Type 2 Diabetes Tough on Teens
With the incidence of type 2 diabetes and its complications among young people on the increase worldwide, aggressive measures are needed to treat and prevent the disease, says a study reported in The Lancet.
"The complications associated with adolescents' type 2 diabetes seems to behave differently than in children and adolescents with type 1 diabetes," says
article co-author Dr. Orit Pinhas-Hamiel, at Sheba
Medical Center in Tel-Hashomer, Ramat-Gan, Israel.
These complications may be present at the time of diagnosis, and their rate of progression may be higher than in children and adolescents with type 1 diabetes, says Dr. Pinhas-Hamiel.
"We need to develop improved approaches to awareness and early treatment of type 2 diabetes and associated abnormalities," she
says.
These complications, including high blood pressure, kidney disease, eye disease, and problems with blood fat [cholesterol and triglycerides] levels, may already be present when type 2 diabetes is diagnosed, while they rarely exist at the onset of type 1 diabetes, notes Dr. Pinhas-Hamiel.
"In addition, studies to date suggest that early onset of type 2 diabetes is associated with a more rapid progression of these complications compared with adolescents with type 1 diabetes," notes
Dr. Pinhas-Hamiel.
Moreover, psychiatric problems are also associated with type 2 diabetes. In a study in Philadelphia, one in five such teens suffered from conditions such as depression, obsessive-compulsive disorder, or other psychiatric conditions.
Another study found that the deaths of seven young African-American males, ages 13 to 21, with undiagnosed diabetes, met the criteria for high blood sugar and diabetic coma, the authors add.
Type 2 diabetes also puts unborn infants at risk. In a Canadian study of 51 pregnant adolescent girls with type 2 diabetes, only 35 had live births, and the pregnancy loss rate was 38 percent, the authors report.
Dr. Pinhas-Hamiel and her colleague Dr. Philip Zietler, at the University of Denver, believe that adolescents with type 2 diabetes should be screened for signs of these complications when they are first diagnosed.
"In addition, there is a need for well-established guidelines for the initiation of antihypertensive and anti-lipid treatments for adolescents with type 2 diabetes," she
says.
Dr. Pinhas-Hamiel says that in type 2 diabetes in children and adolescents there is an association with significant illness and death.
One expert says this review confirms that type 2 diabetes in teens has become a serious public health problem.
"Recent studies have confirmed what most of us have long suspected, that the rate of what used to be called adult onset diabetes is rising rapidly in children and adolescents," says
Dr. David L. Katz, at Yale University School of Medicine.
This study confirms another suspicion that even greater dangers are around the next corner should current trends persist, says Dr. Katz.
"In adults, type 2 diabetes is a potent risk factor for cardiovascular disease and other complications, from kidney failure to nerve damage," explains Dr. Katz. "There
is every reason to expect, and now findings to confirm,
that these relationships hold in youth as well.
“When formerly adult onset diabetes develops in 7-year-olds, the threat of heart disease in 17-year-olds clearly looms," he says. "Anyone
who was waiting for an even more strident alarm before
accepting that epidemic obesity and type 2 diabetes
in our children is a public health crisis of the first
order - this is it.”
Another expert thinks that overweight adolescents who lead a sedentary life need to be tested for diabetes.
"Here we have a situation where we are not examining our youngsters for diabetes, and they already have complications present or developing," says
Dr. Stanley Mirsky, a board member of the Juvenile Diabetes Foundation.
"We have to test these kids that spend all their time in front of the televisions or computers eating junk food instead of being outside exercising and eating right, especially when there already is a family history of diabetes," says
Dr. Mirsky.
Always consult your physician for more information.
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Obesity is a chronic disease affecting increasing numbers of children and adolescents as well as adults.
Obesity rates among children in the US have doubled since 1980 and have tripled for adolescents.
More than 15 percent of children aged six to 19 are considered overweight compared to over 60 percent of adults who are considered overweight or obese.
Earlier onset of type 2 diabetes, cardiovascular disease, and obesity-related depression in children and adolescents is being seen by healthcare professionals.
The longer a person is obese, the more significant obesity-related risk factors become.
Given the chronic diseases and conditions associated with obesity and the fact that obesity is difficult to treat, prevention is extremely important.
A primary reason that prevention of obesity is so vital in children is because the likelihood of childhood obesity persisting into adulthood is thought to increase from about 20 percent at four years of age to 80 percent by adolescence.
Young people generally become overweight or obese because they do not get enough physical activity in combination with poor eating habits.
Genetics
and lifestyle also contribute to a child’s weight
status.
Recommendations for prevention of overweight and obesity during childhood and adolescence include:
-
Gradually work to change
family eating habits and activity levels rather than
focusing on a child’s
weight. Be a role model.
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Parents who eat healthy foods and participate in physical activity set an example so that a child is more likely to do the same.
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Encourage physical activity. Children should have 60 minutes of moderate physical activity most days of the week.
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More than 60 minutes of activity may promote weight loss and subsequent maintenance.
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Reduce “screen” time
in front of the television and computer to less than
two hours daily.
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Encourage children to eat when hungry and to eat slowly.
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Avoid using food as a reward or withholding food as a punishment.
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Keep the refrigerator stocked with fat-free or low-fat milk, fresh fruit, and vegetables instead of soft drinks and snacks high in sugar and fat.
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Serve at least five servings of fruits and vegetables daily.
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Encourage children to drink water rather than beverages with added sugar, such as soft drinks, sports drinks, and fruit juice drinks.
Always consult your physician for more information.
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