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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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Fashion

For modern day power woman

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The traditional soft and sensual label Anaya aesthetic was transformed into a sophisticated, strong, bold and powerful fashion reflecting the modern day power women.

Paying homage to the postwar era of the 1950’s glamour and drawing inspiration from the fashion muses by the likes of Dovima, Audrey Hepburn and the works of Richard Avedon with his strong black and white contrast of austere sophistication. Our mood is not only visual yet musical with retro music inspired by Frankie Valli and the flamingos taking us all back to romanticism and pure pleasure of the times when everything was slow and dreamy.

The brand broke boundaries of its traditional soft pastel aesthetic to a monochromatic palette with all blacks, shades of off-white ,nudes, botanical greens, and clashing reds. The Fall wardrobe was revitalised with uniquely constructed silhouettes, handmade three-dimensional botanical motifs, beading, figure hugging corsets and delicate embroidered laces and sparkling sequins. The collection with its uniquely deconstructed fabric manipulations with micro velvet, shiny satin, silk taffeta, mecado, and laces with a modern twist of liquid organza, sequins and double-sided silk satins made a fashion statement.

Chathuri, the creative director’s vision for this collection was the transformation of the modern-day women to a powerhouse of strength and independence, fusing the signature Anaya silhouettes with strong elements of high pressure corsets, over exaggerated sleeves and elongated capes and 3D draping.

“This collection was was inspired by the 1950s, the time when the darkest nights were passed with a touch of hope for a beautiful future of women transitioning from a more submissive role to powerful role being able to express themselves through Fashion”.

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Life style

Create unforgettable moments…

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GM Elton Hurtis with sales and marketing team

The much-anticipated Wedding Show 2024 at the Courtyard by Marriott Colombo unfolded on recently, leaving an unforgettable mark on the landscape of the Sri Lankan wedding industry. Courtyard by Marriott Colombo, in collaboration with Asia Exhibitions & Conventions (Pvt) Ltd, successfully orchestrated a two-day celebration that transcended the traditional boundaries of a bridal expo.

The festivities commenced with an inaugural ceremony graced by key figures in the local wedding industry, vendors, and potential clients. The hotel, adorned in wedding-themed splendour, served as the perfect backdrop for the occasion. Elton Hurtis, General Manager at Courtyard by Marriott Colombo, expressed his delight at the turnout, stating, “The Wedding Show is not just an event; it’s a celebration of unity within the wedding industry. We’re thrilled to witness the coming together of vendors and clients in this vibrant community.”

The exhibition hall buzzed with activity as visitors explored a diverse array of offerings from the finest wedding vendors in Colombo. From exquisite bridal wear to innovative event decor, the show showcased the rich tapestry of talent within the local wedding industry. Attendees had the opportunity to engage directly with vendors, fostering connections that extend beyond the event itself.

One of the highlights of The Wedding Show was the inclusive atmosphere that permeated the venue. Vendors, irrespective of their scale or specialization, collaborated to create an environment where diversity and creativity flourished. This collaborative spirit echoed the sentiments of Courtyard by Marriott Colombo’s commitment to building a more supportive community within the wedding industry.

In addition to the vendor stalls, The Wedding Show featured insightful panel discussions and workshops led by industry experts. Topics ranged from the latest trends in wedding planning to sustainable practices within the industry. The interactive sessions provided attendees with valuable insights and inspired meaningful conversations about the future of weddings in Colombo.

Imran Noordeen, Director of Sales & Marketing , reflected on the success of the event, saying, “The positive response from both vendors and attendees affirms the need for platforms like The Wedding Show. It’s clear that our community values the opportunity to come together, share ideas, and contribute to the growth of the wedding industry.”

As The Wedding Show 2024 drew to a close, the echoes of joyous conversations, newfound connections, and shared enthusiasm lingered in the air. Courtyard by Marriott Colombo and Asia Exhibitions & Conventions (Pvt) Ltd succeeded in not just hosting an exhibition but creating an experience that celebrated the spirit of unity and collaboration within Colombo’s wedding industry. As the event concluded, it left participants eagerly anticipating the continued growth and success of the local wedding community, inspired by the bonds forged at The Wedding Show 2024.


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Life style

latest cancer treatments give families hope

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Dr Tanujaa Rajasekeran

T anujaa Rajasekeran, Senior Consultant Medical Oncologist Parkway Cancer Centre was in Sri Lanka recently to take part in an exclusive medical workshop with CanHope Colombo.

In an interview Dr Tanujaa revealed the latest developments in cancer treatments. She explained how Cancer slowly becomes less of a catastropic moment in families as new research and clinical trials reduce its physiological effects to something more chronic, While some get cancer from the toll of thier risky lifestyles,while others have it in thier genes.

Some families are more genetically pre-disposed to develop cancer. Cancer treatment doesn’t mean eliminating the cancer. It also means helping the patient adjust to thier new lifestyle, especially when they take on these treatments reveals Dr Tanujaa.She also said when you are diagnosed with cancer, it is not immediately a death sentence, there is always hope for patients now with advanced technology. New clinical trials and studies are revealing ones that are more targeted and less debilitating.

She also spoke about cutting edge cancer treatments now available for . patients

A pretty and petite medical oncologist, of Indian origin based in Singapore. In most caes of cancer usually we treat with chemotherapy

The side -effects people often report when they recieve chemotherapy is because the treatment is designed to target cells that have a protein that causes them to constantly multipy, We have other good cells in our hair,stomach etc which is why they report vomitting,hair loss,nausea and others.

Receiving news about cancer has always devastated families. It usually spells certain and slow death; it also foreshadows the heavy financial burden that comes along with it. These are what uproot families from their usual lives, requiring them to make thier lives around among those afflicted with the disease.

Because of the latest advancements,families no longer need to fear the grim future of the long C fight against cancer.

She said cancer has always devastated families. In addition, the heavy financial burden upset families, thier lifestyles are changed. There are multiple tests and treatments to give hope for patients Dr Tanjuaa adds She also said “During palliative care, we want families and people to maintain their quality of life, this is why we have different kinds of therapies to treat. Car T-Cell therapy, Immunotherapy, Targeted therapy, hormone therapy are some treatments depending on the hope of cancers and thier structure,some of these therapies can be more optimal than othes she pointed out

The Car T-Cell Therapy will help fight the cancer but with less obvious signs of the battle,” shares Dr. Tanujaa. “We now have the technology that can enhance the patient’s T-Cells with antigen receptors that can immediately recognize these cancer cells to eliminate them. There will be a low dose chemotherapy to help the body adjust to these new cells. But, once the body adjusts, the therapy will take over the fight.”

Immunotherapy for cancer is also becoming more popular because of its less macabre side effects. “This kind of therapy customizes the cell to make sure that the cancer cells don’t stop our body from fighting against the cancer. Cancer cells are smart. They release a protein that stops our body from fighting against it,” explains the oncologist. “Immuno- therapy fights against that mechanism.”

But when the cancers are more hormone-related like breast or prostate cancer, there are tests that can discover which hormone is causing the cancer. “Once we discover the hormone that is causing these cells to grow, we often give patients medicine that reduces the production of this hormone to prevent these cells from growing.”

Cancer is a terrifying, time consuming ,expensive disease With these new advancements cancer may eventally become chronic instead of something catastrophic.. But Dr Tanujaa Rajasekeran and her team at parkway Centre in Singapore are offering hope. And hope for the critically ill could result in miracles too.

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