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Faiz Cenna’s parents were thrilled when the 6-year-old started elementary school and suddenly had a big appetite.

His father, Muhammad Arif Novianto, said Faiz had, until then, always been underweight and did not eat much.

“But then he started getting hungry and thirsty all the time but he didn’t gain any weight,” Arif said.

The family grew concerned when Faiz started having to urinate every half-hour and he grew thinner even as his stomach became bloated.

“I brought him to the doctor because I feared he might have diabetes,” Arif said. “But the doctor said that was impossible because he was only 6 years old.”

But tests showed that Faiz’s blood sugar level was abnormally high. He was diagnosed with type 1 diabetes.

According to Badriul Hegar, president of the Indonesian Pediatric Society (IDAI), there is a common misconception that diabetes is only an adult disease. “But they’re wrong, because more and more children are now getting type 1 diabetes,” he said.

“Many die untreated because they aren’t diagnosed properly.”

He added that there was no accurate data on how many children in the country had diabetes. When the IDAI started to focus on treating diabetic children in 2008, it recorded just 156 patients. So far this year, it has already seen 684 children.

“The numbers seem low, but this is a serious problem because the medical cost is awfully high and the complications can be fatal,” Badriul said.

Aman Bhakti Pulungan, project manager for the World Diabetes Foundation and chairman of the Asia Pacific Pediatric Endocrinology Society, said children who suffered from diabetes were at risk for ketoacidosis, a potentially life-threatening condition where the blood sugar skyrocketed, leading to organ failure.

“Though the IDAI has found fewer than 700 cases, I believe this is just the tip of the iceberg,” he said. “Sadly, the awareness in Indonesia remains very low and many children die without being diagnosed.”

Aman said children’s blood sugar levels tended to soar during the school holidays, when they typically consumed larger amounts of sugary snacks and drinks.

Given how crucial early detection is, he said that parents needed to watch out for symptoms such as excessive thirst, hunger and excessive urination.

“Pay attention if your child keeps on eating but doesn’t gain any weight, especially if they start losing weight and getting easily tired,” he said. “Any of these symptoms warrants an immediate blood sugar check.

“Many parents wrongly assume that these symptoms indicate a parasite infection or appendicitis, but they should be thinking diabetes, because it could easily turn fatal.”

However, Aman also said that the “disease is completely manageable. No child should die from diabetes.”

But he said children with type 1 diabetes would have to take regular insulin injections for life.

Ekowati Rahajeng, director of noncommunicable diseases at the Health Ministry, said diabetes was a life-changing diagnosis, but “with the proper treatment they can still have the opportunity to live a relatively normal life.”

Aman added that if a child had been diagnosed with diabetes it was important to watch out for breathing difficulties, nausea, vomiting and a loss of consciousness. And if any of those symptoms occur to “rush them to the emergency room because those are the symptoms of ketoacidosis, which can cause serious complications like blindness or even death.”

Ekowati conceded that children’s diabetes had been overlooked for years because the government had long focused on type 2 diabetes, which occurs in adults. However, she said things were starting to change. “We realize diabetes among children is one of the most serious health problems we face.”