Is Your Child at Risk for Type 2 Diabetes?

1/18/2008

Once there were two basic types of diabetes—

• juvenile diabetes, an autoimmune disorder of insulin deficiency that appeared in children, and
• adult-onset diabetes, a more lifestyle-dependent form of diabetes that typically appeared in obese adults over 50.

But in the past decade there has been an unexpected explosion of cases of adult-onset diabetes in children and teens, that we can’t identify the two types by age anymore. Now we call them type 1 and type 2.

Type 2 diabetes is a metabolic disorder that arises when genetic vulnerability collides with obesity, inactivity, and poor dietary choices to cause insulin resistance. Normally the hormone insulin ferries blood sugars into the cells for use as fuel. When levels of circulating blood sugars are too high, the cells start ignoring insulin when it knocks at the door, forcing the pancreas to produce more and more of the hormone until there is an excess of circulating insulin and fat cells grow at an abnormal rate.

What causes type 2 diabetes?

Genetics and environment both play a crucial role:

• Certain ethnic groups—African-Americans, Hispanics, Asian-Americans, and Native Americans—are at greater risk
• Family history matters too--half of children with type 2 diabetes have at least one parent with the same condition.
• Children with type 2 diabetes are almost always obese
• Children of mothers who were diabetic while pregnant are probably at greater risk, as that fetal environment can switch on genes that increase vulnerability to type 2 diabetes.
• There’s good evidence that over-exposure to high-fructose corn sweeteners in processed foods may increase risk.
• Children who watch a lot of television or who get little exercise are at higher risk.

How do you know if your child is developing type 2 diabetes?

Unfortunately, children with type 2 diabetes don’t usually display obvious symptoms. If your child falls into one of the high-risk categories listed above, it would be a good idea to check his or her fasting blood-sugar levels every two years.

In addition, watch for key signs of possible trouble like these:

• Body Mass Index (BMI) greater than 85th percentile for age or more than 120% of ideal for height, especially in the years just before or during puberty
• Velvety dark skin lesions called acanthosis nigricans in areas between the fingers and toes as well as the back of the neck.
• Conditions such as high blood pressure, blood fat disorders, or polycystic ovary disorder.

Type 2 diabetes can often be reversed with a family program that integrates nutritional education, exercise promotion, behavioral therapy and emotional support. Adherence to a healthier lifestyle by your child—and his parents—can prevent diabetes from ever becoming serious enough to require supplemental insulin.

Federal agencies, professional medical groups, and individual health professionals are working hard to reverse this epidemic, because it casts our children’s long-term health in doubt. Type 2 diabetes at an earlier age will probably translate into cardiovascular disease at an earlier age, and into more disability and earlier death from diabetes and heart disease than seen in the generations before them. It’s essential that you take steps now to teach your children the habits and behaviors that will keep them healthy their whole lives.