As an endocrinologist, I see patients with hormonal problems, most of whom have diabetes mellitus. Diabetes is a condition where patients have high blood glucose levels.

It is estimated that one out of 14 adult Filipinos have diabetes, and the number is quickly growing all over the world. The International Diabetes Federation (IDF) projects that by 2045, one in eight adults will have diabetes, approximately 783 million persons worldwide.

The complications of diabetes include heart attack and stroke, vision problems, kidney disease, issues with digestion, nerve damage causing numbness or pain in the hands and feet, hearing impairment, dementia and depression.

A common misconception is that diabetes only develops if you eat sweets or too much rice. All food is broken down eventually into glucose, the form of energy that the body can readily use. After we eat, the glucose level in our body rises and the pancreas produces insulin, a hormone that helps glucose enter the cells where it can be stored and used, and glucose levels in the blood return to normal. Diabetes occurs when the pancreas cannot make enough insulin or when the body cannot use insulin properly, a condition called insulin resistance.

The main types of diabetes include type 1 diabetes mellitus (T1DM), where the pancreas cannot make any insulin. While typically seen in children, it can also occur at a later age and can only be treated with insulin injections. Type 2 diabetes mellitus (T2DM) accounts for around 90 percent of all diabetes cases and is the result of long-standing insulin resistance. Treatment includes developing a healthy lifestyle, exercise and a proper diet, and the use of oral medications or insulin. Oral medications and insulin can also be combined to treat T2DM. Being on insulin does not mean you have T1DM, but that the oral medications are not enough or are not the right medication for your situation.

Symptoms of diabetes can include increased thirst, frequent urination, weight loss despite an increased appetite, blurring of vision, fatigue, irritability, lightheadedness and frequent skin or urinary tract infections. Many, however, do not have any symptoms initially, but may develop them depending on their glucose levels.

The diagnosis of diabetes is made if a blood test after an overnight fast of at least eight but not more 12 hours shows a plasma glucose level of >126 mg/dL, or if a random plasma glucose level taken at any time of the day is >200 mg/dL in a patient who has symptoms, or if during an Oral Glucose Tolerance Test (OGTT) where after an overnight fast you are given a drink with 75 grams of glucose and a plasma glucose measured after two hours is >200 mg/dL. In patients without symptoms, these tests should be repeated in two weeks to confirm the diagnosis.

All patients should be assessed for diabetes at least annually. All Filipino adults >40 years old should be tested, or even earlier or at any age if with any of the following: strong family history of diabetes, previous abnormal glucose levels, are overweight or obese, previous gestational diabetes, polycystic ovary syndrome (PCOS), hypertension, abnormal cholesterol levels, previous heart attack or stroke, or a sedentary lifestyle.