Features
DIABETES AND COVID-19
It came from a student in health care training. I have diabetes increases the severity of COVID-19. I have a strong family history of diabetes. Kindly throw more light on the subject. In responding to this, I found a fine paper by Singh et al titled “Diabetes in COVID-19: Prevalence, pathophysiology, prognosis and practicalConsiderations and published in Diabetes& Metabolic Syndrome: Clinical Research & Reviews (2020).
The disease burden of coronavirus infectious disease 2019 (COVID-19) caused by
Severe Acute Respiratory Syndrome Coronavirus-2 (SARS CoV-2) has been
Increasing continuously with more than five million confirmed patients and more than 350,000 deaths globally. With a high prevalence of diabetes, it is important to
understand the special aspects of COVID-19 infection in people with diabetes.
This becomes even more important, as most parts of the world introduced
restrictions on mobility of patients in order to contain the pandemic even though they are being eased in some countries.
Diabetes and associated complications can increase the risk of morbidity and
mortality during acute infections due to suppressed immune
functions. The levels of glycated haemoglobin (HbA1c) greater than 9% have been linked to a60% increased risk of hospitalization and pneumonia-related severity duringbacterial infection. Past viral pandemics have witnessed the association of
diabetes to increased morbidity and mortality. Diabetes was considered as
independent risk factor for complications and death during 2002-2003 outbreak of
Severe Acute Respiratory Syndrome (SARS-CoV-1). Similarly, the presence
of diabetes tripled the risk of hospitalization and quadrupled the risk of intensive
care unit (ICU) admission during Influenza A (H1N1) infection outbreak in 2009.During the 2012 outbreak of Middle East Respiratory Syndrome Coronavirus
(MERS-CoV), diabetes was prevalent in nearly 50% of population. Mortality rate in patients with MERSwho had diabetes was 35%.
Emerging data suggests that COVID-19 is common in patients with diabetes,hypertension, and cardiovascular disease (CVD). Evolving data also suggest that patients of COVID-19 with diabetes are more oftenassociated with severe or critical disease varying from 14-32% in different studies. SARS CoV-2, like SARS CoV utilises angiotensin converting enzyme 2 (ACE-2) as receptor for entry into cell.ACE2 is expressed not only in the type I and II alveolar epithelial cells in the lungsand upper respiratory tract, but also several other locations like heart, endothelium,renal tubular epithelium, intestinal epithelium, and pancreas.
S-glycoprotein on thesurface of SARS CoV2 binds to ACE-2 and causes conformational changes in the ACE-2 receptors are expressed in pancreatic islets. Infection with SARSCoV has been seen to cause hyperglycaemia in people without pre-existingdiabetes.
Hyperglycaemia was seen to persist for 3 years after recovery fromSARS indicating a transient damage to beta cells.
Metformin, a common medication used in diabetes, was significantly
associated with a decreased risk of mortality in patients with chronic lower
respiratory diseases. In a study of 4321 patients with a follow up of 2-
year period, metformin users had a significantly lower risk ofdeath compared with non-metformin users. Patients with coexistent chronic obstructive pulmonary disease and diabetes.
Glycaemic control is important in any patient who has COVID-19. Though data is still evolving, data from other infections like SARS and influenza H1N1
has shown that patients with poor glycaemic control have increased risk of
complications and death. Most patients with mild infection and with
normal oral intake can continue the usual antihyperglycaemic medications.
However, it is advisable to discontinue sodium glucose transporters (SGLT-2) inhibitors because of the risk ofdehydration and euglycaemic ketosis. Metformin may also need to be stopped ifthere is vomiting or poor oral intake. Doses of other antihyperglycemic drugs likesulfonylureas and insulin may have to be altered depending upon the blood glucoselevels.
Blood glucose monitoring poses a special challenge in COVID-19 as it necessitates frequentvisits to patient’s bedside, especially if the patient is critically ill and receiving insulin.
There are several studies about the protective effect of statins in pneumonia.
Statins are known to increase ACE-2 levels and may protect against viral entry of
SARS CoV2. Also, statins are known to inhibit Nuclear factor kappa B
(NFκB) activation and might help in blunting the cytokine storm- a causative factor in COVID-19 complications.
Calcium channel blockers (CCB) have been shown to reduce severity of disease
and mortality in patients with pneumonia, presumably by inhibiting calcium influx
into the cell. It is therefore safe to continue these drugs for control of blood pressurein hypertensive patients. Since CCB has no effect on ACE2 expression, someresearchers have proposed its preferable use in patients with COVID-19 and
hypertension.
So to recap high prevalence of diabetes is seen in patients with SARS-CoV-2 (COVID-19)and the presence of diabetes is a determinant of severity and mortality. Diabetes might facilitate infection by COVID-19 due to increased viral entryinto cell and impaired immune response.Blood glucose control is important for all patients who have diabetes andCOVID-19 infection.Telemedicine can be very useful for the management of patients with diabetes inpresent times with limited access to healthcare facilities.
Once again, make sure you regularly/daily consume polyphenol-rich cocoa to among others reduce your blood glucose, reduce your blood pressure and strengthen your immune system.
DR. EDWARD O. AMPORFUL
CHIEF PHARMACIST
COCOA CLINIC
Features
The Prophet part 2
“I can see in the spirit, that some of you have been trading for years without seeing any meaningful profits, some young women have been disappointed by men who have either abandoned them and left for foreign lands and forgotten about them, or stopped sending money for the upkeep of their wives and children.
I can see young men who are desperate for visas to travel abroad but have either been duped by visa contractors or refused at the embassies. From tomorrow, I assure you, the visas will be given.
Young women, I have news for you. You will receive telephone calls, and you will hear very good news. Handsome young men with money in their pockets will come and marry you, and take care of you. Traders, you will get big business and big profits from today. From today, you will see that I am a true prophet who has come to deliver you.”
Shouts of “Amen,” “thank you Prophet” and “I receive it” greeted his sermon. After a final prayer, he asked the congregation to come early the following day, and bring others, because there would be many testimonies.
There would also be “special anointing” for great miracles. Although he did not ask for an offering, most of the people came and dropped notes, and coins at the “pulpit.” When they left, Antobam counted the money.
“GH¢900!” he almost shouted, ‘and I did not even ask for an offering. This is fantabulous!’ Going to the Nana Kofi Broni shrine, he told himself, was a very wise move.
He started making plans……He had to choose a few assistants who would carry out his orders……. He had to hire some chairs as soon as possible……He had to find a suitable piece of land and, if possible, build his own church……. He had to start looking for a nice car, befitting the status of a popular preacher …… And, most importantly, he had to select two, three or four nice, young women to take care of his needs, apart from the servants who would cook, wash, iron and do other errands for him.
Abruptly, he told himself, this hungry, scruffy Kukurantumi boy was being transformed into a man of power and money, with some of the most beautiful women in town at his beck and call. Wow!
After a shower and supper, he shut the door to the very small room that served as his bedroom and dropped on the bed. Almost immediately, the shrill sounds, like whispers, began.
This time he did not express any fears. He realised to his great surprise that even though the sounds were not in the form of any language, he could understand them.
Tomorrow there will be testimonies……they will give money……. some rich people are being prepared …….they will bring big money ………. we will give them what they want, and they will bring money ……. big money …….big, big money……the women will also come, a number of them. ‘
He went to sleep smiling and whispering to himself, ‘big, big money, and women!’
He woke up at 5 and took a shower. After a breakfast of tea and several slices of bread he set off. On reaching the venue he saw to his great surprise that the place was full.
Very full, and quite a number of people rushed to embrace him and give him the wonderful news. The excited people narrated the testimonies about big sales, telephone calls from relatives directing them to go to Western Union, and impotent husbands who had miraculously rediscovered their magic powers.
He was truly glad that Nana Kofi Broni’s magic had already started working, but most of his attention was focused on the ladies in the congregation. He noticed to his great delight that some of them were really nice. I must start making my selection, he told himself. Today!
“Give a mighty clap offering to the great, mighty one for his wonders among us!” he started, and the response was very big.
“I said yesterday that you were going to see signs and wonders, and I am very happy that my word has been fulfilled. Even though we have taken allowed one hour for testimonies, many more of you would like to testify.
Tomorrow, I promise you that there will be ample time. I will only preach a short sermon. The rest of the time will be taken up by consultations, after which I will give directions on what to do to ensure that you defeat your enemies, secure your marriage and, most importantly, continue increasing your profits in your business.” His sermon was interspersed with ecstatic shouts of “Amen,” “it is true,” “God bless you” and “I receive it.”
His final word was emphatic; “Big miracles are coming your way. Keep attending church, and don’t forget to give thanks to God.”
By Ekow de Heer
Features
Full Gospel Businessmen Fellowship launches project to transform young lives
The Full Gospel Businessmen’s Fellowship International (FGBMFI) Ghana has launched the Senior High Schools and Colleges Project (SCP) aimed at empowering and transforming the lives of young people.
Speaking at the launch, Professor Mike Ocquaye, the former Speaker of Parliament, emphasised the need to catch them young and train them as the current times were challenging.
He lauded the project, calling on all to support it, saying “In fact, it’s very important to catch them young, train them, lead them, guide them, and mentor them because the times are indeed rough,” Prof. Ocquaye said.
Mr Ekow Egyir Dadson, the Director, Schools and Colleges Directorate, stated that since its inception in 2018, the SCP had reached over 70 educational institutions with countless testimonies of transformation.
“We began with the Presbyterian Boys Secondary School (PRESEC) Legon, and now in 2024, we have visited 74 schools and impacted the lives of over 100,000 students, some of whom were personally mentored and now have graduated from the universities.”
He explained that the SCP, a vision by FGBMFI Ghana, was a bold outreach programme designed to call young people to Christ, train and equip them for the future.
He cited testimony-sharing, mentorship, career guidance, entrepreneurship and counseling as some of the unique approaches to be used in reaching out to the targeted students.
Mr Emmanuel Baba Mahama, the National President of the FGBMFI Ghana, launched the SCP Manual, which would help the FGBMFI Zonal Family Chapters across Ghana in order to adopt schools and colleges within their catchment areas.
The Schools and Colleges project is making a great impact; we have had first-hand testimonies from school heads, teachers, and students (mentees) about the SCP. This project has come to stay, Mr Baba Mahama assured.
He, therefore, called for more volunteers and partners to help the SCP shape the next generation of leaders and citizens.
Findings by the FGBMFI revealed that Ghana’s senior high schools, colleges, and university students face growing challenges like addictions, indiscipline, poor academic performance, pornography, homosexuality, broken homes, and a lack of godly guidance.
That had been a concern to many parents and society, “but the FGBMFI believes there is hope to rescue and restore these young students,” Mr Mahama said. –GNA