Blood Sugar Management is
More Than Just Treating Diabetes

Diabetes is the 4^th leading cause of death in the Philippines. And half of the people with diabetes might not even know they have it. And while it is the most talked about when it comes to glycemic health, it’s just the tip of the iceberg.

In a recently concluded seminar organized by CTC Group Philippines in collaboration with innoVactiv, subject matter experts shared their valuable insights regarding blood sugar management. innoVactiv is a Canada-based manufacturer of nutraceutical ingredients with two decades of industry expertise, with most of their products sustainably sourced from the marine environment. The morning session comprised topics ranging from the current status of glycemic health in the Philippines to product applications that brands can develop.

The prevalence of Filipinos with diabetes has risen steadily from 4.8% in 2008 to 8.2% in 2019. However, a more alarming picture regarding prediabetes is unfolding. In the same period, prediabetes prevalence rose from 7.4% in 2008 to 29.1% in 2019.

But what exactly is prediabetes? The normal fasting blood sugar level is considered to be less than 100 mg/dL while levels higher than 125 mg/dL correspond to a diabetic state. The 100-125 mg/dL zone is what’s referred to as prediabetes, in which the blood sugar level is abnormally high but not high enough to be classified as diabetes.

But ignoring prediabetes would be flirting with disaster. On its own, prediabetes increases an individual’s risk for cardiovascular diseases. Left unchecked, most individuals with it could eventually develop type-2 diabetes. That’s why Dr. Joy Fontanilla, a medical expert in endocrinology, metabolism, and diabetes, noted during her talk in the seminar that Filipinos should not be misled by the “pre-” in prediabetes, thinking that it is something that they can put off in the meantime.

Dr. Fontanilla, who is the chief of the endocrinology section in the Asian Hospital and Medical Center and the head of the Center of Weight Intervention & Nutrition Services in St. Luke’s Medical Center BGC, emphasized that prediabetes is still a state of abnormal blood sugar levels and that individuals must take immediate changes in their lifestyle to lower it and prevent it from further progressing into diabetes. She also shared practical ways on how to prevent or lower high blood sugar levels. Essentially, this involves eating healthier, moving more, stressing less, and sleeping well.

Lastly, she identified some challenges in diabetes treatment such as late detection, inherently high cost, lack of care accessibility, lack of knowledge and prevalence of misconceptions, and lack of adherence to treatment regimen.

While these challenges refer to the treatment of diabetes, these may also provide inspiration for a preventive approach toward maintaining optimal glycemic health. For instance, the general lack of symptoms of prediabetes may contribute to the late detection of diabetes in unsuspecting individuals. This must compel consumers to adopt changes in their lifestyle choices. And brands keen on helping address this concern must ensure that they offer solutions that are socio-culturally acceptable and supported by scientific evidence.

The increasing prevalence of prediabetes and type-2 diabetes offers food, beverage, and health brands an opportunity to innovate products that support lifestyle modifications and/or supplementations for better glycemic health. This also presents an avenue for brands to promote prevention through innovative products for mainstream consumers who might be unaware of their glycemic health status

In her presentation in the seminar, Michelle Teodoro, Mintel’s Associate Director for Food Science and Nutrition in APAC, noted how the Southeast Asian market is dominated by “no/low/reduced sugar” and “no sugar added” claims in products that are positioned for the diabetic consumer segment. She also described how brands can differentiate by tapping other claims such as “high/added fiber”, “wholegrain”, and “low/reduced glycemic index (GI)” in developing products that can help lower blood sugar levels.

Elaborating on how this can be done, she used an example from Singapore where an innovative fiber-based product can be added to traditionally high-refined carbohydrate foods to help lower their GI without affecting the sensory aspects of the food item (such as taste and texture). She also advised that brands must explore other ways to holistically tackle blood sugar health with their products. For instance, some brands may fortify their food products to make them more nutrient dense. Others may introduce other functional claims such as helping improve sleep (since better sleep quality is one way to help reduce the risk of diabetes).

Given all this information, where do brands go from here? Ernest Wang, innoVactiv’s director for the Asia-Pacific region, discussed why brands should consider targeting the prediabetic and diabetic segments of the market for the glycemic health category. He presented an array of studies describing the critical role of carbohydrate overconsumption in the development of abnormally high blood sugar and its metabolic repercussions. Noting the similarity in some of the data presented by Dr. Fontanilla, Wang stated that prediabetes is also more prevalent than diabetes globally. Moreover, he mentioned that up to 21% of normal weight and 35% of overweight individuals, both considered non-obese, could be prediabetic. He then suggested that brands should not be limited to targeting obese individuals and diabetics when developing glycemic health products. The wider prevalence of prediabetes presents a better and more proactive opportunity for brands to help consumers prevent diabetes and achieve optimal glycemic health.

To help brands achieve this, he introduced InSea2®, a proprietary brown seaweed extract that can regulate the release of glucose from food to prevent glycemic stress arising from chronic abnormal blood sugar spikes after a meal. InSea2® contains a certain class of polyphenols, called phlorotannins, that acts by partially inhibiting both α-amylase and α-glucosidase, enzymes that release glucose from the food eaten. He also highlighted two long-term clinical studies that show the safety and efficacy of InSea2® in helping achieve better blood sugar levels in prediabetic and diabetic individuals.

In the first study, Wang presented how InSea2® taken at 250 mg doses thrice a day (once before every meal) for 6 months helped prediabetics revert toward a better glycemic state. All 62 individuals either had impaired fasting glucose (IFG) or impaired glucose tolerance (IGT), which the latter is considered the more severe type. At the start of the study period, 35.3% and 64.7% of patients who were to be given InSea2® had IFG and IGT, respectively. For the placebo group, 41.9% had IFG while 58.1% had IGT.

By the end of the 6-month study, 18.2% of the patients who took InSea2® reverted to a normal glycemic status while 69.7% and 12.1% are in the IFG and IGT states, respectively. The apparent rise in the portion of patients with IFG is caused by some of the patients with IGT reverting to the less severe state. For the placebo group, 17.2% had IFG and 82.8% had IGT, with most of the individuals with IFG progressing to the IGT state.

The second study presented by Wang explored the suitability of InSea2® in being co-administered with anti-diabetic medications. In this study, 164 type-2 diabetic patients received either an InSea2® product or the placebo daily for 6 months along with their anti-diabetic medications. Their glycated hemoglobin (HbA1c), fasting plasma glucose (FPG), and postprandial glucose (PPG) served as biomarkers of glycemic health status. At the end of the study period, patients from both the InSea2® and placebo groups had improved glycemic biomarkers since all of them are taking medications. But the extent of improvements between these groups differed significantly.

In the InSea2® group, HbA1c was reduced by 10.8%, FPG by 23.4%, and PPG by 17.0%. On the other hand, HbA1c, FPG, and PPG were reduced in the placebo group by 2.8%, 4.2%, and 3.7%, respectively. These results show the safety and efficacy of InSea2® in supplementing the typical anti-diabetic medications, ideal for patients who want to better help improve their condition. Despite these results, Wang also emphasized that InSea2® is not intended to replace anti-diabetic medications and must not be used as such.

Capping off the morning session, Ms. Wendy Reyes, the Innovation and Applications Specialist of CTC Group Philippines, exhibited different innovative food and beverage applications of InSea2®. She noted that while capsules and tablets remain to be the most convenient format for this nutraceutical ingredient, developing other formats is another way by which brands can differentiate themselves in the market. Food and beverage formats offer additional sensory value that consumers can enjoy, something that may not be experienced in traditional capsules and tablets.