Jakarta – Indonesian endocrinologist Dr. Wirawan Hambali explained the classic symptoms of diabetes mellitus and its potential complications, ranging from acute to chronic, during a media briefing in Jakarta on Thursday.
“The classic symptoms of diabetes are often remembered as the ‘4 Ps’: high blood sugar, unexplained weight loss, excessive thirst, and frequent urination,” Dr. Hambali stated. He explained that the dramatic rise in blood glucose and concurrent weight loss occur because glucose is unable to enter the body’s cells due to a lack of insulin. This cellular starvation then drives individuals with diabetes to overeat.
Dr. Hambali noted that untreated, advanced diabetes can paradoxically lead to weight loss. “We often observe patients who were initially overweight gradually losing weight because glucose isn’t being utilized by the cells,” he said.
Another key symptom is polyphagia, or excessive hunger, resulting from the body’s inability to access energy from glucose. Frequent urination, or polyuria, is similarly characteristic of the disease. Dr. Hambali observed that urine from diabetic patients often attracts ants due to its high sugar content, indicating elevated blood glucose levels being excreted through the kidneys. “The urine of diabetic individuals contains sugar, making it highly osmotic and drawing fluids from the body. That’s why they urinate so frequently,” he explained.
The increased osmotic pressure leads to dehydration and, intense thirst, known as polidipsia.
Dr. Hambali categorized diabetes complications into short-term and long-term effects. Short-term complications stem from rapid and drastic fluctuations in blood sugar, potentially leading to life-threatening conditions like diabetic coma. Long-term complications arise from chronically elevated blood sugar, damaging compact and large blood vessels, as well as affecting non-vascular systems.
Damage to small blood vessels can result in blindness and kidney dysfunction. Large blood vessel damage increases the risk of coronary heart disease and stroke. Long-term non-vascular complications include fatty liver disease and impaired intestinal motility.
According to a study published by PubMed, the prevalence of diabetes in Indonesia is projected to rise from 9.19% in 2020 (18.69 million cases) to 16.09% in 2045 (40.7 million cases). The study suggests interventions could lower this to 15.68% (39.6 million) or even 9.22% (23.2 million) with the addition of risk factor prevention programs. The projected number of deaths due to diabetes is also expected to increase, from 433,752 in 2020 to 944,468 in 2045.
Research from the Faculty of Public Health at the University of Indonesia indicates a strong correlation between central obesity and the incidence of diabetes, with individuals experiencing central obesity having a 2.34 times higher risk of developing the disease.
