00:00More than 279 million adults across Southeast Asia, including millions of Filipinos, are living with diabetes, many of them unaware they're already in the thick of it due to late diagnosis.
00:14Here in the Philippines, rising cases continue to be a wake-up call as unhealthy diets and limited screening put more families on thin ice.
00:22Our country is likewise integrating these measures into its primary health care system to improve long-term management.
00:30Governments, health workers and communities are urged to double down on efforts so patients are no longer left in the dark when it comes to diabetes care.
00:42And to tell us more about the growing threat of diabetes in the Philippines and the region,
00:46we have with us tonight Dr. Monica Therese Katting-Cabral, endocrinologist and current treasurer of the Philippine College of Endocrinology, Diabetes and Metabolism via Zoom.
00:57Good evening. Good evening, Doc. I'm Sharm Suspita from PTV News tonight.
01:01Thank you for joining us on Interface.
01:04All right, Doc, let's get right down to it.
01:07How alarming or how dangerous is the current rise of diabetes cases in the Philippines and which age groups are most at risk?
01:14What are these statistics and numbers on these?
01:16Well, right now we're looking at about 5 million Filipinos who are diagnosed with diabetes,
01:25but there can actually be about another 15 million who are diagnosed with pre-diabetes.
01:32And that's where the pre-diabetes comes from.
01:34You know, it starts somewhere.
01:36And these numbers have been increasing over the past years.
01:39If you look at our national surveys, it's going from 3 to 5 to now 8 percent.
01:45And the numbers are just really going to start rising.
01:48And we're seeing diabetes more in younger individuals as well.
01:52Okay, Doc, what are the early warning signs of diabetes that Filipinos often can overlook or misinterpret?
02:00What are the things that we need to look out for?
02:01Actually, with diabetes, unless you have really bad complications, you don't feel anything.
02:09So it's kind of like a silent disease.
02:11But once you start seeing patients, you know, who have unexplained weight loss, they're always hungry, they keep eating, but they're still losing weight.
02:20They're very thirsty and they're peeing a lot.
02:22Those are some of the signs that can indicate that you have uncontrolled diabetes.
02:26But most of the time, you don't feel anything and you don't present with anything.
02:31So it's really important to get screened to see your doctor and get tested for diabetes if you are at risk.
02:39So, Doc, the usual, you know, yearly screenings or every six months, you know, to get your blood test, that would be very helpful for early diagnosis, right?
02:48Definitely. So we recommend that if you're 35 years or older, to start getting tested annually.
02:57And if it's normal for like one, two, three years, maybe every three years.
03:01But you should get tested earlier, even if you're younger than 35.
03:05If you have a strong family history of diabetes, like your parents and siblings have diabetes as well.
03:11If you yourself are overweight or obese.
03:13If you are a woman of childbearing age and you've had gestational diabetes, or if you've had a baby who was born 8 or 10 pounds heavy,
03:25because that's not the usual weight for Filipino babies.
03:28So these are the risk factors really that we should be looking at.
03:32And these are the patients who should be screened earlier than 35 years old.
03:36Okay, why do many patients, though, remain undiagnosed or untreated?
03:42And what are the barriers in our health system that can contribute to this gap?
03:49So number one, you don't feel anything most of the time.
03:52And lack of awareness.
03:54Other areas in our country, you really, they don't have good access to health care.
03:59And that's one of the limitations really in getting tested.
04:02Another thing is the cost of getting tested.
04:05These lab tests aren't cheap.
04:07And medications themselves are also expensive.
04:10So sometimes, you know, if you're given a choice between putting food on the table or taking medications,
04:15you'd rather put food on the table.
04:17Right.
04:18But in the long run, how can families help support their children, pregnant women and older adults,
04:25in managing diabetes across the different stages of life?
04:31So you mentioned pregnant women and children.
04:33It really needs to start when pregnancy, preconception.
04:37If you are at risk for diabetes, get checked.
04:40Women who are pregnant should be checked for diabetes, screened with something called a 75-gram oral glucose tolerance test
04:47in the first trimester during their first prenatal visit.
04:50And if it's negative, it's repeated around 24 to 26 weeks.
04:53Once these babies are born, you know, cute babies, sometimes we make them, you know, really chubby and fat, you know,
05:01because fat babies are cute.
05:03But unfortunately, fat adults are not.
05:06So let's try and not, you know, make our children unhealthy by giving them unhealthy food choices.
05:12So at home, if someone is dealing with diabetes, a person living with diabetes will have it very difficult to control their diet
05:20and stick to their lifestyle changes if the whole family is not involved as well.
05:25So good family support from all ages.
05:29So basically, go see your doctor.
05:53If you have healthy food choices, follow our pingang, pinoy, the way we, you know, divide our plate up into carbohydrates and vegetables and proteins.
06:05Stay active.
06:06Try to exercise, you know, 30 minutes a week, 30 minutes a day, at least five days a week.
06:10And of course, take your medicines properly as prescribed by your doctor.
06:16Doc, very, very interesting because you led into my next question.
06:20You talked about how families can help support those with diabetes and being able to manage these risks and help be able to live a healthier lifestyle.
06:29But what exactly are these lifestyle changes?
06:32And we're talking about realistic, doable and everyday habits for Filipinos, which can significantly reduce the risk of type 2 diabetes down the line.
06:43Definitely.
06:44So one of the things that we cut out in our diet are sugary drinks.
06:48So I'm talking about sodas, iced tea, energy drinks, milk tea, even flavored coffees, and juice.
06:56These are sugar-sweetened or natural sugar-sweetened beverages that add up in terms of calories and increase your blood sugar levels very quickly.
07:06So that's one thing that you can actually cut out.
07:08Water is still the best.
07:10And buco water is not water, it's juice.
07:12Another thing that we can think about is, you know, you don't really have to avoid things like rice, for instance.
07:19Rice is not the enemy.
07:20It's just the amount of rice that we're consuming.
07:23So if you usually eat, you know, 4 or 6 cups of rice a day, cut it down into half, you're still going to get your rice, but at least you can limit that.
07:32The other thing is fruit.
07:33I know fruit is healthy, but it should also be limited to 3 servings per day.
07:38Basically, what fits in your hand, you know, nothing that's too high, just something that, you know, fits in the palm of your hand.
07:44And it should be eaten as dessert.
07:46So little things, little changes can be made that can be, you know, more acceptable and are easier to do.
07:53And, of course, eating things like processed foods, junk food, and fast food, those should be reserved as, you know, special treats.
07:59But don't let yourself have, like, a total cheat day or a cheat weekend because you could really destroy all the progress that you've made of having a good week if you have a whole cheat weekend.
08:11Doc, very interestingly, you know, I think that it is the habit of always being fatigued or being stressed or lack of sleep that a lot of people don't really pay attention to.
08:23I'd like to know, is this a huge contributor of any to being a diabetes risk?
08:28And if so, how?
08:29It definitely is.
08:32So when you have stressors like not sleeping, stress at work, stress at home, and stress with family, even going through traffic, really, that can increase a hormone in the body called cortisol.
08:43And cortisol can really contribute as well to increased blood sugar levels.
08:47So trying to manage stress, trying to find ways to relax, taking care of your mental health, these are also things that can help reduce the risk of diabetes getting worse and the complications that could follow.
08:59Okay, thank you so much for your time, Dr. Monica Therese-Cateng Cabral, thank you for the information.
09:07Thank you very much. Good evening.
09:08Good evening.
09:08Good evening.
09:08Good evening.
09:09Good evening.
