Type 2 diabetes is on the rise among children in the U.S. The disease – formerly called adult-onset diabetes – now affects four times as many youth as it did 20 years ago.
The culprit is excess weight, according to the Centers for Disease Control and Prevention. Thirty-five percent of teenagers and 18 percent of those 12 and younger are now overweight or obese, having a BMI of 25 or greater. An estimated one in six of these overweight teenagers now has prediabetes – a blood glucose that is higher than normal, or between 100 and 125 – which frequently leads to type 2 diabetes.
What is type 2 diabetes?
Unlike type 1 diabetes – in which the body produces no insulin at all and lifelong insulin therapy is required – type 2 diabetes occurs when the body fails to properly use or make enough insulin, the hormone that moves blood sugar (glucose) into cells where it is converted to energy. Often, the onset of type 2 diabetes is the result of lifestyle choices. The disease is treated by modifying diet and often requires medication.
How does weight contribute to type 2 diabetes?
The cells of the body have special insulin receptors (insulin receptor substrates) that allow them to take in glucose from the bloodstream, store it and convert it into energy. Excess fat hinders the cells’ ability to do this, causing glucose to build up in the bloodstream. This condition is called insulin-resistance and is the first step on the road to diabetes.
Excess fat cells produce a hormone (resistin) and a protein (pigment epithelium-derived factor – PEDF). Both make cells in the body less effective in taking in glucose, and cause the liver and muscles to be less sensitive to insulin, which moves sugar from the blood into cells.
As a result, a greater amount of insulin is needed to maintain blood glucose levels and the pancreas becomes overworked and eventually slows down or stops the release of insulin, ultimately leading to type 2 diabetes.
So strong is the connection between obesity and diabetes that a new word, “diabesity,” has been coined by the medical community.
A dangerous combination for children
Since obesity and diabetes both contribute to serious health problems, the combination of the two further increases the risk of heart attack, stroke and kidney failure as affected children reach early adulthood. A third of children with diabetes already have high blood pressure and a third have elevated cholesterol, two major risk factors for heart disease.
Additionally, research indicates that type 2 diabetes progresses more rapidly in youth and that they develop diabetes-related complications faster than their adult counterparts, according to the National Institute of Health.
Youth at the greatest risk?
Family history of type 2 diabetes
Being overweight (a body mass index of more than 25)
Prediabetes (an above-normal fasting blood glucose of 100-125 mg)
Abnormal cholesterol and/or triglycerides levels
Family history of high blood pressure or cardiovascular disease
Children entering puberty, due to the body’s hormonal changes
People with prediabetes can help prevent or postpone type 2 diabetes by:
Making healthier food choices
Getting 30 minutes of daily exercise – in addition to helping control weight, exercise can improve insulin sensitivity, making it easier for the body to convert glucose into energy
If your child is displaying symptoms of diabetes, please schedule an appointment or speak with a health care provider right away.
Symptoms may include:
Increased thirst and urination
Weight loss or abnormal weight gain
Slow-healing sores or frequent infections
Areas of darkened skin
Salma Makhoul is endocrinologist at Via Christi Clinic.