DIABETES is the fourth leading cause of death in the country. Heart diseases remain the number one cause of death and it is followed by stroke (second) and cancer (third).

Diabetes is the increase of glucose in the blood due to lack of insulin or improper use of it by the body.

The two main risk factors for diabetes are family history and being overweight or obesity. Its incidence among Filipinos increase after the age of 40.

Other risk factors for diabetes include gestational diabetes, polycystic ovarian syndrome, visceral fats or harmful fats in the body (big waist circumference), sedentary lifestyle, increased eating, hypertension, heavy cigarette smoking, darkening of armpits, groin, and neck (signs of insulin resistance), and stress.

Symptoms of diabetes include constant hunger, always thirsty, weight gain, unexplained weight loss, increase in blood pressure, increase in blood sugar, numbness, diziness, lack of energy, lack of interest in sex, blurry vision, frequent urination, and constant infections.

The different parts of the body affected by diabetes are the brain, eyes, heart, kidneys, and nerves it’s a systemic illness characterized by atherosclerosis or aging of the arteries of the body.

In the Philippines, the burden of both diseases is high. The prevalence of diabetes, a chronic, metabolic disorder characterized by hyperglycemia, is about 7.1% in adults between 20-79 years old in 2019.

Data from the DOST-FNRI showed that the prevalence of diabetes in the Philippines increased from 5.6% in 2013 to 8.2% in 2019. Around 14.2% of the population already have prediabetes. Combining the prevalence of diabetes and prediabetes, one out of every five Filipinos have abnormal glucose levels.

According to International Diabetes Federation, the Philippines have 3.9 million total cases of diabetes as of May 2020 which is very alarming. As a chronic illness, diabetes can also bring about an increased risk of developing heart disease and stroke.

Over time , type 2 diabetes can cause serious damage to the body, especially nerves and blood vessels. Type 2 diabetes is often preventable. Factors that contribute to developing type 2 diabetes include being overweight, not getting enough exercise, and genetics.

Overconsumption of refined carbohydrates — i.e., white rice — can raise blood glucose levels and increase the risk of type 2 diabetes. However, qualitative studies have found that Filipinos who reduce white rice intake are socially viewed as rejecting Filipino culture.

Though more dialysis centers will be established in many areas of the country , it’s a sign of the failure of the government to control diabetes and hypertension leading to chronic kidney disease necessitating the more expensive chronic dialysis. There are 4 million dialysis patients in the country. There are many young patients with chronic kidney disease on chronic hemodialysis now thus affecting their productivity and quality of lives.

The health department should be able to prevent the rapid surge of noncommunicable diseases ( NCDs ) which are now at epidemic proportions or we will all be spending a lot on dialysis and other procedures eg coronary angiogram , angioplasty , coronary artery bypass graft , and kidney transplants. The Philhealth is paying a staggering 17 billion a year , a jump of 400 .% from last few years. Although dialysis is often a necessity for patients with these conditions, it can be an incredibly costly procedure.

The cost of dialysis per session ranges between PHP2,000 and PHP5,000 or PHP24,000 to PHP60,000 per month. With an amount of P2,600 per session, PhilHealth shoulders P234,000 for the 90 sessions of each member in the previous years. They pointed out that with the sessions expanded to 156, PhilHealth members can avail themselves of as much as P405,600 per year. This is a sign that we are not focused on the cheaper preventive aspect but rather on the more costly curative but almost a stop gap measure.

PhilHealth members and their qualified dependents diagnosed with chronic kidney disease stage 5 (CKD5) needing hemodialysis as prescribed by their nephrologists may avail themselves of this benefit package. The patient should also be registered in the PhilHealth Dialysis Database prior to availment. Someone who starts dialysis in their late 20s can expect to live for up to 20 years or longer, but adults over 75 may only survive for 2 to 3 years. ( NHS UK ).

Lifestyle modification, balanced diet, exercise and proper medication could help Filipinos avoid having diabetes. We can do this through preventive health education and community leadership through our local government units.

“Apat Dapat” the campaign of the Philippine College of Endocrinology and Metabolism is reminding Filipinos that for treatment of diabetes to succeed, 4 elements have to be met: (1) Ehersisyo (Exercise), (2) Pagkain (Proper diet), (3) Gamot (regular intake of antidiabetes medications/insulin), and (4) Doktor (regular consultations with expert physicians). We need to involve the private sector in this huge endeavor.

We act move beyond the mentality of appearing to be concerned about the rise in diabetes , while lacking the courage to effect substantial change in our government’s health agency to come up with solid programs to reduce the burden by regulating intake of sugar , fats and salts. . If the measures we could adopt now are soft , slow , and directionless , the cost will be all the more heavy the longer we wait.

A common question: what can we, in health care, do about the social determinants of health. The answer is this : a great deal. This will need agile leadership and a coalition of multi sectoral stakeholders. Health care organizations can be active partners to act on social determinants to prevent illness and reduce inequalities.

Ex President Benigno Aquino ( Pnoy ) died from diabetic kidney disease on June 24, 2021, at age 61. For at least five months, Aquino underwent dialysis for his diabetes. GMA NETWORK’s long-time broadcast journalist Miguel ‘Mike’ Enriquez passed away on Tuesday, August 29. Enriquez battled with diabetes, underwent a heart bypass operation in 2018, and a kidney transplant in 2021. He was 71.

They were educated and influential.

But this disease is common among the young and the low to middle income population.

This disease has forced me to change, to talk with people about these huge challenges, and advocate for these poor and less influential patients.

Indeed , health is wealth. An ounce of prevention is better than a pound of cure.

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Anthony C. Leachon, M. D.

Independent Health Reform Advocate

Past President ,
Philippine College of Physicians

Department of Internal Medicine
Manila Doctors Hospital

AUTHOR PROFILE

Dr. Tony Leachon