Diabetes in the Philippines

Being the most common form of diabetes worldwide, Type 2 diabetes is identified by the body’s resistance to insulin. In other words, the sugars in the bloodstream needed for extra energy are no longer absorbed because the cells think that they have enough sugar to begin with.

As a resort, the pancreas thinks that it didn’t release enough insulin for the body to absorb, causing it to release more insulin- more sugar- into the blood stream whenever food is being digested. The production of excess sugar is called hyperglycemia, and this goes on until the pancreas ultimately exhausts itself, leaving the body to deal with the overwhelming levels of sugar.

Effects of Type 2 Diabetes

Excess blood sugar and poor sugar control affects various systems in the body, mainly cardiovascular, nervous, sensory and excretory functions. Common symptoms of diabetes include frequent urination, hearing impairment, eye damage, kidney failure, neuropathy (nerve damage), high blood pressure, and thirst frequency.

Death is also common from diabetes. In 2010, non-communicable diseases such as diabetes accounted for 309, 000 deaths in the Philippines.

Diabetes and Obesity in the Philippines

As of 2012, 85% of diabetic patients in America were obese. One of the most plausible explanations is the nature of fat cells. Fat cells are there to store extra energy or extra sugar. Since the body already has too much sugar, fat cells keep adding up in the body.

Studies in the Philippines also cite obesity and diabetes as a nationwide problem.

In Asia, India and the Philippines are the third world countries with high levels of obesity and malnutrition. Three out of ten Filipino adults are obese. Children are also at risk: from 1% in 1992 to 5% in 2013, UNICEF cites that the Philippines had an increase in child obesity by as much as 400%.

For children aged five to 10, the prevalence of obesity and overweight was higher at 5.8 percent in 2003 but it went down to five percent in 2013. Among 10 to 19 years old, the prevalence increased by 2.5 points, from 5.8 percent in 2003 to 8.3 percent in 2013.

-Ramirez (Philippine Star), 2015

Considered as one of the 15 emerging hotspots for diabetes, Philippines had over 4 million diagnosed with the disease in 2010- with a low prevalence of type 1 diabetes and an alarmingly high prevalence in type 2 diabetes. The numbers are rising. A literature review conducted in 2015 found that the prevalence of type 2 diabetes among adult Filipino patients nationwide was increasing as of 2008, citing increasing dependence on technology and an unhealthy lifestyle among those of high socioeconomic class as major factors that contribute to the epidemic, along with the disadvantage of having limited medical resources and laboratory funds in the country.

Diabetes is typically diagnosed among patients 20-70 years of age. While the phenomenon of diabetes among children is rare, it has become increasingly prevalent in the Philippines and worldwide along with child obesity.

Recommended Diet for Diabetic Patients

The diet for a type 2 diabetic patient is strict and straightforward to weight loss and maintenance. To be specific, a diet low in carbohydrates and rich in fruits and vegetables is ideal for a diabetic patient. Protein includes chicken and seafood, so beef and dairy products (eggs, milk) are out of the question.

In particular, the Mediterranean diet seems to be a popular choice among nutritionists and researchers when it comes to a healthy diet.

meta-analysis on 215 type 2 diabetic patients in Naples, Italy showed that the Mediterranean diet may decrease chances of having to take medication for sugar maintenance. The study looked into the patients who needed blood sugar medication after following an assigned Mediterranean diet and the prescribed diet from the American Diabetes Association after a certain period of time. It found that 56% who followed the Mediterranean diet did not have to undergo medication for blood sugar while 70% who followed the prescribed diet for the American Diabetic Association had to take necessary medication for their blood sugar.

Overall, a diabetic diet is a healthy diet. The key in cooking a healthy meal lies in baking and grilling. There are less oils used and thus less fat, less stored energy.

Treatment 

Not everyone with diabetes needs insulin shots. It really depends on the patient.

Type 2 diabetic patients don’t need insulin injections. Instead, oral antidiabetics (OAD) are a more favorable option. In Tan’s literature review of diabetes care in the Philippines, he noted that a popular choice of OADs in the Philippine healthcare system for type 2 diabetes is biguanide tablets. Biguanide is used for the body cells to absorb sugar & lessen hyperglycemia. Think of it as a key to a lock the cell has on sugar: the cell’s door needs to be unlocked just for sugar to come in.

The most powerful tool against diabetes is prevention through diagnosis. Early diagnosis is important because when a patient goes on with untreated type 2 diabetes, the body deteriorates faster from the excessive blood sugar. This way, treatment can address the problem early on and lessen the need for maintenance through medication.

However, lack of early diagnosis still remains an issue. In 2014, an estimate of 1.7 million Filipinos with type 2 diabetes remained undiagnosed.

The health of Filipinos is crucial to maintain and balance. The fact that diabetes is on the rise in the country is alarming enough to call for action. It is clear that a change of lifestyle and exposure to exercise is needed among both children and adults alike if chronic noncommunicable diseases are to be prevented as soon as possible.

References

JOURNAL ARTICLES

Tan, G. H. MD. (2015). Diabetes Care in the Philippines. Annals of Global Health. Vol. 81. Num. 6, 2015. [http://www.annalsofglobalhealth.org/article/S2214-9996(15)01264-3/pdf]

International Diabetes Federation. Global diabetes scorecard: Philippines, 2014. [http://www.idf. org/global-diabetes-scorecard/assets/ downloads/Scorecard-29-07-14.pdf]

Azurin, J.C. & colleagues (2013). Diabetes mellitus survey in the Philippines. Philippine Association for the Study of Overweight and Obese. [http://obesity.org.ph/v4/wp-content/uploads/2013/09/Diabetes-Mellitus-Survey-in-the-Philippines.pdf]

Jimeno, C. A., MD & colleagues. (2015). Prevalence of Diabetes Mellitus and Pre-Diabetes in the Philippines: A Sub-study of the 7th National Nutrition and Health Survey (2008). Philippine Journal of Internal Medicine. Vol. 53, Num. 2 April-June, 2015 [http://www.pcp.org.ph/files/PJIM%20Vol53%20No2/Prevalence_of_Diabetes_Mellitus_and_Pre-Diabetes_in_the_Philippines_A_Sub-study_of_the_7th_National_Nutrition_and_Health_Survey_2008.pdf]

Sofi, F., Cesari, F., Abbate, R. Gensini, G.F., Cassini, A. Adherence to Mediterranean diet and health status: meta-analysis. BMJ 2008;337:a1344 [doi:10.1136/bmj.a1344]

Global Reports on Diabetes. World Health Organization. (2016). [http://apps.who.int/iris/bitstream/10665/204871/1/9789241565257_eng.pdf]

ARTICLES

Philippines. International Diabetes Foundation. (2010). [http://www.idf.org/BRIDGES/map/philippines]

Torres, T. (October 20, 2014). PHL leads countries with highest obesity levels. The Philippine Star. [http://www.philstar.com/headlines/2014/10/20/1382165/phl-leads-countries-highest-obesity-levels]

Ramirez, R. (July 2, 2015). Number of obese, overweight Pinoys increasing. The Philippine Star.[http://www.philstar.com/headlines/2015/07/02/1472373/number-obese-overweight-pinoys-increasing]

Powell, A. (March 7, 2012). Obesity? Diabetes? We’ve been set up. Harvard Gazette.  [http://news.harvard.edu/gazette/story/2012/03/the-big-setup/]

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