Children and Youth with Type 2 Diabetes

I have helped many children with diabetes over the span of my career.  Sometimes I wonder about the children that I have helped and lost touch with.  Many of the very young children I have helped developed type 1 diabetes but I have also helped children as young as 4 years of age with type 2 diabetes as well as many older children. This blog explores type 2 diabetes and children.

Incidence of type 2 diabetes among children is increasing with time

In May of 2014, a study was released by The Journal of the American Medical Association (JAMA) exploring the prevalence of diabetes in children ages 10-19.  Using data from the years 2001 and 2009, researchers found a 35 percent greater incidence of type 2 diabetes in 2009 compared to the same age group in 2001. Children between the ages of 15 and 19 and girls had more cases of diabetes among them than younger children in the study. Based upon data from the study, researchers estimated that the number of children with type 2 diabetes between 10-19 years would most likely increase four-fold between the years 2010 and 2050. (1)

Possible reasons for the increase in children with diabetes

The JAMA article mentions a few possible reasons for this increase. Childhood obesity, minority population growth, exposure to diabetes in utero and endocrine-disrupting chemicals are listed. (1) It has been found that obese children who have insulin resistance will go on to develop diabetes faster than adults with the same condition. (2)

Children with diabetes have many problems such as an increased risk of diabetes complications. Experts also worry about a possible increase in diabetes for these children’s children with an increase of diabetes during childbearing years. (1) For more information on genetics and diabetes, read the blog Diabetes and the Risk to Your Family Tree.

Endocrine disrupting chemicals

Please do think carefully about the following chemicals/substances and their links to obesity and type 2 diabetes;

1. There is a link between a mother smoking while pregnant and a problem with a healthy weight (overweight or obesity) in their children. (3) It has been shown that in adolescent and adult women that parental smoking is associated with excessive weight in adulthood. (4)
2. Arsenic in the groundwater of an area in Mexico has been suggested and theorized to hinder the production of insulin with glucose stimulation which may potentially lead to diabetes. This potentially happens when the arsenic level in the drinking water is equal to or over 150 micrograms per liter.(5,6)
3. The following chemicals are suggested to have a possible association with the development of diabetes: dioxin-like chemicals and dioxin, trans-nonachlor, dichlorodiphenyldichloroethylene (DDE) and polychlorinated biphenyls (PCBs). (7)

Health issues in children with diabetes

• Experts find that many adolescents do not eat what is nutritionally required. Their intakes are not acceptable.  Current guidelines for limiting saturated fat are followed by 7 percent of youth.
• Depression occurs in approximately 9 percent of adolescent girls.  For those with diabetes problems with unstable, poorly controlled blood glucose is common.
• Type 2 diabetes adversely affects lipid levels in approximately one fifth of youth. This is a problem seen in many people with cardiovascular disease. Multiple cardiovascular disease risk factors are often found in these children. (8)

Factors to Discuss with the Medical Team of a Child with Type 2 Diabetes

The discovery and treatment plan for a child with type 2 diabetes should be discussed with the child if appropriate and the parents or caregivers.  In my experience, I find more children have positive responses to treatment when their whole household makes positive changes that do not seem to punish the child with diabetes. The family should seek advice from a diabetes treatment team including their doctor, certified diabetes educators (especially a nurse and dietitian) and possibly a mental health counselor as well as a physical therapist. I find that in many families where the child is obese with diabetes, others in the family also have the same medical conditions. Suggested treatments for the family include, education to manage the diabetes and if the child is obese, to help stabilize the child’s weight so he/she can grow into it or sometimes the medical team will suggest weight loss for the child. Just like an adult with diabetes, the treatment plan usually consists of a meal plan, exercise recommendations, medications for diabetes and sometimes medications to improve blood lipid levels. Usually blood glucose monitoring is necessary and the child needs to be followed by a team that is comfortable working with children and youth with diabetes. (9)

I have found when families take the condition seriously and follow the advice of the medical team, that the whole family benefits.

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