Tuesday, July 29, 2014

More kids getting type 2 diabetes

From page A9 | August 04, 2013 |

By Richard Fleming, M.D.

When I went to medical school, way back in the 20th Century, medical students were taught there were two kinds of diabetes. Type 1 diabetes was caused by a lack of insulin (the hormone that lowers blood sugar), started in childhood and occurred in kids whose weight was normal. Type 2 diabetes was when the body did not respond well to insulin.

Even though there was plenty of insulin in the blood stream, sugar levels tended to be high because the body could not sense it. Type 2 diabetes was said to start in overweight adults. If I had answered a test question on type 2 diabetes by saying it was common among children, my answer would have been marked wrong. I may have been laughed out of school and had to pick something different to do with my life.

Well, the times have changed. The rate of type 2 diabetes among children has skyrocketed. Nowadays, half of all diabetes in kids is type 2. This is a huge change. How did it happen, and why over such a short period of time? There is one reason — the rapid increase in childhood obesity. When kids are overweight, their bodies face a lot of the same health problems as overweight adults — high blood pressure, high cholesterol levels and, of course, type 2 Diabetes.

This is very scary for several reasons. One is that diabetes causes several health problems like kidney damage, eye problems and hardening of the arteries, which can lead to strokes and heart attacks. These problems tend to happen after many years with diabetes. If an obese 40-year-old man comes down with diabetes, he may get complications in his 60s or 70s, depending on how well he controls his blood sugar. An overweight 10-year-old girl who develops diabetes may come down with complications when she’s 40 or 50.

To make matters worse, a recent study in the New England Journal of Medicine found that type 2 diabetes in kids is harder to treat than in adults. Adults can often lower their blood sugar with a single medicine, at least for a while, especially if they are watching their diet and getting in some exercise. As time goes by, more medicine is usually needed, but being able to get good blood sugar readings with one pill is nice. In the recent study, kids had a much harder time getting their blood pressure down from one medicine, even if they watched their diet and increased their activity. Most kids needed two medicines to treat their diabetes.

If your child comes down with type 2 diabetes, it can be treated, but it is so much better to avoid the problem in the first place. And that is where parental guidance comes in. Parents can help their kids avoid getting heavy. They need to encourage healthy eating. They need to encourage plenty of exercise. They need to keep an eye on their kids’ weight. If it starts to creep up, it is better to make changes in the home earlier, rather than later.

And remember that kids learn by example. If a child’s parents eat unhealthy food, have growing waistline, and avoid taking walks, the child will tend to learn from this example. By helping your child avoid type 2 diabetes, not only are you helping your child live a longer and healthier life, but yourself as well.

— Dr. Fleming is the regional medical director for Partnership Healthplan California in Yolo and Solano counties.



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