Type 2 diabetes: An unexpected slap-down on teenage invincibility

By; Audrey Perkins

Type 2 diabetes (T2D), once referred to as adult-onset diabetes, now affects children and adolescents.  While the demographic of individuals living with T2D has expanded, the causes have stayed the same, with increased inactivity, poor dietary choices, and obesity contributing to its widespread occurrence.

The Centers for Disease Control and Prevention reports roughly 151,000 people under the age of 20 have diabetes, making this one of today’s most common chronic diseases in children and adolescents.

T2D is diagnosed in roughly 3,700 adolescents (youths aged 10 to 19 years old) per year and continues to increase, according to results of the SEARCH for Diabetes in Youth Study, published in a 2007 issue of the Journal of the American Medical Association.  Much of this increase is associated with the parallel relationship between T2D and obesity, a global epidemic that currently affects one in six adolescents within the U.S. population alone.

Timothy J. Halliday and Sally Kwak report in their 2009 Economics and Human Biology article titled “Weight Gain in Adolescents and Their Peers,” that adolescent obesity has risen from just fewer than 5 percent in 1966, to above 15 percent today.

So where does the Rochester community fit in with these statistics?

According to the Monroe County Health Department, which used BMI calculations from 2006 medical records to estimate obesity, 17 percent of adolescents aged 11 to 18 years are obese, and another 16 percent are overweight.

Camp ASPIRE, located at the Rotary Sunshine Camp in Rush, New York, and run by the American Diabetes Association (ADA), works with adolescents with type 1 and type 2 diabetes within Monroe County and surrounding areas.   The camp offers teenagers opportunities to learn about diabetes and develop skills to self-manage the disorder under skilled and continuous medical supervision.

Allison Pitkin, associate manager of delivery and administration for Camp ASPIRE said, in 2011, the camp registered and welcomed two campers living with T2D, but so far none for the 2013 summer session have signed up. She couldn’t say for sure the reason for this.

Sue Bates, a pediatric nurse practitioner at the Golisano Children’s Hospital located at the University of Rochester’s Medical Center, noted there has been an increase in the number of adolescents being treated for type 2 diabetes.

“We certainly are seeing more than we used to, but compared to the rest of the country we are pretty low.”

Many commonalities are presented within the medical literature surrounding adolescents with T2D.  Most of the patients tend to come from minority racial and ethnic backgrounds and have congruent health concerns among family members.  The ADA states approximately 80 percent of youth diagnosed with T2D have at least one parent with T2D.  In addition, adolescents are suffering adult health disparities such as lipid disorders, high blood pressure, obesity, high insulin levels, and increasingly high risk factors for heart and kidney disease.

In 1999, when the occurrence of adolescent T2D was first documented, the Archives of Pediatrics & Adolescent Medicine published a paper referring to T2D as a family condition.

A family condition indeed, especially concerning adolescents, where parental and family support is crucial to the adherence and treatment of this disease.

“The teen brain doesn’t mature until the early 20s,” said Bates.  “Unless they have a committed family who is willing to remind them to check blood sugars, to take medication, if they don’t have good support from the family, they fall through the cracks and they have terrible control.”

Heather Fiore, a registered dietitian and clinical nutrition specialist of pediatric endocrinology at Golisano, said in an email response that adolescents with T2D are such a diverse group it is often hard to generalize them and know how they’re going to react to suggestions regarding lifestyle changes and treating the disease.

“Some teens are diagnosed, but don’t start insulin or even check blood sugars that often,” Fiore explained. “For those teens, it’s very abstract and doesn’t feel real or important.  It’s hard to compare teens in these very different situations – they get very different information about diabetes and how it is treated.”

The good news is, adolescents have the ability to prevent or delay the onset of T2D.  Increasing physical activity, improving dietary habits, as well as a little bit of weight loss can make all the difference, with the smallest of changes being shown to promote healthy and happy outcomes.

REFERENCES

Anderson, B. J., & McKay, S. V. (2009). Psychosocial issues in youth with type 2 diabetes mellitus. Current Diabetes Reports, 9(2), 147-153. doi: 10.1007/s11892-009-0025-6   Link

Flint, A., & Arslanian, S. (2011). Treatment of type 2 diabetes in youth. Diabetes Care, 34 Suppl 2(Supplement_2), S177-S183. doi: 10.2337/dc11-s215   Link

Gregg, E. W. (2010). Are children the future of type 2 diabetes prevention? The New England Journal of Medicine, 362(6), 548-550. doi: 10.1056/NEJMe0912192   Link

Halliday, T. J., & Kwak, S. (2009). Weight gain in adolescents and their peers. Economics and Human Biology, 7(2), 181-190. doi: 10.1016/j.ehb.2009.05.002   Link

Pinhas-Hamiel, O., Standiford, D., Hamiel D., et al (1999).  The type 2 family:  a setting for development and treatment of adolescent type 2 diabetes mellitus.  Arch Pediatr Adolesc Med, 153: 1063-1067.

The SEARCH for Diabetes in Youth Study Group (2006):  The burden of diabetes among U.S. youth:  prevalence estimates from the SEARCH for Diabetes Youth Study.  Pediatrics, 118: 1510-1518

American Diabetes Association

http://www.diabetes.org

Monroe Country Department of Health

http://www2.monroecounty.gov/files/health/DataReports/adolescent%20report%20card%20final.pdf

Centers for Disease Control and Prevention

http://www.cdc.gov

SOURCES

Allison Pitkin

Associate Manager of Mission Delivery & Administration

Camp ASPIRE

585-458-3040 ext 3472

Sue Bates

Pediatric Nurse Practitioner

Golisano Children’s Hospital

585-756-4800

Heather Fiore

Clinical Nutrition Specialist

Golisano Children’s Hospital

Heather_Fiore@URMC.Rochester.edu

About the Author: I am a senior at Rochester Institute of Technology and will be graduating with a bachelors in Nutrition Management with a minor in journalism. I am a true believer in healthly living – it’s an investment many tend to forget about.  I enjoy writing and want to further my experience by educating others on topics related to food, nutrition, health, and overall wellness.  I welcome questions anytime!  My twitter handle is @aperkins31 orhttp://twitter.com/aperkins31

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