’s definitely something I used more for my mental and physical health in becoming a stronger version of myself.

Q• Being a part of The Fitness Connection Family and working out at the Gym what do you feel has been the biggest change? 

A• I think learning to achieve my goals. One thing about fitness is that consistency plays a huge role but so does diet! Learning to cut out on some of my favourite food is a little tricky!

Q• I know You have a hectic schedule and many commitments. How have your workouts at the gym impacted you positively? 

A• It’s impacted my mental and physical health and overall helped me balance my life and find a release from all the stress and strain.

Q• As you and your pathway have inspired so many, what advise would You give to those looking to balance their goals with their everyday lives? 

A• Make sure you love what you do! That makes it easier to balance anything in life because you’re putting your heart and soul into what you do. It doesn’t feel like ‘work’ then, so train your mind!

Q• What motivates you the most, and gets you moving even on the most tiring of days? 

A• My goals and how the future version of myself would be proud that I made the decision to do something then and there.

We are all looking forward to your next chapters in what is definitely going to be an exciting and fulfilling journey. I will surely be speaking with you again soon!

*Sade Greenwood photographed at The Fitness Connection,

Racecourse Colombo 07

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