Years ago, The American Diabetes Association (ADA) classified diabetes as Juvenile Diabetes and Adult On-set Diabetes. Due to the obesity epidemic in America, the diagnoses of adult on-set diabetes was happening younger and younger. The ADA felt pressured to change the names. Diabetes was changed to Type 1 (autoimmune aka insulin dependent) and Type 2 (aka non-insulin dependent).
Today we have documented cases of Type 2 diabetes in 4 year old children due to morbid obesity. The ADA has recently reclassified type 2 into adult on-set type 2 and youth on-set diabetes. Youth on-set is defined as type 2 diagnosed before age 20 years old. You may also hear the term “young on-set” diabetes which is type 2 diagnosed before the age of 40 years old.
Research completed by JM Chan, EB Rimm and GA Colditz shows that weight is directly related to type 2 diabetes. Their research showed females with a BMI over 35 had a 93.2% chance of developing type 2. Males with a BMI over 35 have a 42.1% chance of developing diabetes. (Their data was adult age adjusted. There is no current data for children.)
Children with Type 2 Diabetes
America’s obesity crises is not getting better. More and more children are being diagnosed with type 2 diabetes. Unfortunately, the typical variety of medications for non-insulin dependent diabetes is NOT approved for children. Many of these children as diagnosed while in the hospital. Most of these kids are placed on insulin. That makes it difficult to distinguish between Type 1 and Type 2 in kids. There are specific blood tests used by medical professionals to determine if it is type 1 or type 2.
Youth are at higher risk for type 2 due to the hormone changes in puberty. Kids that might have a slight weight problem may find themselves gaining weight rapidly due to hormone changes. This weight gain causes liver damage plus insulin resistance. The pancreas will work harder to produce more insulin to help control blood sugars. Eventually, the pancreas’ beta cells can no longer keep up the over production and they start to shut down. This causes an increase in blood sugars. At first it may be just after large meals. Symptoms of high blood sugars can be tiredness, thirsty, or even hungry.
Diabetes is also a genetic disorder that runs in families.
If your immediate family has type 2 diabetes, their children are at a higher risk for problems. Part of the problem is genetic, but the lifestyle they learn from their parents triggers many health problems. Kids that are diagnosed with high blood sugar are usually placed on insulin to treat it. Kid’s blood sugars can go up and down for no apparent reason. For example: if their grown hormone increases during puberty, and their pancreas is overworked, their blood sugars may go up.
When kids are placed on insulin, it is so important to check their blood sugars often. I have worked with many teens on insulin. If they get stressed by something happening at school, their sugars were high. If they were stressed with girlfriend/boyfriend problems, their sugars go high. If they get up in front of their class to give a report, their sugars were go up. My point, their blood sugars can appear to be unpredictable.
Children’s Type 2 is not the same as Adult Type 2
Many times these children are diagnosed in the hospital due to their immediate need for insulin. Children with type 2 progress through pre-diabetes rapidly (usually within one year). By the time they are diagnosed their pancreas cells are dying off. They can lose as much as 37% of their insulin producing cells each year. Yet they do not test positive for antibodies typical with Type 1 diabetes.
It is important to properly identify type 2 from type 1 in children. These two types of diabetes are not the same. Children with type 2 often have fatty liver disease which triggers not only diabetes but many other health problems. Also as more medications are approved for children with type 2, it is important to provide the appropriate therapy.
Children have so many hormones that effect their blood sugar. When parents with Type 2 think they know everything they need to know about diabetes, they find out kids can be very different.
Kids on insulin need multiple blood checks.
When children are placed on insulin, everyone needs to follow their physician’s recommendations on checking blood sugars. No body likes to check their blood sugar. I have known many teens who refuse to check their blood. Everyone feels guilty about what number is showing up.
The fact is, if you are not checking your blood sugar, you should feel guilty! Especially if you are taking insulin to correct it. This can be so dangerous!
Genetics is not a death sentence!
Family genetics does not mean your kids are doomed to a life with diabetes. But it does mean parents need to take their weight and activity levels are a more serious level. It is so much easier to lose 10 pounds than 100 pounds. Teaching kids better life skills is important for families with diabetes.
Diabetes is always progressive. If you choose to ignore it, it will get worse. If you know your risk for this disease, then take responsibility for your life. So many people love you and are depending on you, take care of yourself.
For more information about healthy life skills for children,
contact me at Julie@kidsatriskfordiabetes.com
For additional information including additional references, please see my article, “Childhood Diabetes Prevention” “It Takes a Team”
Article: Chann JM, Rimm EB, Colditz GA et al Diabetes Care 1994, 17.961-969 & Ohlson LO, Larsson B, Svadsudd K et al Diabetes 1985; 35 1055-1058