Do not take diabetes lightly, because this disease can cause complications to various other diseases such as heart, stroke, kidney, eye disorders, and nerves. Chairman of the Indonesian Endocrinology Association (Perkeni) Prof. Dr. dr. Ketut Suastika, SpPD-KEMD, Finasim, revealed that currently 1 in 10 adults in Indonesia suffer from diabetes.

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On November 14, 2024, World Diabetes Day will be celebrated worldwide. Currently, diabetes is still a scary specter, because this disease can cause complications to various other diseases. It is no wonder that diabetes is called the "mother of all diseases."

According to Prof. Ketut Suastika, currently 1 in 10 adults in Indonesia suffer from diabetes. "A rough estimate, out of 270 million people, there are around 100 million who are adults. So, there are 10 million who suffer from diabetes," he said. A number that is not small.

Diabetes, like other diseases, will be better and easier to treat if it is still in the preventive stage. In addition to being easier to treat, the cost is also much cheaper. "We must be concerned with diabetes, because this disease is dangerous and has many complications. Diabetes can increase the risk of death and incur high medical costs. That is why the government is very concerned, because the costs incurred to treat diabetes sufferers are very high," explained Prof. Ketut.

Preventive measures, according to Prof. Ketut, are actually not difficult to do. "Preventive measures that can be taken are avoiding being overweight or obese, implementing a healthy diet and lifestyle, and exercising regularly. Bad habits such as smoking and drinking alcohol should also be avoided. This is a simple way to prevent diabetes," he explained to Edy Suherli, Bambang Eros, and Irfan Meidianto during a visit to the VOI office and was contacted again on Friday, November 22, 2024. At that time, he was in Japan as a guest lecturer. Here is the full excerpt.

We have just celebrated International Diabetes Day, what would you like to convey on this important occasion?

Diabetes is one of the diseases that is greatly influenced by lifestyle. When someone lives a healthy lifestyle, the possibility of getting diabetes is relatively small. Conversely, if someone lives an unhealthy lifestyle, they will be susceptible to diabetes. With the commemoration of International Diabetes Day, it is hoped that the public will be more aware and can take preventive measures against diabetes.

The problem is, if you already have diabetes, it becomes more difficult to treat and can spread (complications) to various other diseases. That's why diabetes is often referred to as the mother of all diseases. From diabetes, complications can spread to other diseases such as heart disease, stroke, kidney disease, eye disorders, nerves, and so on.

Is our society aware of diabetes?

Currently, society is more aware of diabetes. One in 10 adults in Indonesia suffers from diabetes. In addition, 1 in 3 people in Indonesia are in the prediabetes category, which means that their blood sugar has started to increase slowly.

We must care more about diabetes because this disease is very dangerous and has many complications. Diabetes can also increase the risk of death and requires large medical costs. That is why the government cares so much, because the costs incurred to treat diabetes sufferers are very high.

What are the tips to prevent diabetes?

Prevention is aimed at those who have risk factors, it is hoped that by taking preventive measures they will not get diabetes. People who have high risk factors for diabetes are obesity, especially obesity accompanied by high blood pressure, blood fat disorders, hereditary factors from parents, pregnant women who have diabetes, pregnant women whose babies are more than 4 kg, and also those who are over 40 years old. There are also certain areas or tribes that have the habit of partying, they are among those who have high risk factors. So you have to be vigilant.

Preventive measures that can be taken are avoiding obesity, then you have to follow a healthy diet and lifestyle. And don't forget to exercise. Bad habits must be avoided such as smoking and drinking alcohol. That's a simple way to prevent diabetes.

So if we want it, it's not difficult?

Taking preventive measures is not difficult, as long as there is intention, strong will, and discipline. Prevention does not always require a lot of money. However, if you already have diabetes, especially if you have complications, then it will feel more troublesome and cost a lot. Remember, prevention is always better than cure.

Are people also aware of the importance of preventive measures?

Many people are still unaware of the importance of diabetes prevention. Therefore, education such as what we do through this interview is very important. Education must be carried out continuously so that public awareness increases.

Once again, preventive measures are simple and inexpensive: live a healthy lifestyle, eat a balanced diet, and don't forget to exercise.

Diabetes is a disease that falls into the endocrine category. Many people still don't know what endocrine and endocrinology are. Can you explain?

When talking about endocrine diseases, maybe many people don't understand the term. However, if diabetes is mentioned, I'm sure many already know it, or in layman's terms it is called sugar disease. Endocrinology is the science that studies hormones, namely everything related to hormones and metabolism in the body. Examples of the most common diseases are diabetes, thyroid disorders or goiter, blood fat disorders such as cholesterol and triglycerides, obesity, and gout.

There are also endocrine diseases that are rarely found, such as hormonal disorders in the brain, gigantism (a condition where someone becomes very large and tall), and adrenal disorders.

Who can be a member of Perkeni?

Perkeni is not a profession-based association, but based on the same interest in endocrinology. Its members are anyone who has an interest in endocrinology.

So far, many of those who have joined Perkeni are consultants in the field of endocrinology and health workers.

Can this endocrine disease be prevented?

Like diabetes, other diseases in the endocrine category can also be prevented through preventive measures. Especially for diabetes and obesity, the triggers are more likely to come from an unhealthy environment, poor diet, and lack of exercise. However, genetic factors cannot be changed.

What is a healthy diet like?

Simply put, healthy food is a balanced composition, carbohydrates (50%), protein (20%) and fat (30%). Sources of carbohydrates from rice and tubers, while protein can come from meat, fish, eggs, tempeh and tofu. Fat can come from animals and plants. The division on one plate; rice 1/3, side dishes 1/3 and vegetables and fruits 1/3. If this is fulfilled, it is already included in the balanced diet category. If there is milk, that is even better.

Apart from diabetes, what other endocrine diseases are also widely suffered by the community?

Apart from diabetes, the disease that is widely suffered is thyroid disorders or goiter. If symptoms appear, either hypothyroidism or hyperthyroidism, it should be treated immediately by a doctor to minimize the risk of complications.

As we age, the function of organs including endocrine will also decline. Are there any efforts to regenerate so that the endocrine system remains healthy and functions well, such as stem cell procedures that have been popular lately?

It is true that as we age, the function of organs also declines, including hormones produced by the body. Stem cell procedures are thought to be able to regenerate organs, but this method is still being debated in the medical world.

In principle, hormones that do not decrease drastically should not be replaced carelessly. Hormone replacement therapy should only be carried out after it has been proven that the body is lacking certain hormones. You should not carelessly add hormones just to look young, such as adding testosterone or growth hormone without medical indication. However, in certain cases, such as after thyroid removal surgery, patients do need to get hormone intake from outside because their bodies are no longer able to produce these hormones.

Currently, how many endocrinologists are there in Indonesia? Is the ratio sufficient compared to the population?

Currently, the number of endocrinology experts in Indonesia is still very lacking, with a total of less than 300 people. This number is very small compared to the need. In the future, endocrinology specialists will be increasingly needed because patients with endocrine-related diseases, including diabetes, continue to increase.

If the condition is like this, what is the solution in your opinion?

We will run a scholarship program for internal medicine doctors so that they can study diabetes specifically for six months. So, they don't need to study all branches of endocrine disease, but only focus on diabetes. That way, they can become diabetes experts. Why diabetes? Because this is the most common endocrine disease and has a high risk of complications.

What is your advice to the public to be more aware of endocrine diseases, so that there is awareness to take preventive measures?

Our task is to continue to provide education so that the public understands endocrine diseases. This education is also aimed at doctors, nurses, and other health workers. In addition, we also coordinate research on endocrine diseases, organize seminars and symposiums, and create a guidebook for handling endocrine diseases. This guide aims to help health workers make the right decisions when treating patients.

For Indonesia currently, 1 in 10 adults suffer from diabetes. With an adult population of around 100 million out of a total population of 270 million, this means there are 10-11 million diabetes sufferers. Of that number, it is estimated that only 1-2 million people are treated using BPJS facilities. There are still around 8 million people who have not been reached by BPJS services. This can happen because people are not aware that they have diabetes. Therefore, our task is to continue to provide education so that people understand diabetes, can do early detection, and get the right treatment.

This Is Why Prof. Ketut Suastika Likes Japan

In addition to his beloved homeland, Indonesia, the country that Prof. Dr. dr. Ketut Suastika, SpPD-KEMD, Finasim, who is also the General Chairman of the Indonesian Endocrinology Association (Perkeni), likes is Japan. Why is this land of the rising sun his favorite?

In terms of teaching, he is not only involved in the country, but also abroad. "As a teacher, I teach at Udayana University Bali and several other campuses. In addition, I am also often asked to be a guest lecturer at universities in Japan, one of which is Kobe Women's University. I can go to Japan twice a year to teach," said the lecturer who teaches in the S1, S2, and S3 programs.

Because he often goes to Japan for assignments as an expert and professor in the field of internal medicine, Prof. Ketut takes advantage of the opportunity to travel.

"Because I often go to Japan, I have explored various cities, from the northernmost to the southernmost," said the man who also works at Sanglah Hospital or Prof. dr. IGNG Ngoerah Central General Hospital.

When he was the Chancellor of Udayana University, the intensity of his visits to Japan was higher because of several cooperation programs between his campus and universities in Japan.

Healthy Life ala Profesor Ketut

As a doctor, he advises his patients to live a healthy life almost every day. However, before giving this advice, he himself has implemented a healthy lifestyle.

"You shouldn't eat too much, just enough. My breakfast is usually just a fruit or vegetable salad. I also exercise every day, because exercise can keep our muscles elastic and healthy," said the grandfather of two grandchildren.

In the past, when he was young, he exercised more often. "I used to be able to play tennis three times a week. However, after the injury, I can't anymore. Now my exercise is a stationary bike at home for 30 to 60 minutes every day," he said.

In addition to teaching and carrying out various activities, Prof. Ketut also maintains mind management to avoid stress. "I used to serve as a dean, rector, and other positions. At that time the workload was very high, so it was very important to manage my mind so as not to get stressed. I try to always be cheerful and think positively," he explained with his signature smile.

Every problem, he continued, must be resolved immediately. "When you find a problem at work, solve it at work too. There's no need to take it home, let alone bring it to your feelings, aka baper, as young people now call it. If you bring it to your feelings, it will become a burden," he said with a laugh.

Traveling in Japan

Despite living in Bali, which is one of the world's tourist destinations, Prof. Ketut Suastika still makes time to visit other regions or countries. Japan is the country he visits most often.

"I rarely go traveling specifically. Usually, when there is an assignment, seminar, or invitation to be a guest lecturer, I take advantage of the opportunity to travel," said the man who has full support from his family in his career.

"Japan, for example, is the country I visit most often. Before COVID-19, I could go there more than twice a year. After the main event is over, I usually take the time to travel and see the interesting sides of the country," he added.

Because of that, he fell in love with Japanese culture and cuisine. "To taste Japanese cuisine now you don't have to go all the way to Japan, but when I'm there, I always taste the authentic food. There are also many Japanese restaurants in Bali," he said.

Another thing that makes him like Japan is the safety and friendliness of its people. "When we go to Japan, it feels very safe at any time. In addition, Japanese people are very helpful. When I asked for directions, they not only gave me directions but also took me to my destination. That was very impressive," said Prof. Ketut Suastika.

"Indeed, many people still do not realize the importance of a healthy lifestyle. Therefore, education such as this interview is very important. Continuous education must be carried out so that public awareness increases. Again, preventive measures are simple and cheap: live a healthy lifestyle, eat a balanced diet, and don't forget to exercise,"