Health

Kids Headed for Diabetes Disaster

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Kids Headed for Diabetes Disaster

From: Duke and the Doctor

Date: Fri Jun 21, 2002 12:30 pm

Subject: Kids Headed for Diabetes Disaster

June 17, 2002 -- More and more children are developing type 2 diabetes, and a new study suggests they will suffer devastating health problems as a result.

Until recently, type 2 diabetes was known as "adult onset diabetes" because it was unheard of in children. But just over 20 years ago, doctors began to see it in kids, as well. And in the last 10 years, researchers have seen a four-fold increase among children -- largely due to the rising number of overweight and obese kids.

Now, the consequences are becoming clear. At the annual meeting of the American Diabetes Association in San Francisco, researchers reported on the first-ever study of type 2 diabetic adults who were diagnosed in childhood.

Having uncontrolled high blood sugar from diabetes can have damaging effects on the body. Over the years, it can lead to heart attacks and strokes at an early age, blindness, foot and leg amputations, and kidney failure -- requiring dialysis.

The researchers looked at 51 young adults aged 18-33 who'd been diagnosed with type 2 diabetes before age 17. In the years since they'd been diagnosed, seven of them had died -- two were young women who experienced sudden death while on dialysis. Three others were also on kidney dialysis and one of these was blind. One woman had a toe amputation. The women in the group had 56 pregnancies -- but 21 ended in miscarriage.

These rates of death and disease are far higher than in the general population, said University of Manitoba pediatrician Heather Dean, MD, who presented the findings. She cautioned that not all children with type 2 diabetes will necessarily suffer so much. The patients in the Manitoba study were all Native Americans whose health is worse in some respects than other groups (for example, a high percentage of the patients smoked.) Also, the Manitoba doctors are already getting better at catching and treating the disease among kids.

But at a press conference preceding Dean's presentation, University of Florida pediatrician Janet Silverstein, MD, warned that type 2 diabetes will certainly take a toll on the children who have it throughout the world. "They are at risk for [heart attack and stroke]. I think the cost on society will be huge."

The reason for the rise in diabetes type 2 among children isn't hard to determine, said Silva Arslanian, MD, a University of Pittsburgh pediatrician. "Obesity is pulling the trigger," she said. "It's shooting up like a rocket. Two-fifths of kids are overweight."

Unlike type 1 diabetes, which is caused by the body's innate inability to produce insulin, type 2 diabetes develops more slowly, over time. Excess fat -- particularly around the midriff -- significantly increases the risk of the disease. Children are fatter now than in the past because they are eating more high-calorie foods and are getting less exercise.

So far, only one drug, Glucophage, has been approved to treat the effects of diabetes in kids. As with adults, a healthy lifestyle is the best way to attack the disease. "Let's change the way we're living," said Arslanian. "Let's start eating healthier. No kid needs to have eight to 10 cans of pop, but I see that every day."

When kids do change their behavior, the signs of diabetes can disappear very quickly. "In two weeks of summer camp, running here and there, kids can normalize," said Dean. Silverstein said diabetes clinics for kids have produced the same results -- with their diet and exercise controlled, the children can stop taking medicine.

But the disease often returns when the kids go back home. And since the symptoms of diabetes take years to develop, it's hard to change kids' behavior. Young people aren't much concerned about diseases they might get in future decades, and when they become teenagers, they rebel against adults who tell them how to live, says Arslanian.

Acting U.S. Surgeon General Kenneth Moritsugu, MD, MPH, attended the press conference to underscore the importance of type 2 diabetes in children. "I would like to congratulate you for putting this on the front burner," he said. "Sixty-one percent of the American public is overweight or obese. It's going to have a lifelong effect on our health."

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