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The early onset of childhood diabetes, particularly type 2 diabetes, is becoming a growing health problem in the United States. Currently, an estimated 100 million Americans have diabetes or are at extreme risk of developing diabetes (prediabetes). Additionally, an estimated 132,000 of these cases were diagnosed in children and adolescents under the age of 18 (Centers for Disease Control and Prevention, 2017).
In the past, children diagnosed with diabetes most often had insulin-dependent type 1 diabetes, which is caused by an autoimmune disease that affects the body's ability to make insulin. In contrast, type 2 diabetes is traditionally referred to as “adult-onset” because its prevalence is strongly influenced by diet, activity level, and lifestyle-related factors.
Currently, type 2 diabetes is growing in adolescents and adolescents at a rate of approximately 5,000 new cases per year (Lawrence et al., 2014), and the diagnosis of type 2 diabetes in this population has increased by more than 30% over the last 10 years (Dabelea et al., 2014).
It appears that rising rates of type 2 diabetes in children may be another health concern arising from the broader childhood obesity epidemic. Physical inactivity, poor diet and excess body fat have been identified as risk factors for type 2 diabetes in both adults and children (Copeland, 2011). Children who are in their 85sthBMI percentiles or higher are more than four times more likely to develop type 2 diabetes (Abbasi et al., 2017). Currently this represents approximately one in three children (Ogden et al., 2014).
The mechanisms behind type 2 diabetes
One of the main mechanisms behind type 2 diabetes appears to be a decrease in insulin sensitivity (Hannon and Arslanian, 2015). When tissues and cells lose sensitivity to insulin, this leads to damage to the metabolic infrastructure that helps regulate blood sugar levels. When elevated blood sugar becomes chronic, it leads to a variety of acute and longitudinal medical complications. The risk factors listed in the paragraph above contribute significantly to a reduction in insulin sensitivity (Copeland et al., 2011).
Medical complications due to type 2 diabetes include microalbuminuria, hypertension, kidney disease, dyslipidemia, and neuropathy. Advanced symptoms of these complications generally occur approximately 10 years after diagnosis (Hannon, Arslanian, 2015). This could significantly increase the risk of morbidity and mortality in the most productive years of life, as children grow up to join the workforce and have families. It also prolongs the physical and financial burden of the disease.
How to reduce a child's risk of developing type 2 diabetes
An increase in the prevalence of type 2 diabetes in children clearly has future implications for the country's workforce and healthcare system, as well as for the health and happiness of individuals. The good news is that making fundamental lifestyle changes can significantly reduce a child's risk of developing type 2 diabetes and the associated health complications.
To address this troubling trend, the Centers for Disease Control and Prevention (2017) makes several recommendations:
- Ersetzen Sie den Konsum von zuckerhaltigen Getränken durch Wasser
- Iss mehr Obst und Gemüse
- Beziehen Sie Kinder in die Zubereitung gesunder Mahlzeiten ein
- Essen Sie am Tisch statt vor dem Fernseher oder einzeln in einem Raum
- Bringen Sie Kindern Lebensmitteletiketten bei
- Als Familie zusammen essen
- Kleinere Portionen servieren
- Erleichtern Sie täglich 60 Minuten Aktivität
- Kinder in den Sport einbeziehen
It is also recommended that parents talk to their pediatricians about the risks of developing type 2 diabetes so that early action can halt the progression of the disease.
If we take steps to create a culture of wellness at home by supporting and demonstrating healthy habits, we can increase the likelihood that our children will grow into happy and healthy adults.
References
Abbasi, A. et al. (2017). Body mass index and incident type 1 and type 2 diabetes in children and young adults: A retrospective cohort study.Journal of the Endocrine Society,15 (524-537).
Centers for Disease Control and Prevention (2017). National Diabetes Statistics Report, 2017. Atlanta, Ga.: Centers for Disease Control and Prevention, U.S. Department of Health and Human Services.
Copeland, KC et al. (2011). Characteristics of adolescents and adolescents with recent-onset type 2 diabetes: The TODAY cohort at baseline.The Journal of Clinical Endocrinology and Metabolism96, 1, 159-167.
Dabelea, D. et al. (2014). Prevalence of type 1 and type 2 diabetes in children and adolescents from 2001 to 2009.Journal of the American Medical Association,311, 17, 1778–1786.
Hamman, RF et al. (2014). The SEARCH for diabetes in youth study: Rationale, results, and future directions.Diabetes treatment37, 12, 3336-3344.
Hannon, T.S. and Arslanian, S.A. (2015). The changing face of diabetes in youth: Lessons from studies of type 2 diabetes.Annals of the New York Academy of Sciences,1353113-137.
Lawrence, J. M. et al. (2014). Incidence of diabetes among US adolescents by type, race/ethnicity, and age, 2008–2009.diabetes63 (Supplement 1), A407.
Ogden, C. L. et al. (2014). Prevalence of obesity among children and adults in the United States, 2011-2012.Journal of the American Medical Association,311, 8, 806-814.