You may remember way back when type 2 diabetes was called adult-onset diabetes. In recent decades, however, the term has fallen out of use for two reasons: First, health experts saw that labeling the condition type 2 diabetes more clearly differentiated it from type 1 or insulin-dependent diabetes, and second, they formally recognized that more and more children were being diagnosed. An April 2017 report published in the New England Journal of Medicine confirms that rates of both type 1 and type 2 diabetes are increasing among children and teens.
The term diabetes refers to metabolic disease that occurs when the pancreas stops producing enough insulin or the body doesn’t respond appropriately to the level of insulin being produced, resulting in a persistent rise in blood sugar. Prolonged elevated levels of blood sugar can cause a number of health issues.
Type 1 diabetes can occur at any age, but it is typically diagnosed some time between infancy and one’s late thirties. To treat the disease, the individual must inject insulin several times a day or use an insulin pump. The exact cause of type 1 diabetes isn’t known but the most prominent theory is that the body’s immune system begins to attack islet cells in the pancreas. Some patients with type 1 diabetes can also develop insulin resistance (normally associated with type 2 diabetes), which can greatly increase heart-disease risk.
Until the last few decades, type 2 diabetes typically developed in mid-life, with contributing factors including obesity, a highly processed diet, and a sedentary lifestyle. Family history also raises the risk of developing type 2 diabetes. In this case, some insulin is still being produced by the pancreas, but levels may be too low, and the body may not respond well (insulin resistance). There may be a genetic component to the disease, which is then influenced by lifestyle or other influences. Weight loss and other health habit changes can reverse the disease in in many cases. So can bariatric surgery, even when there’s no significant weight loss. A treatment plan usually includes diet, exercise, and oral medications, though sometimes insulin injections are also necessary.
According to the New England Journal of Medicine report, newly diagnosed cases of type 1 and type 2 diabetes increased significantly in five child and teen racial and ethnic groups in the U.S.:
- Non-Hispanic whites
- Non-Hispanic blacks
- Asian Americans/Pacific Islanders
- Native Americans (with some caveats)
The research follows an earlier study, SEARCH for Diabetes in Youth Study, funded by the Centers for Disease Control and Prevention (CDC) with support from the National Institute of Diabetes and Digestive and Kidney Diseases. This 2014 study found that the rate of newly diagnosed cases of type 1 diabetes rose 1.8 percent yearly from 2002 to 2012. Rates of newly diagnosed type 2 diabetes rose even faster, increasing 4.8 percent. The report revealed:
From 2003-2012, rates of type 1 diabetes diagnoses in males 19 and younger increased by 2.2 percent annually and in females, 1.4 percent annually.
The sharpest rise in type 2 diabetes occurred among Native Americans ages 10 to 19 (8.9 percent annually).
The lowest increase of type 2 diabetes was seen among Caucasian youth (0.6 percent annually).
Among all 10 to 16 year olds, rates of newly diagnosed type 2 diabetes cases were higher among girls (6.2 percent annually) compared to boys (3.7 percent annually).
It’s important to remember that the earlier the onset of diabetes and the longer the duration, the higher the risk of diabetes-related complications at younger ages. These complications impact quality of life, shorten life expectancy, and come with significant health-care costs.
Why are rates of both types of diabetes rising among young children and teenagers? There may be many contributing factors, but the researchers theorize that, in the case of type 1 diabetes, having a genetic predisposition that is then triggered by environmental influences that are now more prevalent may be instigating immune-system attacks on the pancreas. In the case of type 2 diabetes, obesity may be at play since the latest World Health Organization (WHO) report reveals that one in three teens around the globe is obese. Still, there is certainly more to investigate, with more research planned by the National Institutes of Health.
It’s been clear for some time that childhood obesity is a public health crisis in the U.S., in part because of its role in diabetes. Until we understand more, there are some sensible steps that parents or soon-to-be parents can take to keep their children from developing the disease. Strategies include:
Helping both parents adopt healthier lifestyle habits before pregnancy.
Encouraging pregnant women to engage in healthy lifestyle habits and keep their weight gain in a safe range.
Understanding family history or genetic risks for gestational diabetes and for the risk of type 1 diabetes and type 2 diabetes developing in children.
Seeking help from your pediatrician and a team including a dietitian or nutritionist and diabetes educator if your child is at high risk for or has been diagnosed with type 2 diabetes.
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Known as The HealthGal, expert contributor Amy Hendel is a popular medical and lifestyle reporter, nutrition and fitness expert, columnist, and brand ambassador, as well as a health coach. Trained as a physician assistant, she maintains a health coach private practice in New York and Los Angeles. Author of The Four Habits of Healthy Families, you can find her on Twitter @HealthGal1103 and on Facebook at TheHealthGal. Her personal mantra is “Fix it first with food, fitness, and lifestyle.”