by Henrylito D. Tacio
WHAT do pop singer Gary Valenciano and movie and television actor Subas Herrero, have one thing in common? Both are a diabetic, that’s what. Diagnosed more than two decades ago, Valenciano – who has juvenile diabetes — injects himself with insulin, watches what he eats, and checks the sugar level in his system. “I’ve had many close calls,” he told a news magazine.
During one recent attack, his wife Angeli was roused from sleep by his spasms. He was unconscious and minutes away from going into a coma. Instant glucose she carries with her saved him. “Diabetics should never be alone,” he declares.
Herrero, on the other hand, has late onset diabetes. As such, he doesn’t have to take insulin. “I exercise, control my diet and take some oral antidiabetic medications,” he wrote in a national daily. “I have also lost a lot of weight. In my early or mid-30s, I even reached 330 pounds or a whooping 150 kilograms. A crime, really. But I have been losing weight steadily, by design. Through my own efforts and guided by my nutritionist, I have been able to lose weight.”
The World Health Organization (WHO) estimates that 177 million people worldwide have diabetes, a figure that’s expected to surpass 300 million by 2025. Dr. Paul Zimmet, director of the International Diabetes Institute (IDI) in Victoria, Australia, predicts that diabetes “is going to be the biggest epidemic in human history.”
The disease is spreading more rapidly in Asia than anywhere else. In the Philippines, for instance, there are about four million diabetics, with more than three million not knowing they have it. Out of the one million who know they have the disease, only 200,000 are undergoing treatment.
“There’s a potential time bomb here in numbers of people who are going to develop the complications of diabetes,” points out an official of the Novo Nordisk, a diabetes care company. “Only a few are diagnosed and treated due to inaccessibility to health care and medication, lack of government spending on health care, meaning patients have to provide for their own medication and education. But even in countries where there’s free medication and access to health care, the control of diabetes is not a lot better than in the Philippines because something is wrong in the education aspect.”
Diabetes mellitus (its complete name) is a chronic, debilitating and often deadly disease that affects how the body turns food into energy. Normally, the food we eat is converted into glucose and used or stored by the body with little problems. Circulating insulin hormone stimulates the uptake of sugar by the body’s cells. But with diabetes something goes awry. The pancreas, which is the organ responsible for producing insulin, becomes irresponsible.
There are two main types of diabetes – Type 1 and Type 2. In the less common Type 1, the body produces little to no insulin. In Type 2, which affects 90 to 95 percent of people with the disease, the cells begin to
resist insulin and the body stops producing enough of it.
Unlike certain crippling diseases, which attack without warning, diabetes sends out warnings by displaying symptoms. Medical scientists list the following: frequent urination and great thirst; weight loss and extreme hunger; weakness and tiredness; and skin problems. Other symptoms include nausea and vomiting, blurred vision, drowsiness, cramps or numbness in the toes and fingers, and abdominal pain.
“Many Filipinos simply don’t know they have the disease,” says Dr. Augusto Litonjua, one of the country’s leading experts on diabetes. “We cannot win the war against diabetes if we do not know the enemy,” says the Philippine Center for Diabetes Education Foundation (PCDEF) in a statement. “Get to know about the disease.”
For instance, diabetes tends to run in the family. “Diabetes is a hereditary disease passed on from generation to generation,” said Dr. Alberto Romualdez, when he was still the health secretary. “When there is a diabetic in the family, no matter how distant a relative the patient is, the characteristic is still passed on through the genes. If both parents have diabetes, the offspring’s chance of developing the disease is greater.
It is very important therefore that everyone in a family with a diabetic member must prepare early to prevent the onset of the disease.”
Other predisposing factors include age and weight. Most diabetics discover the disease when they are past 40. On the other hand, three out of four diabetics are overweight. “Obesity is a risk factor for diabetes,” points out Dr Gauden Galea, of the WHO regional office in Manila. “Fat also makes the control of blood glucose more difficult, causing lowered responsiveness to insulin.”
If not managed properly, diabetes can lead to many other complications. Among these are coronary heart disease, kidney failure, eye problems including blindness, neuropathy and impaired circulation of the feet which could lead to gangrene development and amputation of the leg.
“Diabetes is a very expensive disease,” Dr. Romualdez said. “It affects all tissues and organs of the body. There is no known cure. Once a person is diagnosed a diabetic, he or she will be on medications for the rest of his or her life and will die a diabetic.”
About 40% of diabetes sufferers require oral agents for satisfactory blood glucose control, and some 40% need insulin injections. This hormone was isolated by Frederic Banting and Charles Best in 1921 in Canada. It revolutionized the treatment of diabetes and prevention of its complications, transforming Type 1 diabetes from a fatal disease to one in which long-term survival became achievable.
People with Type 1 diabetes are usually totally dependent on insulin injections for survival. Such people require daily administration of insulin. The majority of people suffering from diabetes have the Type 2
form. Although they do not depend on insulin for survival, about one third of sufferers needs insulin for reducing their blood glucose levels. – ###