The New Face of Diabetes: Children!
Author's Note: When I was growing up, in our neighborhood, there was maybe one child who was on the chubby side. Most of us were slim or skinny. Today, it seems that almost every other child is overweight or obese!
Today Type 2 Diabetes is being diagnosed more frequently in children and adolescents!
- New study: 1 in 4 overweight children showing early signs of Type 2 diabetes (impaired glucose intolerance)
- 4% of Childhood diabetes was Type 2 in 1990 -- > 20% in 2001.
- 30% of newly diagnosed cases of childhood diabetes are Type 2, associated with obesity.
- 4% overweight 1982 -- > 16% 1994 -- > 25% 2001 -- > 33% 2006
- 25% White children, 33% African-American, Hispanic
- Hospital costs associated with childhood obesity rising from $35 Million (1979) to $127 Million (1999)
- New study: 1 in 4 overweight children showing early signs of Type 2 diabetes (impaired glucose intolerance)
- 60% of overweight children already have one risk factor for heart disease
- 4% of Childhood diabetes was Type 2 in 1990, Today it's more than 20%.
- 30% of newly diagnosed cases of childhood diabetes are Type 2, associated with obesity.
- Onslaught of TV ads about fast foods and other junk food
- School lunches, vending machines
- Fast food restaurants: very convenient, low cost
- Elimination of physical education classes due to budget cuts
- Computer games, leading to a sedentary lifestyle, no physical activity
- Acceptance that being fat is okay
- Both parents working, Single-parent families
- Lack of knowledge about superior nutrition
- Decreased interest in science and mathematics
- Decreased participation in going to college, especially for ethnic groups
Types of Diabetes in Children
Type 1 diabetes (diabetes caused by a defect in the immune system which leads to destruction of the insulin-producing beta cells) has classically always been considered the only type of diabetes in children except in rare instances. Indeed, type 1 diabetes was called "juvenile diabetes" in the past.
However, some recent findings suggest that somewhere 30% - 45% of newly diagnosed children with diabetes, may indeed have type 2 (insulin deficiency due to other factors). At the time of diagnosis, it may not be possible for the classification to be correctly determined, because symptoms and findings often are similar.
Type 2 Diabetes In Children
The "new face" of Type 2 diabetes is children! With the increase of obesity, sedentary children on their computers, and processed junk food and soda in the school lunch programs, children are becoming more susceptible to Type 2 diabetes long before they become adults.
There is an underlying genetic susceptibility that, when exposed to a variety of social, behavioral and environmental factors, unmasks diabetes. While this genetic background is important, the alarming increase in new cases of children with type 2 diabetes is primarily driven by poor food choices, a sedentary lifestyle and enablers in the family, school, and community.
Maintaining blood sugars in the normal range requires a delicate balance between the amount of available insulin and its action at the cellular level. Experts do not agree as to whether diminished insulin secretion or insulin resistance is the primary problem in the population of adults with type 2 diabetes. From what has been observed in children the abnormality appears to be that of inappropriate insulin action progressing to insulin resistance, obesity, and later possible failure of the insulin-producing cells.
Puberty has been identified as important in the development of type 2 diabetes in children. Changes in hormone levels during this period cause insulin resistance and decreased insulin action. Therefore it is quite understandable that type 2 diabetes in children most often occurs during mid-puberty although cases as young as 4 years of age have been reported.
Obesity is another significant factor. It is well understood that obese children produce too much insulin so that when the need for more insulin arises, they are likely to be unable to produce enough more. In addition, the presence of too much fatty tissue (adipose cells) leads to insulin resistance.
Since type 2 diabetes in children is similar to type 2 diabetes in adults, the good news is that a good diet and regular exercise will do wonders for children with type 2 diabetes.
Unfortunately, children are victims of their environment: home, school, activities, etc. One or both parents may be overweight or diabetic; the school provides processed junk food for lunch; and, exercise programs are absent. In addition, today's technology of computers and video games has turned our children into teenage couch potatoes!
And, don't forget about the fast food TV commercials that encourage children to eat their junk food.
Education
Children with type 2 diabetes and their significant others should participate in a diabetes self-management education. Ideally, the program selected should have a team of educators (physician, dietitian, nurse, social worker, exercise specialist, etc) who are well-versed in education of children. Education should include but should include: meal planning, exercise, self-monitoring of blood glucose, and support. Ideally, diabetic medications should be avoided if possible.
Meal Planning
It is essential that meal plans be developed by a dietitian with experience in nutritional science and the pediatric population. The dietitian needs to stress the importance of healthy eating patterns for the entire family while taking into account financial and other family resources, lifestyles, and cultural preferences.
A program like the Death to Diabetes Training Program would work very well for children with type 2 diabetes.
Physical Activity
Changing sedimentary lifestyles is essential to weight loss and control of type 2 diabetes in children. Exercise speeds up calorie expenditure promoting weight loss. It also increases insulin sensitivity at the cellular level. A pediatric exercise counselor should work with the child and family to develop an appropriate program.
Statistics
More than a million adolescents are at risk for developing type 2 diabetes and 50,000 more already have the disease.
The average age of diagnosis of type 2 diabetes in youth is 12-14 years. It is more common among girls than boys.
Each year, more than 13,000 young people are diagnosed with type 1 diabetes.
Those affected with type 2 diabetes belong to all ethnic groups, but it is more commonly seen in non-white groups. American Indian youths have the highest prevalence of type 2 diabetes. In the 15-to-19-year age group, the current prevalences were
* 50.9 per 1000 for Pima Indians from Arizona;
* 4.5 per 1000 for all U.S. American Indian populations (reported cases from the U.S. Indian Health Service outpatient clinics);
* 2.3 per 1000 for Canadian First Nation people from Manitoba (reported cases from outpatient clinics).
African-American children have lower rates of type 1 diabetes than white American children. Researchers tend to agree that genetics probably makes type 1 diabetes less common among children with African ancestry compared with children of European ancestry.
However, just like African-American adults (who are dying at a faster rate), African-American children have a much higher rates of type 2 diabetes than white American children.
The Real Solution?
Find a way to create a grass roots movement by utilizing technology that children use every day, i.e. computer, iphone, video game, music, etc.
And, educate the parents and schools about superior nutrition, spiritual health, and a program like the Death to Diabetes wellness program.
However, some recent findings suggest that somewhere 30% - 45% of newly diagnosed children with diabetes, may indeed have type 2 (insulin deficiency due to other factors). At the time of diagnosis, it may not be possible for the classification to be correctly determined, because symptoms and findings often are similar.
Type 2 Diabetes In Children
The "new face" of Type 2 diabetes is children! With the increase of obesity, sedentary children on their computers, and processed junk food and soda in the school lunch programs, children are becoming more susceptible to Type 2 diabetes long before they become adults.
There is an underlying genetic susceptibility that, when exposed to a variety of social, behavioral and environmental factors, unmasks diabetes. While this genetic background is important, the alarming increase in new cases of children with type 2 diabetes is primarily driven by poor food choices, a sedentary lifestyle and enablers in the family, school, and community.
Maintaining blood sugars in the normal range requires a delicate balance between the amount of available insulin and its action at the cellular level. Experts do not agree as to whether diminished insulin secretion or insulin resistance is the primary problem in the population of adults with type 2 diabetes. From what has been observed in children the abnormality appears to be that of inappropriate insulin action progressing to insulin resistance, obesity, and later possible failure of the insulin-producing cells.
Puberty has been identified as important in the development of type 2 diabetes in children. Changes in hormone levels during this period cause insulin resistance and decreased insulin action. Therefore it is quite understandable that type 2 diabetes in children most often occurs during mid-puberty although cases as young as 4 years of age have been reported.
Obesity is another significant factor. It is well understood that obese children produce too much insulin so that when the need for more insulin arises, they are likely to be unable to produce enough more. In addition, the presence of too much fatty tissue (adipose cells) leads to insulin resistance.
Since type 2 diabetes in children is similar to type 2 diabetes in adults, the good news is that a good diet and regular exercise will do wonders for children with type 2 diabetes.
Unfortunately, children are victims of their environment: home, school, activities, etc. One or both parents may be overweight or diabetic; the school provides processed junk food for lunch; and, exercise programs are absent. In addition, today's technology of computers and video games has turned our children into teenage couch potatoes!
And, don't forget about the fast food TV commercials that encourage children to eat their junk food.
Education
Children with type 2 diabetes and their significant others should participate in a diabetes self-management education. Ideally, the program selected should have a team of educators (physician, dietitian, nurse, social worker, exercise specialist, etc) who are well-versed in education of children. Education should include but should include: meal planning, exercise, self-monitoring of blood glucose, and support. Ideally, diabetic medications should be avoided if possible.
Meal Planning
It is essential that meal plans be developed by a dietitian with experience in nutritional science and the pediatric population. The dietitian needs to stress the importance of healthy eating patterns for the entire family while taking into account financial and other family resources, lifestyles, and cultural preferences.
A program like the Death to Diabetes Training Program would work very well for children with type 2 diabetes.
Physical Activity
Changing sedimentary lifestyles is essential to weight loss and control of type 2 diabetes in children. Exercise speeds up calorie expenditure promoting weight loss. It also increases insulin sensitivity at the cellular level. A pediatric exercise counselor should work with the child and family to develop an appropriate program.
Statistics
More than a million adolescents are at risk for developing type 2 diabetes and 50,000 more already have the disease.
The average age of diagnosis of type 2 diabetes in youth is 12-14 years. It is more common among girls than boys.
Each year, more than 13,000 young people are diagnosed with type 1 diabetes.
Those affected with type 2 diabetes belong to all ethnic groups, but it is more commonly seen in non-white groups. American Indian youths have the highest prevalence of type 2 diabetes. In the 15-to-19-year age group, the current prevalences were
* 50.9 per 1000 for Pima Indians from Arizona;
* 4.5 per 1000 for all U.S. American Indian populations (reported cases from the U.S. Indian Health Service outpatient clinics);
* 2.3 per 1000 for Canadian First Nation people from Manitoba (reported cases from outpatient clinics).
African-American children have lower rates of type 1 diabetes than white American children. Researchers tend to agree that genetics probably makes type 1 diabetes less common among children with African ancestry compared with children of European ancestry.
However, just like African-American adults (who are dying at a faster rate), African-American children have a much higher rates of type 2 diabetes than white American children.
The Real Solution?
Find a way to create a grass roots movement by utilizing technology that children use every day, i.e. computer, iphone, video game, music, etc.
And, educate the parents and schools about superior nutrition, spiritual health, and a program like the Death to Diabetes wellness program.
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