INTRODUCTION: Current evidence supports a central role of inflammation in the pathogenesis of atherosclerosis and diabetes. Diabetes Mellitus (DM) type 2 is an inflammatory atherothrombotic condition associated with high prevalence of thrombotic cardiovascular disease. In patients with DM, this inflammation is
reflected by elevated plasma C-reactive protein (CRP) levels. High specificity (hsCRP) is considered as a strong predictive of cardiovascular risks and death. Some evidence showed that CRP may represent an active participant in atherogenesis. Among the DM risk factors (like hypertension, atherogenic dyslipidemia, insulin resistance, impaired fibrinolysis, inflammatory profile), inflammation is the neglected one. Moringa oleifera (M.oleifera) has been suggested to exert anti-inflammatory and hypoglycemic property.

OBJECTIVE: To determine the effect of M.oleifera leaves supplementation on the hsCRP, and HgbA1c levels of diabetics of Ospital ng Maynila Medical Center DM clinic

METHODS: We performed a prospective quasi experimental study on 56 adult diabetics who were given 12-weeks supplementation of M.oleifera. Plasma hsCRP and serum HgbA1c were compared before and after treatment with M.oleifera.

RESULTS: The over all population mean prehsCRP is 3.38 mg/dl (95% CI 2.77-3.99). Supplementation of
M.oleifera decreased significantly (p<0.0001) the posthsCRP to 1.69 mg/dl (95% CI 1.28-2.09). The mean pre-HgbA1c of 6.96% (95% CI 6.64-7.09) was reduced post-HgbA1c to 6.06% (95% CI 5.88-6.24).The mean reduction of 0.6% in HgbA1c was significant (p-value   <0.0001).     

CONCLUSION: Our study confirms that diabetics may have additional benefit from intake of M.oleifera leaves by reducing hsCRP and by improving blood sugar control as evidenced by the reduction of Hgba1c.

Human ; Male ; Female ; Middle Aged ; Adult ; Moringa Oleifera ; C-reactive Protein ; Cardiovascular Diseases ; Atherosclerosis ; Diabetes Mellitus, Type 2 ; Hemoglobin A, Glycosylated ; Dyslipidemias ; Hypertension

Diabetes remains as the 6th leading cause of death in the Philippines, with more than 33,000 deaths in 2016. Given this alarming prevalence, it is imperative that this public health concern be prioritized in the country and to answer such concern, a group of cardiologists and endocrinologists who are in active clinical practice and research, formed a technical working group composed of five members. Their primary objective was to develop an evidence-based consensus document for Filipino healthcare practitioners and people in the academe that would serve as a guideline on the approach to lower the CV risk of individuals with T2DM. The TWG agreed on focusing with the pharmacological approach to treatment of lowering CV risk for T2DM patients using the ADAPTE model which is a more systematic approach to guideline adaptation. The recommendations were developed using the ADAPTE framework appraising all international practice guidelines and recommendations through to 2013. The technical working group’s overall objective of guideline adaptation is to take advantage of the existing guidelines to enhance the efficient production and use of high-quality adapted guidelines specially in the local Philippine setting. Each of these articles was then assessed using the AGREE instrument. Based on the key questions that the technical working group had identified regarding the approach to lower the risk of individuals with type 2 diabetes, 9 recommendations concerning the antidiabetic drug of choice for persons with type 2 diabetes with or without established ASCVD and management of type 2 diabetes mellitus patients with hypertension and dyslipidemia were drafted and are presented in this report.
Diabetes Mellitus, Type 2 ; Heart Disease Risk Factors

Dyslipidemia is a cardiovascular risk factor that is increasing in prevalence in the country. The need to treat and manage elevated cholesterol levels, both pharmacologic and non-pharmacologic, is of utmost importance. Different medical societies and groups bonded together to formulate the 2020 Philippine Clinical Practice Guidelines for dyslipidemia. The group raised nine clinical questions that are important in dyslipidemia management. A technical working group analyzed the clinical questions dealing with non-pharmacologic management, primary prevention for both non-diabetic and individuals with diabetes, familial hypercholesterolemia, secondary prevention, adverse events of statins and the use of other lipid parameters as measurement of risk for cardiovascular disease. Randomized controlled trials and meta-analyses were included in the GRADE-PRO analysis to come up with the statements answering the clinical questions. The statements were presented to a panel consisting of government agencies, members of the different medical societies, and private institutions, and the statements were voted upon to come up with the final statements of the 2020 practice guidelines. The 2020 CPG is aimed for the Filipino physician to confidently care for the individual with dyslipidemia and eventually lower his risk for cardiovascular disease.
Dyslipidemias ; Hyperlipoproteinemia Type II ; Diabetes Mellitus