Indonesia is witnessing a concerning surge in type 1 diabetes mellitus (DM) among children, prompting urgent calls for improved access to healthcare services and early screening measures.
According to data from the Indonesian Pediatrician Association (IDAI), the prevalence of type 1 DM in children reached two cases per 100,000 people in January 2023—a staggering 70-fold increase compared to 2010. Over the past decade, the total number of pediatric type 1 diabetes cases has climbed to 1,948.
“Children can develop diabetes mellitus, and the most commonly diagnosed form is type 1 DM, characterized by an insulin deficiency,” explained Dr. Nur Rochmah, Sp.A, Subsp. Endo(K), from IDAI’s Endocrinology Coordination Unit, during a seminar on diabetes management in children.
Dr. Nur highlighted a troubling trend: many cases are only detected when children present with severe complications. This delay in diagnosis contributes to the rising number of cases and worsens outcomes. She stressed the critical importance of parents recognizing early symptoms so that children and adolescents with type 1 DM can lead longer, healthier lives.
Historical data paints a stark picture. The incidence of type 1 DM among Indonesian children rose from 3.88 per 100,000 in 2000 to 28.19 per 100,000 in 2010. Recent figures indicate the situation is escalating: 584 new cases were recorded in 2022, followed by 594 in 2023, totaling 1,178. In 2024, an additional 527 cases were reported, bringing the cumulative count to 1,948.
Gender distribution shows a slight skew, with 58% of cases occurring in girls and 42% in boys.
Despite these alarming statistics, many cases remain undiagnosed or are misdiagnosed. Dr. Piprim Basarah Yanuarso, Head of IDAI, emphasized that numerous children are only diagnosed after experiencing life-threatening conditions such as diabetic ketoacidosis-induced coma.
“Screening is vital for early detection. Often, children are only diagnosed in critical condition, which could have been prevented with better awareness and healthcare services,” Dr. Piprim said.
Type 1 DM predominantly affects children aged 7 to 12, but type 2 diabetes is also increasingly affecting younger populations. The primary cause of type 1 DM is the pancreas’s inability to produce sufficient insulin—a hormone essential for transporting glucose into the body’s cells for energy.
Without insulin, glucose accumulates in the bloodstream, leading to severe health complications. The exact cause remains unknown, though autoimmune reactions that attack insulin-producing cells are a leading theory.
Common symptoms in children include excessive thirst and hunger, frequent urination, and unexplained weight loss despite increased food intake. “We need to be vigilant for these warning signs. Blood sugar levels above 200 mg/dL in symptomatic children should trigger immediate medical attention,” Dr. Nur advised.
For children diagnosed with type 1 DM, lifelong insulin therapy is non-negotiable. Consequently, equitable access to diabetes care, especially in remote and underserved regions, is essential.
Dr. Nur further emphasized the need for collaborative efforts involving the government, healthcare providers, communities, and families to curb the rising morbidity and mortality rates associated with childhood diabetes.
Such efforts, she suggested, should include widespread public education campaigns, routine blood sugar screenings, and the promotion of healthy lifestyles to prevent and manage diabetes more effectively.
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