Type 2 diabetes in Children and adolescents
For many years, type 2 diabetes was called “adult-onset diabetes”. Unfortunately, with a more sedentary lifestyle, development of the food industry and many changes in our world, what was once a disease mainly effecting adults is now becoming more common in children.
Dr Nisrine Alghazal, Specialist Endocrinologist at Mediclinic Dubai Mall and Mediclinic Al Sufouh tells us more about type 2 diabetes in children and adolescents.
Type 1 vs type 2 diabetes
Both types of diabetes are chronic diseases that affect the way your body regulates blood glucose (sugar). Glucose is the fuel that feeds your body’s cells, but to enter your cells it needs a key. Insulin is that key.
Type 1 diabetes means that your body is not producing enough insulin, whereas patients with type 2 diabetes don’t respond to insulin as well as they should and in later stages don’t make enough insulin.
Causes of type 2 diabetes
- Being overweight or obese – obesity numbers are annually increasing amongst children and adolescents
- High carbohydrate diet – sugary juices, fizzy drinks and candy being consumed regularly
- Sedentary lifestyle – less activities and more screen time
- Genetic predisposition – even though type 2 diabetes is mainly caused by unhealthy lifestyle habits, genetics can put us at a higher risk
Until 2001, type 2 diabetes accounted for fewer than 3 percent of all newly diagnosed diabetes cases in adolescents. Studies from 2005 and 2007 show that type 2 now comprises 45 percent of those diabetes cases. Between 2011 and 2012, about 23 percent of new diabetes diagnoses in children Trusted Source were type 2 diabetes (CDC).
The below graph shows the cut-offs of blood glucose readings. (American Diabetes Association)
Symptoms
These are the most common symptoms of type 2 diabetes:
- Increased thirst
- Frequent urination
- Unintended weight loss
- Fatigue
- Blurred vision
- Slow-healing sores
- Numbness or tingling in the hands or feet
- Areas of darkened skin, usually in the armpits and neck
Managing diabetes in teenagers is quite challenging because of the interplay between pubertal hormones, personality development and societal pressures which all impact compliance and glucose control.
The progression from pre-diabetes to diabetes is faster in teenagers than in adults. We suggest to our pre-diabetic/insulin resistant patients to target 60-90 minutes of physical activity daily and less than 60 minutes of screen time (television, computer and video games), low carbohydrate healthy diet with or without pharmacotherapy (shared decision).
It is vital to teach type 2 diabetic or pre-diabetic patients to lead a healthy active life to stabilize and in some cases reverse their insulin resistance.
Treatment
Treatment can be through oral anti-diabetic pills (and more importantly should target weight management and the prevention of complications. Early diagnosis and management of type 2 diabetes can reverse diabetes.
In conclusion, teenage diabetes management is not confined to the endocrine clinic. It requires governments and local communities’ involvement. Limiting the availability of sugary drinks and snacks and providing healthy alternatives in venues frequented by children, promoting programs that value and reward physical activity and raising awareness on “clean eating” could help in halting the catastrophic rise in adolescent insulin resistance.
