Text by Henrylito D. Tacio
Photo: Istock and Facebook
Those were the days!
Growing up in a small town, we used to play with other children. Among those we did were shatong, tigso, biros, tumba lata, and of course basketball. All these entailed running.
“Those are really fun games, competitive, teamwork and socializing aside from being healthy games,” said Dr. Roy B. Ferrer, an assistant secretary of the Department of Health (DOH).
When asked he played those games, too, he answered affirmatively. “Of course. We are seven in the family: 5 boys and two girls,” said Dr. Ferrer from Davao City. “All the games you mentioned, we played them.”
Unfortunately, most of those games are now unheard of. You don’t see children doing those games anymore. “Instead of indulging in field sports and street games – which were popular during our era – today’s children are hooked on their computers,” Dr. Ferrer lamented.
Not only that, most children are not eating healthy foods – thanks to fast foods and the availability of junk foods anywhere. Unlike in the past, children were eating boiled banana or ginanggang, suman, sitsiritsit, fried camote, and the like, which were healthy.
In those days, diabetes among children was unheard of. But today, the scenario has completely changed. More and more children are suffering from this debilitating disease.
It has been found that Filipino children are now more prone to diabetes due to changes in diet and technology. In an interview on DZMM’s “Magandang Gabi Dok,” Dr. Susana Campos, a pediatric endocrinologist, said that fast food and candy commercials on television greatly influenced children’s food preferences. This increases the risk of children with diabetes.
Throughout the world, the International Diabetes Federation reported that there are more than one million children and adolescents that are living with type 1 diabetes. Previously called insulin-dependent or juvenile diabetes, it is usually diagnosed in children, teens, and young adults, although it can develop at any age.
“With stress and challenges in life and with a sedentary lifestyle brought about by technology, diabetes is getting younger these days,” deplores Dr. Ferrer, who is nicknamed Sugar Doc as he is a diabetologist.
“Children as young as five years old have been diagnosed with diabetes,” said the Philippine Diabetes Association (PDA), an umbrella organization of all associations involved in the care of diabetic patients.
Right now, no one knows exactly how many Filipino children are having diabetes. But Dr. Ellen Du, immediate past president of the Philippine Society for Pediatric Metabolism and Endocrinology, told Manila Bulletin that “based on the registry of the Philippine Pediatric Society, there were around 3,000 cases of type 1 diabetes among the four million admissions from 2006 to May 31, 2021.
“This is an underestimate because the data is only from pediatric training hospitals and this doesn’t also include those patients who were diagnosed in the clinics as outpatients,” she clarified.
Johanah Co, a member of the International Diabetes Federation Young Leaders in Diabetes Program, was 13 when he was diagnosed with diabetes. “I knew something was wrong because I would always be thirsty, I would get tired easily and ants were attracted to my urine,” he told Philippine Star. “That’s when my parents decided to seek medical help.”
Because diabetes is almost always associated with adults, children are neglected of being diagnosed with diabetes. “A doctor cannot tell that a child is diabetic until he starts to complain and usually that is already late as far as complications are concerned,” said Dr. Ricardo Fernando, founder of the Institute for Studies and the Diabetes Foundation.
“(Diabetes) has no cure,” Dr. Fernando stressed. “What doctors can do is just minimize the complications or push its onset a little later because the disease is more manageable among older people.”
Parents need to know more about diabetes – or else they may lose their children from complications of the disease. “The silent plague is haunting our children, and it’s time we broke the age misconception, talked about it more and took it very seriously,” urged Terence Repelente in an article which appeared in Philippine Panorama.
Most children, however, have Type 1 diabetes. “Being able to recognize the signs and symptoms (of either types) can help a child to get an early diagnosis, which in turn gives a chance of a better outcome,” wrote Honor Whiteman for Medical News Today (MNT).
The MNT considers diabetes as “a metabolism disorder.” Metabolism refers to the way the body uses digested food for energy and growth. Most of what one eats is broken down into glucose. Glucose, a form of sugar in the blood, is the principal source of fuel for our bodies.
“When our food is digested, the glucose makes its way into our bloodstream,” MNT explained. “Our cells use the glucose for energy and growth. However, glucose cannot enter our cells without insulin being present – insulin makes it possible for our cells to take in the glucose.”
Insulin is a hormone released from the pancreas. “After eating, the pancreas automatically releases an adequate quantity of insulin to move the glucose present in our blood into the cells. As soon as glucose enters the cells blood-glucose levels drop,” MNT noted.
Type 1 diabetes – which appears during childhood or adolescence, although it can start at any time – occurs when the pancreas is unable to produce insulin. “Without insulin, sugar cannot travel from the blood into the cells, and high blood sugar levels can result,” Whiteman wrote.
The most common symptoms include increased thirst and urination, hunger, weight loss, fatigue, irritability, fruity smell on the breath, and blurred vision. Girls might develop a yeast infection.
Type 2 diabetes – formerly called adult-onset diabetes – is less common among children, but it can occur when insulin is not working properly. “Without enough insulin, glucose can accumulate in the bloodstream,” Whiteman wrote.
The symptoms include: urinating more often (especially at night), increased thirst, tiredness, unexplained weight loss, slow healing of cuts or wounds, blurred vision (as the eye’s lens becomes dry), and itching around the genitals (particularly for girls).
The website healthline.com says diabetes in children is most common in those aged 10 to 19 years old. A child may have an increased risk for Type 2 diabetes if he has a sibling or other close relative with Type 2 diabetes, shows symptoms of insulin resistance, including dark patches of skin, and is overweight or obese.
“Symptoms of Type 1 diabetes in children tend to develop rapidly over a few weeks,” Whiteman wrote. “Type 2 diabetes symptoms develop more slowly. It may take months or years to get a diagnosis.”
According to Whiteman, children and adolescents with diabetes usually experience four main symptoms, but many children will have only one or two. In some cases, they will show no signs.
“If a child suddenly becomes more thirsty and tired or urinates more than usual, their parents may not consider diabetes a possibility,” Whiteman said. “Doctors, too, since diabetes is less common among very young children, may attribute the symptoms to other, more common illnesses. For this reason, they may not diagnose diabetes at once.”
Diabetic ketoacidosis (DKA) is one of the most serious consequences of undiagnosed Type 1 diabetes, MNT reports.
“DKA is the leading cause of mortality in children with Type 1 diabetes,” Whiteman wrote. “If insulin levels are very low, the body cannot use glucose for energy. Instead, it begins to break down far from energy. This leads to the production of chemicals called ketones, which can be toxic at high levels. A build-up of these chemicals causes DKA, where the body becomes acidic.”
As for Type 2 diabetes, younger people also seem to have a higher chance of complications, such as kidney and eye disease, earlier in life than children with Type 1 diabetes. “There is also a greater risk of high blood pressure and high cholesterol levels, which raise a person’s risk for blood vessel disease,” Whiteman said.
For Type 1 diabetes, treatment involves lifelong insulin use and blood sugar monitoring. In addition, diet and exercise management must also be observed to help keep blood sugar levels within the target range.
“If your child has type 1 diabetes – especially a young child – you’ll be involved in diabetes care on a day-to-day basis, from serving healthy foods to giving insulin injection to watching for and treating hypoglycemia (low blood sugar),” the US Centers for Disease Control and Prevention (CDC) says.
The parents also need to stay in close contact with their child’s health care team. “They will help you understand the treatment plan and how to help your child stay healthy,” CDC says.
On the other hand, type 2 diabetes can be managed through a change in diet, more exercise, and maintaining a healthy weight. In some instances, a child may need medication.
Diabetes has been identified by both the WHO and the Department of Health as one of five non-communicable diseases that kill more Filipinos; the other four are heart disease, stroke, cancer, and chronic diseases that affect the airways and lungs.
“(All five diseases) take almost 300,000 lives in this country every year,” Health Secretary Francisco Duque III pointed out. “While these diseases affect different parts of the body in different ways, they often share common origins. The good news is, many of these factors are avoidable.”