Sugar, Culture, and the Rising Burden of Diabetes | Dan Degamo
Sugar, Culture, and the Rising Burden of Diabetes
In the Philippines, food is more than nourishment—it is memory, comfort, culture, and celebration. Yet behind many of the country’s most beloved dining habits lies a quieter and more dangerous reality: the growing burden of sugar exposure and its connection to metabolic disorders.
Coffee, cream-filled donuts, and cup after cup of rice—these are just a few highlights of the Philippines, a nation celebrated for its complex gastronomy. Even under the blazing 40-degree summer heat, Filipinos find joy in savoring a hot cup of coffee paired with sweet treats like banana cue or the mild taste of pandesal.
Let us not forget the cultural significance of extra rice. Who can resist multiple servings after indulging in flavorful inasal or tender spare ribs when hunger strikes? And of course, no meal feels complete without the pièce de résistance of Filipino dining: soft drinks. Nothing quite compares to the refreshing fizz on the tongue after a savory mix of chicken oil, followed by a delightful serving of halo-halo.
There is one common thread uniting all of these culinary experiences: a substance so deeply embedded in everyday life that, despite awareness of its risks, it continues to be welcomed into the body—sugar, or in Filipino, kalamay and asukal.
However, dietary habits do not exist in a vacuum. The pervasive "sugar culture" is heavily driven by structural and socioeconomic factors. In many communities, ultra-processed foods and sugar-sweetened beverages are more accessible and affordable than whole, nutrient-dense foods. Aggressive marketing by beverage companies further normalizes these products, embedding them into daily routines and making them the default choice for populations facing economic constraints.
Over time, this constant exposure to refined carbohydrates and sugars does not simply pass through the body without consequence. It gradually alters how the body processes energy, promoting insulin resistance and significantly increasing the risk of developing Type 2 diabetes.
Diabetes is not simply a matter of “too much sugar.” It is a chronic metabolic disorder in which the body either does not produce enough insulin or cannot effectively use the insulin it produces, resulting in persistently elevated levels of glucose in the blood (American Diabetes Association [ADA], 2026a; Centers for Disease Control and Prevention [CDC], 2026; World Health Organization [WHO], 2024).
Insulin, a hormone produced by the pancreas, plays a critical role in allowing glucose to enter cells and be used for energy. When this cellular lock-and-key system fails, glucose accumulates in the bloodstream instead of nourishing the body’s tissues (ADA, 2026a; CDC, 2026).
Understanding the Types of Diabetes
The condition exists in several major forms. Type 1 diabetes develops when the body’s immune system mistakenly attacks the insulin-producing cells of the pancreas, resulting in little to no insulin production and making lifelong insulin therapy necessary (ADA, 2024).
Type 2 diabetes, the most common form, occurs when the body becomes resistant to insulin or when insulin production becomes inadequate over time (ADA, 2026b; CDC, 2026). This specific form is the one strongly associated with long-term dietary patterns, obesity, and lifestyle factors.
Gestational diabetes develops during pregnancy and may resolve after childbirth, though it increases the future risk of type 2 diabetes for both mother and child (WHO, 2024).
A Public Health Reality in the Philippines
In the Philippine context, the issue is especially urgent. The International Diabetes Federation (IDF, 2025) identifies the Philippines as one of the countries in the Western Pacific region carrying a substantial diabetes burden. This reality becomes more concerning when viewed alongside dietary norms in which sugary drinks, white rice, sweet coffee, and processed foods are frequently normalized.
As Stanford Medicine (2023) notes, Filipino communities face elevated diabetes risk due to a combination of dietary patterns, lifestyle shifts, and broader social determinants of health.
Moving Beyond Individual Choice
Addressing this crisis requires shifting the focus from individual behavioral modification to systemic public health interventions. The implementation of the excise tax on sugar-sweetened beverages under the Tax Reform for Acceleration and Inclusion (TRAIN) Law was a critical first step in using fiscal policy to curb consumption. However, comprehensive reform must also include stricter food labeling regulations, restrictions on marketing to children, and aggressive subsidies to make fresh, whole foods economically viable for all socioeconomic classes.
What begins as comfort and culture on the plate can, over time, evolve into a silent public health crisis.
Diabetes often progresses quietly. Many individuals may live for years with elevated blood glucose before diagnosis, only recognizing the condition after complications arise. Over time, poorly controlled diabetes can damage the eyes, kidneys, nerves, heart, and blood vessels (CDC, 2026; WHO, 2024).
Seen in this light, the Filipino table is not just a site of cultural pleasure; it is the frontline of a metabolic crisis. Awareness is necessary, but it is insufficient. Reversing the rising burden of diabetes demands structural changes that make the healthy choice the accessible choice.
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References
American Diabetes Association. (2024). Understanding type 1 diabetes. https://diabetes.org/about-diabetes/type-1
American Diabetes Association. (2026a). About diabetes. https://diabetes.org/about-diabetes
American Diabetes Association. (2026b). Understanding type 2 diabetes. https://diabetes.org/about-diabetes/type-2
Centers for Disease Control and Prevention. (2026, January 26). Diabetes basics. https://www.cdc.gov/diabetes/about/index.html
International Diabetes Federation. (2025, May 20). The Philippines. https://idf.org/our-network/regions-and-members/western-pacific/members/the-philippines/
Stanford Medicine. (2023). Why do Filipinos have high rates of diabetes? https://med.stanford.edu/nourish-project/education/filipino-health/filipino-health-education/why-do-filipinos-have-high-rates-of-diabetes-.html
World Health Organization. (2024, November 14). Diabetes. https://www.who.int/news-room/fact-sheets/detail/diabetes
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