For Immediate Release
November 18, 2010

KDHE Office of Communications
communications@kdheks.gov, 785-296-0461

Preventing Type 2 Diabetes in Childhood

An Op-Ed Column by Jason Eberhart-Phillips, MD
Kansas State Health Officer

No sign of the nation’s childhood obesity epidemic is more heartbreaking than the rising incidence of type 2 diabetes among adolescents. Some experts call it the “first consequence” of America’s emerging problem of youth obesity.

Type 2 diabetes is supposed to be an adult disease. In fact, it was once called “adult-onset diabetes,” because it hardly ever occurred before 40 years of age – until recently.

Now, thanks to unprecedented levels of obesity in childhood, the disease is turning up in thousands of American teenagers every year. Although no one knows for sure, the number of youths with type 2 diabetes aged 12 to 19 years may now exceed 40,000 nationwide.

This November, as Kansas observes National Diabetes Month, it is these kids, whose illness we adults are failing to prevent, who stand at the forefront of our minds.

The risk of developing type 2 diabetes increases sharply when a child has excess weight for several years. With obesity rates doubling among children aged 6 to 11 years since 1990 – and more than tripling among adolescents aged 12 to 19 years during that time – it should come as no surprise that type 2 diabetes is also on the rise in young people.

Type 2 is by far the most common form of diabetes in adults. It develops when glucose, the basic fuel for the body’s cells, builds up in the blood because the cells have become resistant to the action of insulin, a hormone produced in the pancreas.

At first, the pancreas pumps out more insulin to overcome the resistance, but eventually it can’t keep up. Over time, high levels of glucose begin to damage critical blood vessels, leading in some cases to blindness, kidney disease, problems with the nervous system, and higher risk for heart attacks and strokes.

The warning signs of type 2 diabetes can include fatigue, increased thirst, frequent urination, blurred vision, slow healing of sores and cuts, and irregular periods in girls. Some youngsters exhibit a darkening patch of skin on the back of the neck or elsewhere that doctors call acanthosis nigricans.

But often there are no obvious signs at all. The onset of type 2 diabetes can be slow and insidious, leaving many young people undiagnosed for years.

That’s why clinical screening for diabetes in overweight youth is so important. The only way to detect type 2 diabetes for sure is to routinely offer high-risk kids a simple blood test, such as a serum glucose level measured after an overnight fast.

If these tests show evidence of diabetes, glucose-lowering treatments can begin right away, before the damaging effects of diabetes become severe. The tests can also identify kids who have “pre-diabetes,” a condition half way down the path to full-blown disease.

It is estimated that in America today there are two million adolescents with pre-diabetes. Fully one in five overweight teenagers now finds themselves in this high-risk group.

How can we together prevent these young people from developing type 2 diabetes? How can parents, health professionals and other concerned adults join forces to reverse the troubling increase of type 2 diabetes among young people today?

The twin pillars of diabetes prevention are healthy eating and active living. This means keeping junk food out of our homes and schools, helping kids avoid excessive consumption of calorie-rich fast foods and other snacks, and putting more effort into ensuring that children receive nutritious, well-balanced meals every day.

It also means being more intentional about encouraging physical activity, so that the calories kids take in get burned off in active play.

For parents that means turning off the television and the computer games. For school leaders it means working more vigorous physical activity into the school day. For community leaders it means ensuring that there are attractive recreational areas for children to play, and programs that promote physical activity.

No one in Kansas needs to develop type 2 diabetes before they are well into middle age. It should never happen to a child. Together we can make sure it never does.

Dr. Eberhart-Phillips is the Kansas State Health Officer and Director of Health in the Kansas Department of Health and Environment. He can be reached at jeberhart-phillips@kdheks.gov. Go to his blog at: www.kdheks.gov/blogs/dr_jasons_blogs.htm.