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
Today, I focus on the Apostolic Church International in Finland, as I continue with my description of institutions and personalities and their accomplishments as members of the Ghanaian Diaspora in Finland.
The Apostolic Church International, Finland (or, Apostolic International Association Ry) was established in October 9, 2023. The Church in Finland has seen significant strides and accomplishments within the short time that it has been established in Finland, which must be highlighted.
History of the Church in Ghana
The Apostolic Church Ghana originated from the 1904–1905 Welsh revival, officially established in Ghana (then called Gold Coast) in 1935 following connections between a local prayer group in Asamankese (a town in southern Ghana), led by Peter Newman Anim, and the Apostolic Church, UK. There were historical splits in 1939 and 1953, but the Apostolic Church attained autonomy in 1985.
Today, the Church is headquartered in Accra. Last year (2025), it dedicated its new 10-storey headquarters, “The Apostolic Church Tower,” in Frafraha, Adenta West in Accra.
Activities of the Apostolic Church in Finland
The Apostolic Church in Finland conducts church service on Sundays. The service starts at 11a.m. in the morning and closes by 1 p.m. in the afternoon. There are no other activities during other days for now.
The Minister in charge of the church in Finland is also the Area Head of Italy Area. He is Pastor Daniel Kofi Addison who is the new Italy Area Head, and has just been transferred from UK South Area to Italy Area during the just-ended Council Meeting in March this year. Italy Area comprises Italy, which has 13 Assemblies, Germany, one Assembly, and Finland, one Assembly.
Elder Ebenezer Amoaning-Coffie is the Presiding Elder in charge of the Assembly in Finland. A Presiding Elder is responsible for day to day activities of the church (Assembly) and reports to the District Pastor, or in the absence of the District Pastor, reports to the Area Head.
Achievements
The Apostolic Church International, Finland was officially registered under the Finnish Law, guaranteeing freedom of worship and providing legal foundation for future growth. The church service is conducted in both English and Twi.
The church opens its doors to all people of every nation, especially Ghanaians who are in Finland and other African nationals. Now, the membership comprises Ghanaians, Nigerians and Sierra Leoneans.
The Church and the Ghanaian migrant community in Finland
The Apostolic Church in Finland plays a prominent role as a religious group that serves Ghanaian migrants and others in the Finnish society.
Thus, the Apostolic Church is a religious body for Ghanaian migrants in Finland and other nationalities who want to worship with them for diversity and better intercultural and multicultural understanding.
Elder Amoaning-Coffie said that the main and primary aim of the church is to bring people closer to God. “We aim to win souls for Christ. We aim to preach the gospel to the world. By propagating the gospel to the people, we are hopeful that they will turn away from any ungodly ways and be good individuals in the community and in society in general”, he stated.
He said that everything is going well so far. A key challenge, however, is how to get more members especially the youth. As a new Assembly, we are in need of instrumentalists, for example. We pray to God Almighty to help us do His work, the Elder disclosed.
Integration
By its activities, the Apostolic Church is helping to ensure integration of its members well into the Finish society. This is important since social interaction and citizens’ well-being are an important part of the integration process in Finland.
As I mentioned some time ago, the role of migrant associations and groups such as the Apostolic Church acting as bridge-builders for the integration and inclusion of migrants through participation in the decision making process and by acting as a representative voice is highly appreciated in Finland. Thank you!
With Dr Perpetual Crentsil
The landscape of the Ghanaian palate is shifting, and not necessarily for the better. In our bustling urban centres, from the streets of Accra to the suburbs of Kumasi, a quiet culinary revolution is taking place; one where the mortar and pestle are being replaced by the pizza oven and the deep fryer. This transition from traditional staple foods like fufu, banku, akple, kenkey, tuo zaafi, and ampesi toward “continental” dishes is more than just a change in appetite; it is a reflection of a deeper social struggle with identity and prestige.
The illusion of modernity
For many, “stepping out” for a meal has become synonymous with consuming foreign cuisine. There is an unspoken social hierarchy where a bowl of Abunuabunu is relegated to the village category, while burgers, pizzas are branded as prestigious choices. We have reached a stage where we equate foreign with modern and local with primitive.
This perception is a dangerous illusion. Our traditional dishes are marvels of culinary engineering complex, nutrient-dense, and deeply rooted in our history. When we choose a processed foreign import over a meal made from local tubers or fermented maize, we are not just changing our lunch; we are eroding the indigenous knowledge attached to our local ingredients and foods.
We need to turn the consumption of indigenous grains and tubers like millet, sorghum, and plantain into a statement of self-worth and national pride.
The cultural and health erosion
Every time a local dish disappears from a restaurant menu to make room for foreign fast food, we lose a piece of our cultural fabric. Traditional Ghanaian cooking is an art that requires patience and skill. By choosing the convenience of foreign fast food, we are raising a generation that may know the taste of a pepperoni pizza but cannot identify the rich, earthy profile of Prekese or the subtle tang of well-fermented dough dishes like corn porridge, banku, etew, abolo, agidi or kamfa, and kenkey.
Furthermore, we are at the crossroads of a nutrition transition. Replacing high-fiber, indigenous crops with calorie-dense but nutrient-poor foreign fast foods is driving a rise in lifestyle diseases such as obesity, hypertension, diabetes, stroke, cancer, and liver disease. We are trading our longevity for 15-minutes convenience or unhealthy diet.
A call for culinary patriotism
It is time for us to appreciate, preserve, and promote our indigenous foods and culinary traditions. We need to be proud of our local dishes, ingredients and cooking methods, rather than relying heavily on foreign or imported foods. We must stop viewing our local delicacies as low-class and start treating our culinary heritage as the high-end gastronomy it truly is.
True sophistication does not come from imitating Western fast food; it comes from innovation and adding values to our own resources. We see glimpses of this potential in the rise of branded Sobolo and the creative use of gluten-free plantain flour in modern baking of flour-based dishes such as bread, cakes, biscuits and others. This is the path forward. We must elevate our local dishes, making them as accessible, affordable, presentable and trendy as any foreign alternative.
To the hospitality industry: Innovate or stagnate
Our hotels and high-end restaurants must lead the charge. They must stop relegating local dishes to the “traditional corner” of the buffet, and apply the same culinary finesse given to imported dishes to our Fante Fante, apapransa, aborbi tadi, fetritoto, akple, abolo, yakayeke, fufu, ampesi, kokonte, wasawasa, tubani, apapransa, mpotompoto, kelewele, aliha, brukutu, pito, and other local dishes. The industry must enhance customer experiences making eating local dishes the ultimate luxury experience for both tourists and residents alike. We must elevate the presentation of our foods by using modern plating techniques to show that a bowl of light soup can be as visually stunning as a French consommé. We need to reclaim our Ghanaian plate before it is too late.
To the policy makers: Let us encourage buying of local ingredients to promote the local food industry and economy. There should be educational programmes and talks about the nutritional and cultural benefits of local foods so that people understand their value.
We need to encourage serving traditional dishes at school programmes, parties, and celebrations instead of only fast foods,
To the Youth: Let us value and appreciate our traditional dishes instead of always choosing foreign foods. There must be balance in our choice of local and foreign dishes. Confidence in our culture encourages others to respect it too. Our local dishes can also be promoted by sharing pictures, recipes, and videos on platforms such as Instagram, TikTok, and WhatsApp to make them attractive and trendy.
Young citizens must learn from their parents and elders how to prepare local meals to keep the knowledge and cultural relevance alive. Local dishes can be modernised to appeal to younger generations and tourists.
Conclusion
We cannot afford to trade our heritage for foreign cuisines which are gaining grounds across the country at an alarming rate. We must disabuse our minds of the perception that anything foreign or imported is better than those locally made. Our health, economy, and identity are tied to the soil. It is time to stop apologising for our local flavours and start celebrating them. It is possible to embrace modernity without losing ourselves and our cultural identity. Let us make the Ghanaian kitchen the heart of our modern identity once again.
By: Marilyn Gadogbe
