Child Malnutrition in Indonesia: An Iceberg of Triple Burden by dr. Eta Auria Latiefa Liaison Officer to Student Organizations CIMSA 2015/2016 Recently, the public was shocked by a fact presented by the Indonesian Pediatrician Association (IDAI) that in 2023, cases of diabetes in children aged 0-18 years have increased by 700% over a 10-year period. Yes, you read that precisely: a 70-fold increase. Many people are wondering, how is it possible the disease that mostly affects adults and the elderly actually occurs in children?
Basically, diabetes mellitus (DM), or what is known as “kencing manis” does have several types. Type 1 DM is a disease that often occurs in children and adolescents due to pancreatic cells being unable to produce insulin, usually caused by an autoimmune process. However, along with lifestyle changes and unhealthy eating patterns of children and their families, there is a tendency for an increase in cases of type 2 DM as well, whose pathophysiology is insulin resistance. The risk factors are related to obesity, genetics, ethnicity, and family history of type 2 DM. From the data presented by IDAI in 2023, more than 59% of children with diabetes are girls. The age of 10-14 years dominates the
epidemiological distribution with 46% of the total reported, followed by the age group of 5-9 years with 31.5%. In addition, as stated by the Head of the IDAI Endocrinology Coordination Work Unit, Muhammad Faizi, the incidence of diabetes in children could be even higher than what has been recorded at this time.
This data might be a new thing for most people, considering that the issue which has been intensified so far is about how to overcome stunting in Indonesia. However, as it turns out, malnutrition in Indonesia is not merely talking about stunting. This country has an overnutrition problem and micronutrient deficiency at the same time as well. The triple burden of malnutrition, the term that represents this condition, is the coexistence of overnutrition (overweight and obesity), undernutrition (stunting and wasting), and micronutrient deficiency at all levels of the population— country, city, community, home, and individual. Even before the COVID-19 epidemic, Indonesian children faced a triple burden of malnutrition. This condition has a direct influence on a kid's physical and mental development and
33