Text by Henrylito D. Tacio
Photo: Getty Image
(First of Two Parts)
Unlocking cures for diabetes (First of Two Parts). With an infected toe, Rommel Barro went to see a doctor in one of the largest hospitals in Davao City. When the doctor told him that his foot had to be amputated, he was totally unprepared for what he heard. He went home and refused to see any other healthcare providers.
As expected, the wound worsened, that even neighbors could already smell the foul odor. They complained to their barangay captain, who approached Dr. Isagani Braganza for help.
Dr. Braganza is a physician who is involved in an innovative project initiated by Handicap International, which is implemented in collaboration with local health authorities and supported by the World Diabetes Foundation (whose story of Rommel was featured on its website).
Rommel has no other choice but to see Dr. Braganza. When he came to the consulting room at the Jacinto Health Center, the doctor welcomed him. After removing his tennis shoe and sock, the doctor saw a swollen ankle and a foot with a missing second toe.
All over the world, diabetes is fast becoming a threat to public health. In the Philippines, diabetes is now the eighth leading cause of mortality, according to a handout circulated by The Diabetes Store. About 500 Filipinos are added to the demographic daily.
Unlocking cures for diabetes (First of Two Parts). Unknowingly, diabetes has exceeded projected rates worldwide. In 2000, the International Diabetes Federation estimated about 320 million diabetics globally by 2025. But even before that forecasted year, there were already 415 million diabetics in 2015.Unlocking cures for diabetes (First of Two Parts)Unknowingly, diabetes has exceeded projected rates worldwide. In 2000, the International Diabetes Federation estimated about 320 million diabetics globally by 2025. But even before that forecasted year, there were already 415 million diabetics in 2015.
Considered before as a “disease of affluence,” diabetes is now taking its place as one of the main threats to human health in the 21st century. “Diabetes is going to be the biggest epidemic in human history,” warns Dr. Paul Zimmet, director of the International Diabetes Institute in Victoria, Australia.
In the Philippines, the number of people with diabetes is expected to double by 2030, according to the World Health Organization (WHO). The Philippine Center for Diabetes Education Foundation, Inc. discloses that 50% of those suffering from diabetes do not know they have the disease.
As a result, “many patients die because it is already too late to remedy the situation,” to quote the words of Dr. Ricardo Fernando, director of the Institute for Studies and Diabetes Foundation in the Philippines.
Diabetes, as defined by the Merck Manual of Medical Information, is “a disorder in which blood sugar (glucose) levels are abnormally high because the body does not produce enough insulin.”
Insulin is the hormone released from the pancreas. “Insulin controls the amount of sugar in the blood,” the Merck manual notes. “When a person eats or drinks, food is broken down into materials, including sugar, that the body needs to function.
“Sugar is absorbed into the bloodstream and stimulates the pancreas to produce insulin. Insulin allows sugar to move from the blood into the cells. Once inside the cells, sugar is converted to energy, which is either used immediately or stored until it is needed.”
The levels of sugar in our blood vary normally throughout the day. “They rise after a meal and return to normal within about 2 hours after eating,” the Merck manual informs. “Once the levels of sugar in the blood return to normal, insulin production decreases.”
“But with diabetes, something goes awry,” says The Doctors Book of Home Remedies. “The pancreas becomes irresponsible. It either stops producing the hormone completely or else produces too much, which leads to insulin resistance. Either way, concentration of sugar in the blood shoots sky-high.”
Actually, there are two types of diabetes. Type 1 (formerly called insulin-dependent diabetes or juvenile-onset diabetes) occurs in only 10-15% of all cases and tends to occur in people under the age of 30.
“Type 1, characterized by little to no insulin production due to the destruction of the insulin-producing beta cells of the pancreas by the immune system, results in an inability to process sugar from the bloodstream,” explains Dr. Portia Mahal G. Sabido of the University of the Philippines at Diliman.
Type 2 (called previously as non-insulin-dependent diabetes or adult-onset diabetes) is the most common form; it accounts for about 90% of all cases. “In type 2 diabetes, there is production of insulin: however, the cells cannot use it effectively due to abnormalities in both insulin secretion and action,” Dr. Sabido points out.
While Type 1 is somewhat hereditary in nature, Type 2 is considered a lifestyle disease. “Type 2 is often the result of poor lifestyle choices or genetic influence and is especially common among the aging population and those with unhealthy diets, obesity, and sedentary lifestyles,” Dr. Sabido writes in a paper published by the Department of Science and Technology (DOST).
Dr. Edgardo E. Tulin of the Visayas State University considered Type 2 diabetes as “the most prevalent form of diabetes affecting 90% to 95% of diabetics worldwide.” In fact, in the Philippines, “about 95% of Filipino diabetics have Type 2 diabetes,” disclosed Dr. Irene M. Villaseñor and Juane Marco B. Gonzales, authors of another DOST paper.
As 3.56% of Filipinos were diagnosed with diabetes in 2000, the disease is indeed common. “Beyond its prevalence, its complications add to its complexity,” pointed out Dr. Jose V. Nevada, a medical doctor who is with the University of the Philippines at Los Baños. “From people having their feet amputated, to those who become blind; from patients undergoing dialysis to those who have had heart attacks or strokes – these horror medical stories are real. The medical cost of diabetes is expensive; and the loss of lives, enormous.”
The United Nations health agency agrees. “Because of its chronic nature, the severity of its complications and the means required to control them, diabetes is a costly disease, not only for the affected individual and his/her family, but also for the health authorities,” the WHO says.
Direct costs to individuals and their families include medical care, drugs, insulin, and other supplies. Patients may also have to bear other personal costs, such as increased payments for health, life, and automobile insurance.
“With continued rise of diabetes incidence, there is an urgent need to develop more alternative yet effective anti-diabetic drugs for Filipinos especially those who do not make ends meet,” wrote Villaseñor and Gonzales. (To be concluded)