Text and Photos by Henrylito D. Tacio
Additional Photo: IDF
Unlike in the past, the country is now living at a time where diabetes seems to be the norm. Ask someone you know, and he or a member of his family is having this chronic disease.
“We live in an age so conducive for developing diabetes,” says Dr. Joy Arabelle Fontanilla, section chief of Endocrinology at Asian Hospital and Medical Center. “Though diabetes is not spread by contagion, its breeding grounds are ubiquitous nonetheless.”
Diabetes has something to do with the pancreas, about six inches long, and sits across the back of the abdomen, behind the stomach. It plays an important role in converting the food you eat into fuel for the body’s cells.
Diabetes happens when the pancreas does not produce enough insulin or when the body cannot effectively use the insulin it produces. Insulin is a hormone that regulates blood sugar.
“Uncontrolled diabetes leads to serious complications such as stroke, heart attack, end-stage kidney disease, blindness, and lower limb amputation, among others,” says the Department of Health (DOH).
The number of people with diabetes rose from 108 million in 1980 to 422 million in 2014, according to the Geneva-based World Health Organization (WHO). Prevalence has been rising more rapidly in low- and middle-income countries than in high-income countries.
In the Philippines, diabetes is the sixth leading cause of death, the health department states. The number of people with diabetes has considerably increased: from 3.4 million in 2010 to 3.7 million in 2017. “Each day, there at least 100 deaths due to diabetes-related acute or chronic complications,” a study reported.
Among the 770 people with diabetes coming from general hospitals, diabetes clinics, and referral clinics, who were included in a survey conducted in 2008, it was found that 85% of them had uncontrolled diabetes, and almost all (99%) had cardiovascular complications. Foot problems (82%), kidney diseases (81%), neuropathy (67%), and eye difficulties (62%) were the other complications reported.
Actually, there are two general types of diabetes. Type 2, formerly known as non-insulin-dependent, is the most common form; more than 95% of people with diabetes have this type.
“Type 2 diabetes results from the body’s ineffective use of insulin,” the United Nations health agency explains. “This type of diabetes is largely the result of excess body weight and physical inactivity.”
Type 2 diabetes is also used to be called adult-onset diabetes. But later on, it was found that this type also affects children and teenagers, mainly because of childhood obesity. In the Philippines, “children as young as five years old have been diagnosed with diabetes,” says the Philippine Diabetes Association.
“If you have type 2 diabetes, cells don’t respond normally to insulin; this is called insulin resistance,” the US Centers for Disease Control and Prevention (CDC) explains. “Your pancreas makes more insulin to try to get cells to respond. Eventually, your pancreas can’t keep up, and your blood sugar rises, setting the stage for prediabetes and type 2 diabetes.”
More often than not, symptoms of type 2 diabetes develop over several years and can go for a long time without being noticed (in some instances, there aren’t any noticeable symptoms at all). So, there are those who may have diabetes already but don’t know they have the disease.
Sofia Evangelista was diagnosed with type 2 diabetes in 2003. “I’ve experienced all the symptoms,” she told beyondtype2.org. “I was always thirsty, frequently using the bathroom, a yeast infection, and my vision blurry. I was also always hungry. I would eat and then an hour or two later, I was hungry again. It was also tough to sleep at night at times.”
Despite all these symptoms, she was still shocked to learn when the doctor diagnosed her of having diabetes. “I didn’t think the symptoms I was experiencing were due to diabetes,” she said. “No one in my family has it, plus, I didn’t think I was doing anything extraordinary to lead me to this kind of illness.”
Filipino medical experts are in unison that type 2 diabetes cases may surge in the coming years. “The high-risk populations for the development of diabetes that we commonly see are those with family history of diabetes, and those who are obese or overweight,” warns Dr. Jocelyn Capuli-Isidro, a consultant endocrinologist at the Makati Medical Center.
“Similarly important are those who are taking medications that can increase blood sugar,” she continues. “Another important risk for diabetes is a history of gestational diabetes which can lead to more than 40% increased risk for having diabetes in the future.”
The most basic risk factors for type 2 diabetes, according to Dr. Capuli-Isidro, are obesity and a family history of diabetes coupled with poor eating habits and a sedentary or inactive lifestyle.
“Westernization plays an important role in the increasing prevalence of diabetes,” Dr. Capuli-Isidro states. “More white-collar jobs are made available, most of them encouraging sedentary lifestyle. Most people, when at work, are just sitting down and are hooked to their computers.”
There are several ways you can prevent developing type 2 diabetes. Dr. Capuli-Isidro shares the following tips:
Go for an active lifestyle: “Physical activities allow us to burn the calories that we take everyday especially if we take more than what we need,” she says, adding that some effective forms of exercise include bicycling, running, swimming, brisk walking, and even climbing up the stairs.
“Children are encouraged to limit their use of electronic gadgets or television viewing to one hour a day only and instead engage in sports such as basketball, volleyball, and swimming for boys or gymnastics for girls,” Dr. Capuli-Isidro says.
Eat proper diet: Eat a high fiber, low calorie, and low-fat diet. Highly recommended are vegetables and fruits. “These are high in vitamins and minerals and high in fibers, which allow us to feel full right away, preventing undue indulgences in food,” says Dr. Capuli-Isidro.
Choose steamed or roasted food over fried ones. “Home-cooked are preferred over foods that we buy from fast-food chains since these are less fatty,” the doctor says. Red meats should be avoided as they “can increase the risk for diabetes by 20%.”
Maintain an ideal body weight: “Overweight and obesity increases the chance of having diabetes in the future,” Dr. Capuli-Isidro says. Overweight is defined by a body mass index (BMI) greater than 25, while obesity relates to a BMI of 30 or above. The BMI is calculated by dividing body weight (in kilograms) by height (in meters) squared. For example, a person who is 1.7 meters tall and weighs 6.5 kilograms would have a BMI of 22.5.
“Maintaining ideal body weight cuts the chance in half,” Dr. Capuli-Isidro says. “If you are obese or overweight, 7% weight loss at a rate of one pound (0.453592 kilogram) weekly is desirable.”
Get enough sleep every day: Just as diabetes can cause sleep problems, sleep problems also appear to play an important role in diabetes. Too little sleep can increase insulin resistance, the CDC claims. It can also make you hungrier the following day and reduce how full you feel after eating.
“Adequate sleep everyday consists of at least eight hours for adults and 12 hours for growing kids,” Dr. Capuli-Isidro says.
Know your family history: A family history of type 2 diabetes is recognized as a significant risk factor of the disease. “If one parent has diabetes, you have a 3.5-fold higher chance of having it, too, more so if both parents are afflicted causing as high as a 7-fold higher risk of diabetes in the future compared to those without family history of diabetes.”
Consult early with the doctor if obese or overweight: An ounce of prevention, so goes a saying, is better than a pound of cure. This is true in the case of type 2 diabetes. Cleveland Clinic says a person who is obese is about six times more likely to develop type 2 diabetes than those at a healthy weight.
“In cases of obese or overweight children or adults, having realized the risk for diabetes in them, early consultation with a specialist is very important,” Dr. Capuli-Isidro says. “They can be given a dietary prescription and/or weight-reducing exercise program to follow. If warranted, they can also be prescribed safe weight-reducing medication that can work effectively with their diets and exercise.”
The health department says screening for diabetes and educating the people on its signs, symptoms, ways to prevent and avoid complications play a great role in addressing the debilitating disease.
“Diabetes keeps on increasing in prevalence, but we shouldn’t give up the fight against the disease,” says Health Secretary Francisco T. Duque III. “It may be chronic and incurable but diabetes can be managed.”