Since November is American Diabetes Month, this week and next will pertain to this timely topic. One of the reasons I started this blog and wrote my book is because of seeing adult-type diabetes - type 2 diabetes - in children. I’ll never forget my first case in a child of only 10, thinking "this isn’t supposed to occur in kids!" Since then, almost twenty years ago, I have seen this and many more children with insulin resistance, or prediabetes, a precursor to type 2 diabetes (T2D). Unfortunately, this disease has become more common in children due to the childhood obesity epidemic.
The word diabetes spelled out with sugar cubes on a blue background representing diabetes awareness.
The prevalence of type 2 diabetes in youth has grown over the past thirty years. In this country, 4 in 1000 adolescents, ages 12-19, are affected. T2D in youth is increasing about 2.5 times faster than type 1 diabetes.
First, let’s distinguish between the two types of diabetes.
Type 1 diabetes (T1D) is an autoimmune disease that affects the pancreas. The islet cells of the pancreas, which make insulin, are destroyed by antibodies. Insulin is the hormone that controls blood sugar. Eating food increases blood sugar and insulin decreases blood sugar. An affected person cannot produce enough insulin and develops high blood sugar. A person with type 1 diabetes must take insulin shots to control their blood sugar.
Type 2 diabetes (T2D), formerly known as adult-onset diabetes, is not an autoimmune disease. It is a disease of insulin resistance. A person makes high amounts of insulin to maintain normal blood sugar levels, but the insulin is not as effective. The person becomes resistant to insulin. This condition is usually treated with diet, oral medication, and sometimes with insulin.
T2D develops gradually, unlike T1D, which comes on more quickly. High sugar levels can lead to the following symptoms in either type:
Increased thirst
Increased urination
Increased hunger
Fatigue
More frequent infections, such as skin and bladder
Blurred vision
Darkened areas of the skin under the armpits and the back of the neck (more common in T2D and insulin resistance)
Weight loss (unintended) - more common in T1D
The word obesity in wooden cubes. Obesity is a major risk factor for developing type 2 diabetes at any age.
There are numerous known risk factors for developing T2D in children.
Obesity or being overweight
Diets high in processed foods and sugary beverages
Inactivity
Family history of T2D
History of gestational diabetes in mother
Age and sex - T2D occurs after age 12 and during puberty in girls more often than boys
Race/ethnicity - This is more common in Hispanic, Native American, and Black populations
Why is this trend alarming?
T2D leads to many complications that affect most of the body’s organs. These complications include:
Heart disease
High cholesterol
Stroke
Liver disease
Kidney damage
Nerve damage
Eye disease
Cartoon of a child and organs in the body. Complications of type 2 diabetes affects most of the body's organs.
If a child develops T2D, complications will occur at a much younger age, which can lead to a shorter lifespan.
If you think your child may be at risk for type 2 diabetes, please discuss this with your child’s doctor. Blood tests can screen for this. Being proactive is the first step. If your child has prediabetes, losing weight and having more physical activity can delay or prevent T2D. I have seen it happen in my patients.
Next week, I will outline steps to take for lifestyle changes and prevention. Stay tuned.