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A Steep Rise in Diabetes Seen in Children and Teens in the U.S.

By Esther Entin, MD

Sometimes things really are as serious as they seem. The rising tide of obesity among children and teenagers in the U.S. has been in the news so much that many parents may be becoming deaf to the issue.

But the effects of too many calories, too much screen time, and too little activity are real, and they are showing up in a big jump in the rates of metabolic syndrome and diabetes in our younger population.

The Impact of Diabetes on the Body

Type 1 diabetes mellitus is also called juvenile-onset or insulin-dependent diabetes. It occurs when the pancreas produces little or no insulin leaving the blood sugar level dangerously unregulated.

The exact causes are unknown, but there may be a genetic predisposition to developing this type of diabetes or it may be triggered by exposure to a virus. It is thought that an autoimmune process causes the body to destroy its own insulin-producing cells in the pancreas. Type 1 diabetes accounts for about 10% of cases of diabetes in the United States.

Type 2 diabetes mellitus accounts for the other 90% and is a different disease and much more avoidable. While the body still produces the hormone insulin, it may not produce enough or there may be resistance to the effects of the insulin on controlling blood sugar.

Chronic health conditions and lifestyle factors, such as being overweight or obese, being inactive, having metabolic syndrome, and genetic predispositions all contribute to the likelihood that type 2 diabetes will occur. Even cats and dogs are at a far higher risk for developing type 2 diabetes than they were 10 years ago.

Both types of diabetes can shorten life and cause serious problems in virtually every organ system in the body, including the heart, kidney, eyes, skin, and nerves.

The Study

The researchers compared the cases of both type 1 and type 2 diabetes in 2000 and again in 2009 to determine whether the numbers of young people affected by them had changed. They used data from five centers across the US and included all youth younger than age 20. They examined the data by age cohort, ethnicity, and sex.

The results confirm the medical community’s fears. Over the eight-year study period, the adjusted prevalence of type 1 diabetes increased by 21%. These increases were seen across all age subgroups, both sexes and in white, black, Asian Pacific and Hispanic youth ages 5 years and older. In addition to showing that there are more cases of type 1, the results challenge assumptions that have held that type 1 diabetes primarily affects white youth.

Similarly, during the same study period, the adjusted prevalence of type 2 diabetes increased by 30%. The increase was seen in both sexes, in those aged 10-14 and 15-19 and in white, black and Hispanic youth but was not seen in Asian Pacific islander or American Indian youth. Projecting the data forward suggests that between 2010 and 2050, the number of youth with type 2 diabetes will quadruple.

The reasons for the increase in type 1 are unclear. The researchers suggest that the increases in type 2 may be caused by obesity, in utero exposure to diabetes or to endocrine disrupting chemicals or changes in diagnostic practices that increase the identification of cases.

More research will be needed both to pinpoint the exact reasons for the changes and to begin to figure out how to address the enormous potential public health burden of the life-long chronic health problems diabetes causes. These require careful medical management and scrupulous adherence to medication.

Hopefully, this study will raise awareness and encourage parents to act on some of the lifestyle recommendations that can help prevent diabetes, including breaking our addiction to carbohydrates.

The study, “Prevalence of Type 1 and Type 2 Diabetes Among Children and Adolescents From 2001 to 2009” is published in JAMA, Journal of the American Medical Association.

May 6, 2014



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