Children and Diabetes

Written by Michael Corrieri

According to the American Diabetes Association or ADA, the rise in Type 2 diabetes in children has reached epidemic proportions.

Type 1 diabetes was historically thought to be the type of diabetes that children contracted, except for rare cases. In fact type 1 is traditionally called juvenile diabetes. But in the last several years there has been a growing percentage of children and young adults that are being diagnosed with type 2 diabetes.

Type 1 Diabetes and Children

Children diagnosed with type 1 diabetes have often had a recent weight loss and generally are not obese. They usually experience thirst and frequent urination and the symptoms have generally been present for only a short period of time. There are other common indicators, like a type 1 diabetic child will generally have a family history of diabetes in only 5% of their first and second degree relatives and about 35% of them have ketones present at testing.

Type 2 Diabetes and Children

Children diagnosed with type 2 on the other hand are almost always overweight at diagnosis. Only 30% will have ketones in the urine, but almost all will have sugar present in the tests. Most of the children won’t have had the signs of thirst and increased urination. There is usually a history in the family of diabetes with over 75% of the children having a first or second degree family member with diabetes.

The type 2 diabetic child is typically Asian, American Indian, African or Hispanic. Close to 90% of those children who are diagnosed with type 2 diabetes will have shinny, dark patches of skin on the back of their neck and/or between their toes and fingers.

Children at Risk

The risk for children to develop type 2 diabetes is on the rise. Genetics plays a part in this upsurge, as more adults are contracting the disease as well. But there is a complex association with environmental, social, and behavioral factors that contribute to the alarming increase in cases of type 2 diabetes in children.

Most cases of type 2 diabetes are found during the onset of puberty. This time of a child’s life can be seen as a trigger, the changes in hormone levels causing insulin resistance and decreased insulin productivity. Although there have been toddler aged children diagnosed with the disease.

One of the most significant factors in the rise of type 2 diabetes is obesity. Obese children produce an abundance of insulin. When there is a sudden need for more insulin, the obese child’s body is less likely to be able to produce what is required.

Added to the insulin production problem is the presence of all the fat cells. The fatty tissue can lead to insulin resistance.

Type 2 Diabetes Screening

The American Diabetes Association has made suggestions on children that should be screened for diabetes. If the child is older than ten, or earlier if they’ve started going through puberty earlier, and they have a body mass index greater than 85th percentile. Or their weight is more than 120% of the ideal weight for their height. If they meet the above, and have any two of the following risk factors, they need to be tested. Those risk factors are:

Having a family history of Type 2 diabetes in a first or second degree relative.
Having an ethnic background of Asian, African-American, American Indian, Hispanic, or Pacific Islander origin.
Having signs of insulin resistance. These signs include fatigue, poor memory, a drop in grades at school, falling asleep immediately after eating a meal with a high percentage of carbohydrates.
Having conditions present that can be associated with insulin resistance: e.g., acanthosis nigricans, polycystic ovary syndrome, high blood pressure, and blood fat disorders.

If the child has two or more of the above, is considered obese, and over ten, you should screen every two years for diabetes. The type of test recommended for this screening is a fasting blood sugar test.

Prevention Before Diagnosis Of Diabetes

One of the best things you can do to possibly prevent diabetes in children is to ensure they get enough exercise and eat a healthy diet. Children and adolescents should have one hour or more of sustained physical activity each day. Most of these sixty minutes should be spent running, jump roping or doing some type of aerobic activity. Start with walking, then walking up and down stairs, do whatever it takes to keep moving.

As they maintain sixty minutes a day of aerobics, include some age appropriate strength training and bone strengthening activities. A good site to visit with detailed information on activities and requirements for active children is: http://www.cdc.gov/physicalactivity/everyone/guidelines/children.html.

The next step in working on preventing diabetes in children is meal planning and eating right. If they aren’t on a doctor specified diet, check out sites like: http://www.americanheart.org/presenter.jhtml?identifier=1477. This is the American Heart Association’s site dedicated to parents for helping their children eat right.