Things to know about diabetes

Diabetes is the fourth leading cause of death in the Philippines in 2023, killing 37,633 Filipinos, as reported by the Philippine Statistics Authority (PSA). 

In 2021, the International Diabetes Federation (IDF) reported that 1 in 15 adult Filipinos has it, comprising about 4 million adults. 

This Diabetes Awareness Week, here’s what you need to know about this killer disease. 

What is diabetes?

The World Health Organization (WHO) describes diabetes mellitus (more commonly known as diabetes) as a chronic, metabolic disease caused by the pancreas not producing enough insulin or the body not being able to use this insulin. 

Insulin, according to the WHO, is a hormone that regulates blood sugar. The insufficient or inefficient use of this hormone can lead to a build-up of sugar in the blood. 

In 2021, the IDF reported in their 10th Diabetes Atlas that 537 million adults were living with diabetes around the world, with over 3 in 4 adults living in low- and middle-income countries like the Philippines. 

“Limited resources in food choice, tendency toward obesity and physical inactivity, and detrimental psychosocial pressures, such as occupational stress and lack of social support, are often found to be unfavorable intermediate factors inherent in disadvantaged economic situations and serve as a link to the high incidence of diabetes,” a 2012 study of the American Diabetes Association found.  

What are the types of diabetes?

There are two main types of diabetes: type 1 and type 2.

Type 1 diabetes happens when the immune system attacks the insulin-producing cells found in the pancreas, according to Diabetes UK. While less prevalent than the other type of diabetes, 9 million people were still living with type 1 diabetes in 2017, according to WHO reports.

At least 96% of people with diabetes fall under type 2, based on the Global Burden of Disease Study 2021 Diabetes Collaborators’ study. This type of diabetes stops the body from properly using the insulin it produces. 

Other types of diabetes include gestational diabetes which occurs during pregnancy when blood sugar levels are above normal but below those diagnosed with diabetes. Meanwhile, impaired glucose tolerance (IGT) and impaired fasting glycaemia (IFT) are “intermediate conditions in the transition between normality and diabetes.” 

The Department of Health (DOH) identified the following factors that can contribute to the development of type 2 diabetes: 

• high blood pressure
• high levels of fat in the blood
• history of diabetes during pregnancy
• high fat diet
• high alcohol intake
• lack of exercise
• obesity or overweight
• genetic factors
• increasing age

But studies show that people of normal weight can still develop the disease. The 2024 National Diabetes Statistics Report of the Centers for Disease Control and Prevention states that 10.2% of diabetes patients in the US were not overweight or obese. 

What are the symptoms and how is it diagnosed?

Diabetes symptoms are often mild and manifest years after the disease’s onset, according to the WHO. The DOH identifies these symptoms as the following:

• being very tired
• unexplained weight loss
• being very thirsty
• urinating more often
• excessive eating
• poor wound healing
• blurry eyesight
• frequent infections (e.g., urinary tract infection, yeast infections)
• irritability

WHO urges early diagnosis. Regular check-ups and blood tests with a healthcare provider are recommended. 

While type 1 diabetes cannot currently be prevented, type 2 diabetes can.

The DOH says that “healthy habits” can help reduce the risk of diabetes, such as maintaining a healthy diet, exercising regularly, and avoiding smoking and drinking alcohol.

What can happen if you have diabetes? 

If not managed, diabetes can result in complications. According to Diabetes UK, there are two types of diabetes complications: chronic complications that build up over time, and acute complications that can happen at any time. 

Chronic complications include:

• eye problems 
• foot problems
• heart attack and stroke
• kidney problems 
• nerve damage 
• gum disease and other mouth problems
• related conditions, like cancer 
• sexual problems

Acute complications include:

• hypos (or when your blood sugars are too low)
• hypers (or when your blood sugars are too high)
• hyperosmolar hyperglycaemic state, a life-threatening emergency brought on by severe dehydration and very high blood sugars
• diabetic ketoacidosis, a life-threatening emergency where the lack of insulin and high blood sugars leads to a build-up of ketones, a kind of chemical that the liver produces when it “breaks down fats.” Low levels of ketones are therefore ideal.

How is diabetes treated

Diabetes UK says there is no existing cure for diabetes. It can be managed thorugh monitoring and treatment of complications, according to WHO. But the disease can go into remission, or “the body does not show any signs of diabetes, although the disease is technically still present.”

The DOH says that the goal for treatment should focus on keeping blood glucose amounts at normal levels (READ: Diabetes is not a life sentence: How Filipinos can manage the ‘lifestyle disease’ from home). 

Other things that could be done, according to DOH: 

• testing blood sugar levels regularly
• regular follow-up with healthcare provider
• having a balanced diet
• exercising regularly
• maintaining a healthy weight
• stopping cigarette smoking 
• medications for those who need to control their glucose levels, such as metformin and insulin

Government aid

While Filipinos do face high costs for non-communicable diseases like diabetes, the government provides several programs to help unburden patients.

According to the DOH’s FAQ page, it has been offering an Insulin Access Program under the Medicine Access Program since 2009. The program partners with pharmaceutical companies to provide affordable insulin at 22 access sites nationwide.

The Philippine Health Insurance Corporation (PhilHealth) also has benefits for diabetes, including coverage for hospitalization and Konsulta packages for diabetes confirmatory tests and selected medications. 

Patients may also avail of other medical assistance programs offered by different government agencies depending on their eligibility. These include the Department of Social Welfare and Development’s Assistance to Individuals in Crisis, the Office of the Vice President’s medical assistance program, and the Philippine Charity Sweepstakes Office. – Shay Du/Rappler.com

Shay Du is a Rappler intern. She is an incoming fourth-year mass communication student at Silliman University.