Diabetes and Kids

"My husband and I were shocked when our pediatrician told us that Debbie is at risk of developing diabetes. I know she is overweight and the bike she used to ride is gathering dust in the shed, but she is only 13 years old. My mom was just diagnosed with type 2 diabetes but she is in her fifties. Actually, my grandmother was about the same age when she started having 'sugar problems.' But Debbie is just a teen. She's too young to develop this kind of problem. What can I do to help prevent her getting this disease?"
~ Linda R ~

Mrs. R. is not alone in believing that diabetes is primarily an adult-onset disease. Many people are surprised to learn that approximately 150,000 school-aged children and teens are diabetic, and that an increasing number of these youthful cases are the Type 2 form that is associated with inactivity, poor nutrition, and obesity.

Diabetes is a chronic disease in which the body does not produce or properly use insulin. It's a metabolic disorder that compromises the body's ability to convert food into energy necessary for growth. Affecting more than 18 million people, or about 6.3 percent of the population, it ranks as America's sixth-leading cause of death.

Types of Diabetes
The pancreas of a non-diabetic individual is able to produce sufficient quantities of the hormone insulin to control blood sugar (glucose) levels. In Type 1 diabetes (insulin-dependent), not enough insulin is produced; the person must rely on daily injections of insulin to control blood sugar. Type 1 diabetes is the most common form of diabetes seen in children, so much so that it previously was called "juvenile diabetes." Five to 10 percent of those diagnosed with diabetes -- primarily children and young adults -- have this form of the disease.

Type 2 diabetes (non-insulin dependent) accounts for the remainder of new diagnoses. With Type 2, the pancreas produces insulin but the body is not able to use it appropriately. People with Type 2 diabetes are said to be "insulin resistant." In most cases, insulin injections are unnecessary. The disease can be controlled with diet, exercise, and oral medication.

While this form of diabetes previously was found most often in adults over 40 -- as with Mrs. R's mother and grandmother -- adolescents account for 33 to 45 percent of new Type 2 cases today. Most of these new teen patients are significantly overweight, and frequently experience hypertension and breathing difficulties as well.

Diabetes of either type can produce long-term complications, including blurring or loss of vision; kidney failure; limb amputation; and/or hardening of the arteries (atherosclerosis), which also can lead to stroke and/or heart attack.

Recognizing the Symptoms
Symptoms of Type 1 diabetes in a teen -- such as fatigue and constant hunger -- may be missed simply because adolescents tend to burn both ends of the candle (causing fatigue) and are feeding a developing body (meaning they're frequently hungry). There are other signals, however, that your teen may have diabetes, including increased thirst, frequent urination, blurred vision, and weight loss.

It is important that the family doctor or pediatrician examine the child with such a combination of symptoms. Delay in diagnosis and treatment may result in a potentially lethal diabetic coma.

While the symptoms of Type 1 diabetes tends to develop over a short period of time, Type 2 signs may develop quickly or slowly, depending upon the youngster. Some symptoms are similar to Type 1 -- fatigue, thirst, frequent urination, weight loss and blurred vision -- but additional signs include nausea, frequent infections, and slow healing of wounds or sores.

It is important to note that some youths with Type 2 diabetes show none of the above external signs. That is why a regular examination to check blood sugar levels is important for children and teens with high-risk factors (primarily, being overweight and having a family history of diabetes of either type).

Prevention is Key
Exercise and nutrition are the twin keys to preventing Type 2 diabetes. Researchers find that even those at high risk for this disease can prevent or delay its onset with a half hour of exercise five days a week, and by losing a small percentage -- 5 to 7 percent -- of their body weight.

For children, that means spending more time in active play and less time in front of the television or computer. It also means learning to make healthier food choices.

But for children to willingly participate in increased exercise and healthier food choices, diabetes prevention must become a family affair. Creating nutritious meals and keeping junk food out of the home helps make it easier for a youth to learn and practice healthy eating habits. Developing active family activities, such as walking along the beach, is fun and raises metabolism. The creation of a healthy lifestyle then becomes a goal for everyone, not a punishment for being overweight.

But diabetes prevention is also a community affair.

Medical professionals need to develop increased measures for identifying youth at risk of developing diabetes, along with ways of helping parents create effective prevention strategies at home. As Linda R. makes so clear, learning that your child is at risk is a shock, and help is needed to identify and implement important lifestyle changes. It would be wonderful if pediatricians included in-depth parent education as a part of every child's annual physical check-up.

Communities need to allocate money to build attractive recreational areas -- both indoor and outdoor -- that encourage and reward physical activity for all members of the family. Building hiking trails and safe bicycle paths are a beginning. But holding old-fashioned community awareness days that feature three-legged races and potato sack races are also a fun way to encourage physical activity.

Schools can institute healthy lunch choices in the school cafeteria, ban soda and snack machines, and make sure each child receives a minimum of 45 minutes of active physical education each day. It is reported that due to budgetary cutbacks, some school systems have as little as 15 minutes of active physical education for each child.

Hopefully, future generations will look back in disbelief at the time when Type 2 diabetes reached epidemic proportions and thank us for taking the necessary personal and structural steps to eradicate this disease.

Copyright 2004 Judy Shepps Battle