When ‘I feel fine’ is not enough
Modern diabetes care is not only about lowering sugar; it also protects the heart, kidneys, eyes and overall quality of life.
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Modern diabetes care is not only about lowering sugar; it also protects the heart, kidneys, eyes and overall quality of life.
Managing diabetes starts with awareness, understanding and action.
But I feel fine, Doc.”
I often hear this after telling a patient that a routine blood test shows diabetes. There may have been no unusual thirst, frequent urination, weight loss or blurred vision — only a glucose result that was easy to dismiss. This is what makes diabetes dangerous: It can quietly damage the body for years before a person feels ill.
Diabetes mellitus is a condition in which glucose builds up in the blood. After we eat, food is broken down into glucose, which the body uses for energy. The pancreas releases insulin to help glucose enter the cells. Diabetes develops when the pancreas makes little or no insulin, or when the body cannot use insulin effectively — a condition called insulin resistance.
The numbers continue to rise. The International Diabetes Federation estimates that 589 million adults worldwide — about one in nine — were living with diabetes in 2024. By 2050, this may reach 853 million, or one in eight adults. Many remain undiagnosed.
There are two main types of diabetes. Type 1 diabetes occurs when the immune system destroys the insulin-producing cells of the pancreas. It can develop at any age and requires injecting insulin for survival. Type 2 diabetes, the most common form, is usually linked to insulin resistance and a combination of genetic and lifestyle factors. Another type is gestational diabetes which is first diagnosed during pregnancy and increases the future risk of type 2 diabetes for both mother and child.
Diabetes is not caused simply by eating sweets or rice. Family history, age, excess weight, inactivity, previous gestational diabetes, polycystic ovary syndrome, high blood pressure and abnormal cholesterol levels can all raise risk. A person who looks thin can still develop diabetes, while someone with obesity does not inevitably have it.
Testing matters because symptoms may appear late. Diabetes may be diagnosed with a fasting plasma glucose of 126 mg/dL or higher, an HbA1c of 6.5 percent or higher, or a two-hour glucose of 200 mg/dL or higher during an oral glucose tolerance test. A random plasma glucose of 200 mg/dL or higher in someone with classic symptoms can also establish the diagnosis. Without clear symptoms, an abnormal result usually needs confirmation on another day.
There is also a stage before diabetes. Prediabetes — an HbA1c of 5.7 percent to 6.4 percent or fasting glucose of 100 to 125 mg/dL – is not “borderline” enough to ignore. It is an early warning and an opportunity to act through weight management, regular physical activity, better food choices, adequate sleep and, for selected patients, medication.
When diabetes is untreated or poorly controlled, high glucose can injure blood vessels and nerves. Over time, this increases the risk of heart attack, stroke, kidney disease, blindness, numbness or pain in the feet, infections and amputations. The encouraging news is that early diagnosis and proper treatment can greatly reduce these risks. Modern diabetes care is not only about lowering sugar; it also protects the heart, kidneys, eyes and overall quality of life.
Be cautious of milk powders, supplements and “natural cures” promoted online, especially advertisements that use a doctor’s name or image without consent. Diabetes has no instant cure. Treatment should be individualized and may include nutrition, exercise, tablets, injectable medicines or insulin. Needing insulin is not a failure, and it does not automatically mean a person has type 1 diabetes.
If you are 40 or older — or younger with risk factors — ask your doctor when you should be screened. Do not wait for symptoms. A simple blood test today may prevent complications years from now.
Diabetes Awareness Week is observed in the Philippines during the fourth week of July. This year’s theme is “Hawak Kamay Nating Tugunan ang Hamon ng Diabetes.” For reliable information on diabetes and other hormone conditions, visit the Philippine College of Endocrinology, Diabetes and Metabolism (PCEDM) at https://endo-society.org.ph. PCEDM can also be found on social media sites such as Facebook, X and TikTok.
