In Canada, about one in 400 children have Type 1 diabetes. Children with Type 1 tend to be of average weight and can come from any ethnic background. When diagnosed, most children with Type 1 diabetes feel quite sick. They will have lost a lot of weight, have very high blood sugars, ketones in their urine and are dehydrated. They also have a dramatic increase in thirst and in amount of urine. In Type 1 diabetes, genetic factors combine with environmental factors and various stresses. These cause the body to destroy the insulin-making cells of the pancreas. Since the body no longer makes insulin, children who develop Type 1 diabetes will need insulin injections for the rest of their lives.
In Type 2 diabetes, the pancreas may produce normal insulin levels but for various reasons the body becomes resistant to insulin. Obesity is largely to blame in insulin resistance. Studies suggest that between 85 to 92 per cent of children and teens with Type 2 diabetes are overweight. Most of these children have a strong family history of obesity and Type 2 diabetes. Children from non-European backgrounds – African, East Indian, Hispanic, Asian, and Aboriginal Peoples - are more likely to develop Type 2 diabetes. They are most often diagnosed after the age of 10 when they have already begun puberty. Girls are affected more often than boys; at a rate of about three to one. When they first develop diabetes, children with Type 2 rarely feel sick. They have glucose in their urine but ketones are uncommon.
Unlike children with Type 1 diabetes, children with Type 2 don’t usually lose a lot of weight. They may have only a mild increase in thirst and amount of urine. There is another notable difference between Type 1 and Type 2 diabetes in children and teens. Up to 85 per cent of kids with Type 2 diabetes have a skin condition called acanthosis nigricans. This shows as patches of dark, velvety skin found on the back of the neck, the folds of the arms, and the inner thighs.
In the past two decades the number of children and teens with Type 2 diabetes has skyrocketed. This trend is very disturbing because diabetes is the seventh leading cause of death in Canada.
There are long term effects of high blood sugar levels associated with diabetes. These can include heart disease, high blood pressure, kidney failure, blindness and problems that can lead to limb amputations. Twenty years ago, when Type 2 was 'adult onset' diabetes, people often had complications in their 50’s, 60’s, and 70’s. Today, a person who develops diabetes in their early teens may see complications in their 20’s or 30’s. These problems can be a personal tragedy for young adults as well as a huge strain on our health care system. Diabetes experts agree that Type 2 diabetes in children and teens is a major concern and even an emerging epidemic. A number of measures are all of great importance in controlling this disease. These are prevention, identifying those at risk, screening for early detection, and aggressive treatment.
Since there is no cure for diabetes, treatment is aimed at managing the disease and keeping blood sugars near the normal range (between 4-7 mmol/L). Managing diabetes includes watching the amount of food eaten, cutting back on excess fat and sugar, and getting regular exercise. It also means taking medication (if prescribed), watching blood sugars, and regular meetings with a diabetes care team.
Although children with Type 1 diabetes depend on insulin for survival, insulin may or may not be used for those with Type 2. Medication used to treat adults with diabetes is now being tested in children and teens with Type 2. Used together with diet and exercise, this medication does two things. It can help the body better use its insulin supply, or slow the absorption of carbohydrates and fats in the digestive system.
Many children who have Type 2 diabetes don’t feel sick. It is hard for them to understand why they need to take medication or make major lifestyle changes. Children with diabetes need supportive role models. Parents and other family members should take a role in caring for their child’s diabetes. When one person is affected, the family as a whole should eat healthy foods, exercise, and learn about diabetes. This gives children with diabetes the best chance of success.
Most experts agree that the key to preventing Type 2 diabetes in children and teens is to intervene early with kids who are at risk for developing the disease. Those who are obese, have a family history of Type 2 diabetes, and whose ethnic background has a high incidence of diabetes are all at risk. A low cost and easy way to screen for Type 2 diabetes is a fasting blood glucose (FBG) test. Discuss with your doctor whether your child could be at risk for Type 2 diabetes and if an FBG test is appropriate.
Obesity in children and teens has become a serious problem due in part to inactive lifestyles and our fast food culture. Avoiding obesity through a balanced diet and regular exercise is the most important strategy in preventing Type 2 diabetes. Parents, educators, and health care providers must encourage children to exercise and eat a healthy, balanced diet from an early age. This is important to establish lifelong habits. Clearly, the dramatic rise in the number of children and teens with Type 2 diabetes makes it vital to intervene early. We must try to stop this growing epidemic that is threatening the health and well being of our young people.