Diabetes in Youth Is Rising… Why Prevention Matters

The last two decades have shown a surge in the cases of youth-onset type 2 diabetes. This used to be a disease of adults only and was called adult-onset diabetes, since it was not seen in children. It is now a pediatric disease. Type 2 diabetes in children is rising at a faster rate than type 1 and is a global problem.

The word diabetes written on a chalkboard surrounded by a scale, glucometer, stethoscope, exercise equipment, and healthy foods.

Type 2 diabetes (T2D) is caused by insulin resistance, not a deficiency of insulin, as seen in type 1 diabetes. Type 2 is not an autoimmune disease as is Type 1. Type 2 is usually related to obesity and high levels of insulin to which the body becomes resistant.

According to the Centers for Disease Control (CDC), the incidence of T2D in adolescents is projected to increase fourfold in the next 30 years. This is an alarming rate of increase, considering we have just been seeing this disease in children in the last 2 decades. Childhood obesity numbers are expected to double by 2035. 

This is a wakeup call to act now to protect our youth.

Reducing type 2 diabetes cases by just 2% yearly through prevention can make a significant difference. One of the goals of this blog is to fight the obesity epidemic in kids and prevent adult diseases through education and nutrition. 

This. Is. Possible.

If someone under 20 develops type 2 diabetes, they will have complications of this disease as a young adult. Complications from this disease affect all organ systems and occur more rapidly when developed in childhood. They will be at risk for a shorter lifespan and for multiple cancers that are related to obesity. 

Complications include:

• Vision loss from diabetic retinopathy

• Kidney disease and failure from diabetic nephropathy

• Nerve and blood vessel disease which often leads to amputations - diabetes is one of the major causes of amputations worldwide.

• Fatty liver disease

• Cardiovascular disease

• High blood pressure

• Depression

• Cognitive impairment

There is a progression in the development of T2D. Prediabetes is the stage before diabetes, in which fasting glucose levels rise above 100 (mg/dl). Prediabetes is the precursor to T2D. Prediabetes in the 12-19 age group has more than doubled since 2000, with 1 in 5 US children thought to have this condition. 

A doctor holding a plastic model of the pancreas (in yellow). The pancreas makes insulin to control blood sugar, which is less effective in prediabetes and type 2 diabetes.

Type 2 diabetes in youth is a more aggressive disease than in older adults and than type 1 diabetes. Complications develop more quickly. Complications from type 2 diabetes are seen to occur within 10-15 years of having the disease, thus, as a young adult.

Obesity is the leading risk factor for developing insulin resistance and type 2 diabetes. 

Eating a diet full of highly processed foods, rich in fat, sugar, and refined carbohydrates, will likely lead to obesity and T2D. In addition, the use of technology among kids has led to more sedentary lives. Additional causes include social, cultural, genetic, environmental, and lifestyle factors. This is a public health issue and one that challenges healthcare funding. 

As individuals and parents, we must do what we can within our families and environments to control what is possible. Hopefully, we will see communities and governments involved, but for now, the immediate changes will come from individuals. 

I offer some steps you can implement now.

1. Be mindful of what food you bring into your home for your family. Begin now to purchase fewer ultra-processed food items and add more fruit and vegetables to your shopping list. 

2. Significantly reduce or eliminate sugar-sweetened beverages, including sodas, fruit juices, sweetened teas, coffees, etc. Half of the sugar consumption in this country comes from sugar-sweetened beverages. 

3. Avoid artificial sweeteners. These can affect insulin levels, leading to the desire for more sweet items and weight gain.

4. Choose complex carbohydrates made from whole grains with the least amount of processing, such as old-fashioned oatmeal rather than instant, whole wheat or whole grain bread and crackers, brown rice instead of white rice, and ancient grains such as farro, barley, and quinoa.

5. Move more and limit technology. Make it a habit to get 30 minutes of exercise for every hour spent on the computer or watching TV. If your child plays video games, find ones that require movement and standing while playing. Use social media to find workouts that can be done at home without equipment, especially if you can’t let your child out by themselves. There are many exercises that don’t require any equipment. A jump rope is cheap and great for cardio and calorie burning. Aim for 4-5 hours of exercise weekly.

   

   Children exercising indoors. Exercise can easily be done at home without special equipment.

   
   

6. Learn your family medical history and risk factors. 

7. Ensure your child gets adequate sleep - too little sleep can lead to changes in appetite regulation, type of food consumption, and increase the risk for obesity.

8. Seek medical attention for a child who snores or has sleep apnea. 

9.  Reduce sugar consumption and look for hidden sugars in food. Read ingredient labels to choose those with the fewest ingredients, ensuring that sugar or sweeteners aren’t in the first 4-5 ingredients. 

10. Decrease red meat, processed meats, and saturated fats. 

11. Have a varied diet to ensure adequate intake of micronutrients (vitamins and minerals). Calcium, iron, zinc, and vitamins A and D are required by the pancreas for insulin production.

12. Be mindful of weight gain during puberty, especially in girls. The puberty hormones naturally lead to an increase in weight and body fat as part of the growth spurt, but excessive weight gain often persists. This is monitored at your child’s annual checkups.

A healthy diet and active lifestyle can be life-saving and prevent diabetes. Early diabetes diagnosis—before age 30—can reduce life expectancy by 15 years. Though complex, solutions exist.

Prevention. Is. Possible.