Dr. Ricardo Fernando and diabetes

World Diabetes Day was celebrated last Wednesday. It is aimed at creating greater awareness of a disease that has affected as many as 7 million Filipinos. This is roughly the number of senior citizens in our country, an indication that most of our diabetics are probably in the senior citizen category.

For many years, I was not even aware that diabetes was a disease. With my sweet tooth, chocolates, ice cream and assorted candies were things I took for granted as part of a good life. The only admonition I heard about taking too much of sweets was its effect on my teeth. And, to my mind, brushing them every day was good enough to keep the doctor or dentist away.

Twenty years later, just before undergoing a triple heart bypass, my doctors informed me that I had diabetes. That was the first time the word entered my vocabulary. Like many things in life, the idea of having to cut down on one of my favorite indulgences did not register immediately. And I continued with my merry ways. Only when nocturnal visits to the bathroom became more frequent did I realize that something was wrong with my system. It was too late. From oral medication, I graduated to shots of insulin.

Through the years, I have paid a high price for not taking seriously the dangers posed by diabetes. Aside from the heart bypass operation and several angioplasty procedures, kidney failure requiring dialysis and, later, a transplant were part of the long and difficult struggle to stay healthy and strong.

Today, the most important items when I travel abroad are not the clothes, shoes or jackets. The most important are a number of medicinal pills along with an insulin pen, since I am insulin-dependent. Actually, one can avoid getting to the insulin stage. All it requires are a disciplined diet and regular exercise for 30 minutes a day, possibly on a treadmill, on a bicycle or just plain walking. Diabetics suffer from too much sugar in the blood, a state known as hyperglycemia, or from very low sugar levels, known as hypoglycemia. In either case, it involves the release of water from the body. Hyperglycemia results in frequent urination, while one indication of hypoglycemia is excessive sweating, most often at night.

It was a Canadian medical scientist, Dr. Frederick Banting, together with Prof. John James Macleod, who were codiscoverers of insulin, a replacement hormone to help keep sugar levels normal. For their work, they were awarded the Nobel Prize for Medicine in 1923.

“Tatay” Ricardo Fernando, or Dr. Ricardo E. Fernando, who passed away in September last year, is considered the “Father of Philippine Diabetology.” He was “Tatay” to the many doctors, nurses, medical technicians, school and pharmaceutical representatives, who were the beneficiaries and coworkers in his unceasing efforts to increase awareness of the existence of diabetes in the country and throughout the region.

The son of a Methodist pastor, Ricardo was able to go through medical school at the University of the Philippines with the help of a small group known as the Methodist Youth Fellowship, based in Wisconsin, United States. Later, a scholarship provided by the National Methodist Church of America allowed him to spend a year at Harvard Medical School. The Harvard program offered different medical subjects in order to guide students toward areas of specific interest for study in detail later.

While attending sessions on diabetic neuropathy at Joslin
Diabetes Center, he fell in love with the subject of diabetes, and spent most of the remainder of his time at the center. This was the spark that started Dr. Fernando’s illustrious career, reaching across all of Southeast Asia and beyond.

The beginning of diabetology in the Philippines was in 1957 with the return of Dr. Fernando from his stint at Joslin Center. He immediately instituted a course at Mary Johnston Hospital, training nurses in the care of diabetics, the first of its kind in Asia. He continued conducting courses on diabetes for internists, nurses and other members of the medical community, and in 1989, he began the Institute for Studies of Diabetes Foundation. After two years of study, the institute offered a Master of Science in Internal Medicine, major in diabetes mellitus. The foundation prospered and grew in influence.

In a magazine article on the icons of Philippine medicine,
Dr. Fernando occupies a special place for his achievements in the fight to overcome diabetes. “Diabetes, one of the top causes of death in the Philippines at present, could have left even more Filipinos defenseless if not for this man. Diabetes was never believed to exist among Filipinos until Dr. Ricardo Fernando—Father of Philippine Diabetology — presented the numbers.” The Philippines is a better and safer place because of the work of men like Dr. Fernando.

Tatay’s only son, Dr. Richard Elwyn Fernando, is a respected medical practitioner also in the field of diabetology. He follows in the footsteps of his distinguished father.

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