Diabetes Association. “Type 2 diabetes was practically unheard of in young people until the last few years,” says Diabetes is the leading cause of new …
ADVANCE for Physician Assistants
Issue Date: 2/1/2000
Type 2 Diabetes Rising Dramatically in Children
BY STEPHEN CORNELL
Doctors fear disaster ahead blared a recent headline on a paper released
by the American
Diabetes Association
The ADA wasnt talking about the Y2K scare, which has since proven more
lamb than lion The
organization instead is warning that type 2 diabetes–often referred to as
adult-onset
diabetes–isnt just for adults any more And health care providers are
worried that the
complications associated with the disease, such as heart disease, strokes,
blindness and
amputations, will be striking people at younger ages if their condition is
not diagnosed early
Type 2 diabetes was practically unheard of in young people until the last
few years, says
Robin S Goland, MD, co-director of the Naomi Berrie Diabetes Center at
Columbia
Presbyterian Hospital in New York Because of the long-term damage that
high blood sugar
levels can do to blood vessels throughout the body, we might see the
devastating complications
of diabetes very early
Type 2 diabetes strikes close to 15 million Americans, while between
500,000 and 1
million
people in the United States are estimated to have type 1 diabetes But up
to 54 million people
are have not been diagnosed
The toll of diabetes is enormous It is the seventh leading cause of death
in the United States,
according to the ADA Diabetes is the leading cause of new cases of
blindness 12,000 to
24,000 cases a year and the leading cause of end-stage kidney disease
about 40 of new
cases; 27,900 in 1995
Diabetes also causes nerve damage in 60 to 70 of patients and
significantly increases the
risk of nontraumatic lower-limb amputations Clinicians perform more than
56,000 amputations
on diabetics every year
Financially, diabetes costs an estimated 92 billion each year in direct
health care costs and the
costs of lost productivity, according to the ADA
One risk factor for type 2 diabetes is being older than 45, but if the
incidence of diabetes in
children continues to rise, so will the cost incurred as a result of
complications that occur
earlier, health care providers believe
Several studies presented at the ADAs 59th annual Scientific Sessions
dealt with the issue of
adult-onset diabetes in children
Canadian Studies
A pair of studies conducted at the University
of Manitoba and University of
Torontos Mount
Sinai Hospital and the University of Western Ontario showed a dramatic
increase in type 2
diabetes among First Nation Cree-speaking children at a pediatric diabetes
clinic in Manitoba
Dean HJ Incidence and prevalence of type 2 diabetes in youth in Manitoba,
Canada,
1981-1998 Abstracts from the 59th Scientific Session of the American
Diabetes Association
1999:A168-A169
Between 1981 and 1998, 82 children had been diagnosed with type 2 diabetes
During the
five-year period from 1981 to 1985, four cases 08 per year average were
reported But during
the five-year period from 1994 to 1998, 42 cases were reported 84 cases a
year
The Mount Sinai study examined the prevalence of pediatric obesity and the
associated
behavioral risk factors among the northwestern Ontario Oji Cree, who have
high rates of adult
obesity and type 2 diabetes Hanley A, Harris S, Gittelsohn J, et al
Pediatric obesity in a native
Canadian community with epidemic levels of type 2 diabetes mellitus
Abstracts from the 59th
Scientific Session of the American Diabetes Association 1999:A169
Researchers measured height and weight along with fitness level, television
viewing
habits,
dietary intake and body image perceptions in 445 children They evaluated
the prevalence of
pediatric obesity and associated behavioral risk factors among the
northwestern Ontario Oji
Cree people, who have high rates of adult obesity and type 2 diabetes
Obesity in the pediatric subjects aged 2 to 19 was higher than in the
general population, and high
levels of TV viewing were positively associated with a significant increase
in obesity in
pediatric subjects aged 10 to 19
Elevated obesity levels in children and teens is a harbinger of future
diabetes risk for them,
because obesity is associated with insulin resistance, the first step in
the development of type 2
diabetes, Bernard Zinman, MD, a senior scientist at the Samuel Lunenfeld
Research Institute in
Toronto, told the ADA
New York Study
The study at Columbia Presbyterian in New York involved 19 children aged 10
to 17 with type 2
diabetes who had been referred to the center over a two-year span The
subjects were all more
than 20 above ideal body weight and had acanthosis nigricans, which is a
dark skin coloration
sometimes seen on the back of the neck and in skin folds and that is often
associated with
insulin
resistance
The average blood glucose level of these children was extraordinarily
high, Dr Goland
said Because physicians are not expecting to see type 2 in youngsters,
the diagnosis is not made
until severe hyperglycemia has developed
Most of these study participants were from ethnic minorities, one of the
significant risk factors
for type 2 diabetes in children and adults
In the Future
The number of people worldwide with diabetes mellitus is likely to double
in the next 10
years, according to a study conducted at St Bartholomews and the Royal
London School of
Medicine and Dentistry, Queen Mary and Westfield College in London
Kopelman PG, Hitman
GA Diabetes Exploding type II Lancet 1998;352suppl 4:SIV5
Three main factors are linked to this explosion of diabetes cases, the
researchers report:
increased incidence of obesity, declining physical activity and a genetic
predisposition The
news wasnt all negative, however The researchers predict that the
confirmation of effective
management strategies are of benefit for patients with type 2 diabetes is a
major and important
advance
We should be optimistic that the recent progress in our understanding of
the etiology of
the
condition will result in new strategies for its prevention and amelioration
before the grim
prevalence predictions are fully realized, the researchers concluded
Warning Signs of Type 2 Diabetes
Any type 1 symptoms frequent urination, unusual thirst,
extreme hunger, unusual weight loss, extreme fatigue, irritability
Frequent infections
Blurred vision
Cuts or bruises that heal slowly
Tingling or numbness in the hands or feet
Recurring skin, gum or bladder infections
Source: American Diabetes Association
Type 2 Diabetes Outside the United States
Figures presented at the 1997 International Diabetes Federation Meeting
held in Helsinki,
Finland in July 1997 estimated that there were 1192 million people with
type 2 diabetes in
developing and newly industrialized nations at that time Bloomgarden ZT
Type 2 diabetes: its
prevalence, causes, and treatment Diabetes Care 1998;21:860-865
Experts estimate that by 2011, 2129 million people will have type 2
diabetes in those nations
One researcher dubbed the process leading to the type 2 diabetes epidemic,
Coca-Cola-nization and called diabetes a Western killer let loose in
paradise
The frequency of diabetes has doubled in many areas
such as Papua New
Guinea 8 to 16,
Singapore 4 to 8 and Hong Kong 2 to 5 Researchers predict
continued increases in
diabetes cases, particularly with the ongoing industrialization in China,
where there may be
more diabetics than the total populations of Australia and California
Complications of Diabetes
Blindness due to diabetic retinopathy
Kidney disease due to diabetic nephropathy
Heart disease and stroke
Nerve disease and amputations
Erectile dysfunction
Source: American Diabetes Association
Source:pspa.net
