Related topics: •  Special Report: Diabetes in the Classroom •  Type 1 Diabetes and Your Child •  Type 2 Diabetes

Type 2 diabetes used to be practically unheard of in people under 30. That explains the other common name for the disease: adult-onset diabetes. Not long ago, almost all children with diabetes suffered from the Type 1 form of the disease, which means their bodies couldn't produce enough insulin. And Type 2 diabetes, in which the pancreas may produce normal insulin levels but cells become resistant to it, typically took decades to develop.

But Type 2 diabetes isn't just for adults anymore. The number of children and adolescents with the condition (most of whom are diagnosed in their early teens) has skyrocketed within the last 20 years, prompting the journal Diabetes Care to call it an "emerging epidemic." While Type 1 diabetes is still more prevalent among children nationwide, experts estimate that Type 2 diabetes has grown from less than 5 percent in 1994 to about 20 percent of all newly diagnosed cases of the disease among youth in more recent years.

Because young children who are obese are more likely to become diabetic when they're older, experts are paying particular attention to how much -- or how little -- preadolescents eat and exercise. Disease researchers at the Centers for Disease Control and Prevention (CDC) recently made the stunning prediction that one in three children born in the United States in 2000 will likely develop Type 2 diabetes sometime in their lifetime unless they get more exercise and improve their diets. The prediction was especially serious for Latino children. Without changes in diet and exercise, their odds of developing diabetes as they grow older was about 50-50.

Type 2 is not usually as life-threatening or dramatic as Type 1 at the time of diagnosis, but it does increase the likelihood that children may develop serious long-term complications such as blindness, kidney disease, and heart disease. If untreated, the child may also eventually develop circulatory problems severe enough to require amputation of limbs.

With proper medical treatment and a self-care program that incorporates exercise, glucose monitoring, and nutrition, however, your child can likely keep his or her blood sugar under control and avoid serious complications.

Over 80 percent of all children and adolescents with Type 2 diabetes are overweight, and about 40 percent are clinically obese. Indeed, researchers suspect that increases in obesity among young people is driving the new epidemic.

There has long been a statistical link between obesity and Type 2 diabetes, but exactly why millions of overweight people develop Type 2 diabetes has long been a medical mystery. In January 2001, a study published in Nature suggested why millions of overweight people go on to develop the disease. The missing link, researchers argued, was a hormone they called resistin, which is produced by fat cells and incites tissues to resist insulin, the hormone our bodies need to turn blood sugar into energy. However in 2003, scientists scuttled this theory in a human study published in the Journal of Clinical Endocrinology and Metabolism. These scientists found no correlation between resistin levels and body mass index, lipid profile, or insulin resistance levels.

Other studies have suggested that the type of obesity -- or where you store your fat -- may make a difference as well. Those who store it around the middle (the so-called apple shape) are at higher risk of developing diabetes. Some experts believe that high-carbohydrate, low-fiber diets are part of the problem. Finally, because exercise makes your body's muscle cells more sensitive to insulin, a sedentary lifestyle is a risk factor. If your child rarely plays outside or exercises, then, he or she may be at greater risk of the disease.

For unknown reasons, Native Americans, African-Americans, Asian-Americans, Pacific Islanders, and Latinos are also especially vulnerable to the disease. (One theory is that people whose hunter or gatherer ancestors led "feast or famine" lives developed a "thrifty gene," which allowed for very efficient fat storage.) Researchers at Children's Hospital in Cincinnati found that, compared with children of European descent, African-American boys and girls were 3.5 and 6.1 times more likely to develop Type 2 diabetes, respectively. And doctors at a Southern California diabetes clinic recently reported that 31 percent of young Mexican-American patients had the Type 2 variety, compared with 3 percent of the white children.

Other factors can also put children at risk. If close family members have the disease or if a mother develops diabetes during pregnancy, for example, children are significantly more likely to develop the disease.

Many children go for years before they have symptoms that they recognize as a problem, but most children with Type 2 diabetes are diagnosed before they ever show symptoms. Still, it pays to be cautious, especially if your child is at high risk for the disease. Watch for these signs: increased urination, extreme thirst, increased appetite, and weight loss. One other potential sign of Type 2 diabetes is a skin condition called acanthosis nigricans. As many as 70 percent of children with Type 2 diabetes have this condition, which is characterized by a patch of extremely dark, velvety, and rippled skin, most often on an underarm, the back of the neck, or between the fingers and toes.

Specific blood and urine tests are used to diagnose Type 2 diabetes. The American Diabetes Association recommends that overweight children with at least two risk factors be given a fasting blood sugar test every two years beginning at age 10. If you are concerned, you should ask the doctor about these tests, especially if there's a history of the disease in the family and if your child is overweight. And again, Native Americans, Latinos, African-Americans, Asian-Americans, and Pacific Islanders are at increased risk.

Yes. Although Type 2 is usually not as serious in the short run as Type 1 -- and is generally easier to control -- there are several possible day-to-day effects of the disease. The American Diabetes Association lists these common ones:

•Headache

•Blurred vision

•Thirst

•Frequent urination

•Dry, itchy skin

Long-term consequences are also a serious concern. If not controlled at an early age, Type 2 diabetes can lead to complications such as blindness, renal failure, heart disease, and the need for amputations.

Unlike children with Type 1 diabetes, those with Type 2 usually don't need insulin shots to control their blood sugar levels. In fact, most can manage their disease simply by eating fewer calories, cutting back on fats and sugars, and getting more exercise. Remember, kids get most of their lifestyle cues (not to mention their groceries) from their parents. By serving healthy foods, encouraging physical activity, and educating the family about diabetes, parents can make a huge contribution to their children's health.

When lifestyle changes aren't enough -- or when they can't be made -- your child may need insulin shots. Some Sulfonylurea drugs and metformin can also help bring a child's blood sugar under control.

The key to preventing Type 2 diabetes in children -- and adults for that matter -- is avoiding obesity. Give your child a balanced diet (including lots of fiber, whole-grain foods, and fruits and vegetables), avoid sugary junk foods and sodas, and encourage your child to get lots of exercise. By encouraging children to exercise and eat right from an early age, parents may be able to put a stop to this epidemic and set their children on the road to a long, healthy life.

-- Chris Woolston, M.S., is a health and medical writer with a master's degree in biology. He is a contributing editor at Consumer Health Interactive, and was the staff writer at Hippocrates, a magazine for physicians. He has also covered science issues for Time Inc. Health, WebMD, and the Chronicle of Higher Education. His reporting on occupational health earned him an award from the northern California Society of Professional Journalists.

Further Resources

Children with Diabetes

http://www.childrenwithdiabetes.com

The American Diabetes Association

http://www.diabetes.org

The National Diabetes Information Clearinghouse (NIDC), part of the National Institutes of Health

http://www.diabetes.niddk.nih.gov/index.htm

Diabetes Care and Education Dietetic Practice Group, a division of the American Dietetic Association

http://www.eatright.org

References

Last updated July 31, 2009
Copyright © 2001 Consumer Health Interactive

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