HARRISBURG, Pa.—It's often a silent threat, frequently showing no symptoms. Yet, this quiet menace can pose long-term health risks for the children it strikes.
The affliction is type 2 diabetes, commonly known as adult onset diabetes and a health problem for middle-aged persons. Unfortunately, that reference is fast becoming a misnomer as the disease is being diagnosed with greater frequency in children. Experts believe it's no coincidence that the increasing occurrence of type 2 diabetes in children correlates with rising obesity rates in the same age group.
In observance of November as National Diabetes Month, the Pennsylvania Medical Society encourages parents to monitor overweight children with one or more risk factors of diabetes, since early treatment could minimize the devastating long-term health risks of the disease. Parents with concerns about their children's weight or suspicions of diabetes in their children should make an appointment with their physician immediately.
Previously, type 1 diabetes was the only form of the diabetes typically associated with children, with only 1 to 2 percent having type 2 diabetes or other rare forms of the disorder. Recently, though, that trend has changed. Although the exact percentage of increase has not yet been determined, the American Diabetes Association (ADA) reports that between 8 and 45 percent of newly diagnosed children and adolescents now are being diagnosed with type 2.
Pennsylvania Medical Society member physician and endocrinologist Dr. Joseph H. Hines says recent medical research indicates that the rising national obesity rate is a likely cause of the increasing rate of childhood type 2 diabetes. “Recent studies provide striking evidence pointing to a link between this type of diabetes and obesity,” notes Dr. Hines. In fact, the ADA recently reported that approximately 85 percent of children diagnosed with this disorder are either overweight or obese at the time of diagnosis.
Approximately 4,800 Pennsylvania children have diabetes. Common in young adults and children, type 1 diabetes occurs when the body does not produce insulin, a substance that allows glucose to enter and fuel our cells. About nine out of 10 of all people with diabetes are diagnosed with type 2, in which the body manufactures insulin but cannot use it effectively.
“In adults, type 2 diabetes is a gradually developing disease, with symptoms appearing over years,” says Dr. Hines. “Currently, 17 million American adults have type 2 diabetes and half are undiagnosed. And, we're seeing the same phenomenon in the adolescent population.”
Three years ago, Schuylkill County mother Kim Fidler noticed that 10-year-old Alex was going to the bathroom a lot and losing weight. Having a father with diabetes, she was aware of the warning signs. So, borrowing her dad's glucose monitor, she checked Alex's levels, saw they were high, and made an appointment with her physician. Though originally diagnosed with type 1 diabetes, Alex has now been confirmed as having type 2.
Typical symptoms of the disorder can include fatigue, nausea, frequent urination, excessive thirst, weight loss, blurred vision, frequent infections, slow healing of wounds or sores, and constant hunger. However, Dr. Hines warns that many children with type 2 diabetes may exhibit no symptoms at diagnosis.
That's why the Pennsylvania Medical Society warns parents to be particularly aware of the risk factors associated with the disease. In addition to being overweight or obese, the risk factors for childhood type 2 diabetes include: Family History. Between 74 and 100 percent of adolescents diagnosed with type 2 diabetes have a family history of the disorder. Puberty. Typically, children with type 2 diabetes are diagnosed in mid- to late puberty. At this time, the body increases its resistance to the action of insulin. Ethnicity. Certain racial groups are predisposed to the disease, including individuals of Native American, Hispanic, African American, and Asian descent.
According to Dr. Hines, early onset of this disease could mean a corresponding early onset of its long-term health complications, including heart disease, stroke, high blood pressure, blindness, kidney failure, and lower extremity amputations. “The implications of this trend are frightening,” says Dr. Hines. “Left unchecked, childhood type 2 diabetes could result in serious medical conditions, such as coronary disease, in a much younger population.”
For those children diagnosed, physicians typically prescribe lifestyle changes - improved diet and exercise habits—as the first course of treatment. At times, physicians complement this regimen with drug therapy. As Alex Fidler is weaned from his insulin and his mother monitors his carbohydrates and sugars, his condition will continue to be controlled with other medication. As a result, he's doing well, with no noticeable changes in his activity level.
“Physicians work with these young patients and their parents to improve the children's diets and to increase their activity,” says Dr. Hines. “If those lifestyle changes are not incorporated, medication will not work.”
As with all health-related issues, the Pennsylvania Medical Society reminds parents to work with their physicians on a comprehensive program to maintain their children's good health. Dr. Hines concludes, “Together, parents and physicians can partner to help children develop a lifetime of good, healthy habits.”