There was a time when Type 2 diabetes, also called “late onset diabetes,” was considered to be your grandmother’s disease. But now pediatricians are warning that your 10-year-old may be at risk.
“I think one of our greatest challenges is the growing epidemic of diabetes that covers all parts of the lifespan,” says Kellie Rodriguez, director of education services at the Diabetes Research Institute at the University of Miami Miller School of Medicine. She is the mother of three young children and hopes to prevent her children from getting it.
Insulin that is produced in the pancreas regulates how blood sugar moves into the cells, where it is used for energy. Children have long been diagnosed with Type 1 diabetes that occurs when the pancreas stops or slows its production of insulin. But the incidence of Type 2 diabetes, which occurs when the body doesn’t respond properly to insulin, is on the rise. (More than 90 percent of diabetes cases are Type 2, which can be controlled with diet, exercise and weight loss.)
According to the American Diabetics Association, about one in 400 children and adolescents have diabetes. And the ongoing SEARCH study that began in 2000 finds that Type 2 diabetes is becoming more common in children over 10, especially for minority populations, including Hispanics.
“The crux of the problem is that we will have a generation of kids who will get the complications we associate with the elderly much earlier in life,” says Dr. Jose Perez-Rodriguez, a pediatric endocrinologist with Baptist Children’s Hospital. “This will be a substantial economic and medical burden.”
It can take 10 to 15 years of having uncontrolled high blood sugar levels to develop more severe complications. Therefore a child at 10 who is diagnosed with diabetes could be suffering complications in his 20s and 30s instead of in old age like his grandmother.
Imagine a four-inch pipe that has thick sugar syrup running through it. As time goes by, the “sugary goop” starts to accumulate in the walls of the pipe, explains Perez-Rodriguez. As it builds up, the opening of the pipe — or lumen — gets smaller and smaller.
After 30 years of sugar syrup running through that pipe, if you cut it crosswise you’ll discover it is clogged. In the body of a person with uncontrolled diabetes, that sugary syrup is blood and that pipe represents blood vessels.
“Your veins and arteries don’t like syrup running through them so they put a wall between the blood vessels and the lumen,” Perez-Rodriguez says. This cuts down the flow of nourishment to every part of the body.
Now think of the protein that is in every cell, every organ and every tissue of your body. When the sugary syrup comes in contact with it, the protein loses its flexibility.
“This also contributes to complications from diabetes,” says Perez-Rodriguez, adding that blood vessels should be flexible like cooked spaghetti. If they become rigid, they can’t do their work well.
The long-term complications of diabetes include nerve damage that can result in a loss of feeling in the hands and feet.
Then you might get a cut on your foot but don’t realize it because the nerves aren’t telling you there’s pain. Because the wound doesn’t get the blood it needs to heal or the proper care, an infection occurs. Without treatment, it can reach the bone and then there’s no solution but amputation.
Chronic high blood sugar over a long period of time can also cause bleeding in the eye and vision loss, as well as glaucoma and cataracts. It can affect your kidneys, liver and heart, even your brain.
But don’t despair.
“One of the most important things doctors can do is to let their patients know these complications are preventable,” says Dr. Adriana Carrillo, assistant professor in pediatric endocrinology at the University of Miami Miller School of Medicine.
Think of a bucket. As a child, you start filling that bucket with a lot of risk factors for getting Type 2 diabetes, explains Dr. Will Charlton, pediatric endocrinologist at Joe DiMaggio Children’s Hospital in Broward.
Start with genetics. It’s known that people who are American Indian, African American, Hispanics and Asians are more likely to develop Type 2 diabetes than others.
Weight and age also play a part, as do your activity levels. And having a mother with gestational diabetes can also contribute to your risk of developing Type 2 diabetes.
“You put all your risk factors in that bucket and when you reach its top and it starts to overflow, you have diabetes,” Charlton says.
So the best way to keep your bucket from overflowing is to eliminate as many risk factors as possible. For example, you can’t change your genetics, but parents, with a little effort, can control what their child eats and how much they exercise.
“After all, there’s nothing special that we recommend for a child with diabetes that we wouldn’t recommend for any child,” Rodriguez says.
Start with diet.
When you go to the supermarket, fill up your cart with food items from around the outside of the store, Rodriguez suggests. You’ll be stocking up on whole foods including fruits, vegetables, wholegrain breads and lean meats and dairy products.
“The less you shop up and down the aisles of the supermarket the better off you will be,” she says. That’s because the center of the store tends to be stocked with processed and packaged foods.
“A lot of those packaged foods are really just packaged problems,” Rodriguez says.
Portion control also is important. Overfeeding is a problem than can start as early as birth.
For the first six or seven months, a baby has the tendency to suck, says Perez-Rodriguez. When a mother sees this she thinks the baby is hungry and feeds him. Then he cries and she gives him more. But he’s crying because his stomach is overextended and uncomfortable, not because he’s hungry.
Once a young child gets used to overeating, it’s a hard habit to break. Doctors also recommend breastfeeding instead of using formulas that contain a lot of sugar.
It was Rodriguez’s pediatrician who told her the best thing she could do as a mother was to not feed her children special food after about age 1. So she feeds her 1-year-old the same food she feeds the rest of the family — just cut smaller and in smaller portions.
“I make one meal and we all eat it,” she says.
Perez-Rodriguez also recommends limiting the amount of soda, milk and juice that you give your children. These beverages contain lots of sugar without much fiber.
“I try to tell parents if their children don’t drink juice, so what? A child who has never had juice in his life is not an unhappy child and he’s not a deprived child. We have to change the perception that the child who doesn’t get juice is making a sacrifice,” Perez-Rodriguez says. He’d rather you give your child an apple than a glass of apple juice.
Another way to cut the risk of developing diabetes is to get your family moving. Limit television time and step away from the computer. Carrillo recommends one hour of television a day and at least an hour of physical activity.
You don’t have to think of this as effort and exercise. Make it fun.
Rodriguez takes her children to the playground. “I make it a family affair. I go with my Munchkins and put my 39-year-old-tush down the slide. It doesn’t fit as well as my 1-year-old’s but I do the best I can,” she says.
After all, being overweight is just as big a diabetes risk factor for parents and siblings as it is for the child whose diabetes has already presented itself.
“Kids are smart and can make good choices. But it’s easier to live better if you have the parents on board, too,” Rodriguez says.