The term “adult-onset diabetes” is no longer relevant, as the numbers of kids and teens who are being diagnosed with Type 2 diabetes continues to climb – at alarming rates.
Doctors attribute poor diets and lack of exercise on the sharp rise of Type 2 diabetes in youth in the U.S., especially among certain ethnic and racial groups.
“Unfortunately, this is all part of the obesity epidemic sweeping our country, which also affects younger kids,” says Dr. Pascual de Santis, an endocrinologist with Baptist Health Medical Group.
“This has to do with increased consumption of processed, and rich-in-calorie foods, as well as the significant decrease of physical activity in this population — less sports and more video games.”
De Santis says genetics and diet are “the two hits” that often determine if someone is at risk for developing Type 2 diabetes. “There are plenty of kids who are obese or overweight that do not develop diabetes,” he says. “This is true mostly in Caucasians. Most other ethnic groups are at higher risks of developing this disease.”
In South Florida, the disease is particularly prevalent within African-American and Hispanic communities.
The Centers for Disease Control and Prevention (CDC) and the National Institutes of Health (NIH), funded a decade-long study, which concluded in 2012, called SEARCH for Diabetes in Youth. It shows alarming figures in the rate of new diagnosed cases of Type 1 and Type 2 diabetes in adolescents.
New cases of Type 2 diabetes in people under 20 increased 4.8 percent per year, more than double the rate of new Type 1 diabetes cases, which increased 1.8 percent annually.
They study also showed that in 10 to 19-year-olds, the rate of new diagnosed cases of Type 2 diabetes rose most sharply in Native Americans (8.9 percent), Asian Americans/Pacific Islanders (8.5 percent) and black non-Hispanics (6.3 percent). In Hispanic youth, it rose 3.1 percent. The smallest increase, according to the report, was seen in white non-Hispanics (0.6 percent).
Additionally, the rate of new diagnosed cases in 10 to 19-year-olds, “rose much more sharply in females (6.2 percent) than in males (3.7 percent),” according to the report.
Type 2 diabetes is when the body resists insulin or doesn’t produce enough of the hormone, causing blood sugars to rise. It can be managed with medications, along with a healthy diet with minimal intake of sugars and carbs. Over time, people with Type 2 diabetes may have to take insulin injections, (as it’s a progressive disease), to keep blood glucose levels within healthy limits.
Dr. Janine Sanchez, director of the Pediatric Diabetes Program at UHealth, says kids and teens should exercise for 30 to 60 minutes daily, avoid naps and staying up late, limit leisure screen time, establish a healthy diet including vegetables, limit snacks, and avoid these things: drinks with high calories like juice, shakes, and sodas, eating dinner late or close to bedtime, skipping meals, and foods like chips, pizza, and fast food.
“It’s best to try to prevent Type 2 diabetes from occurring by developing healthy habits and maintaining them from an early age,” she says.
She advises parents to contact their child’s pediatrician if they have concerns that their child may have or show symptoms of diabetes.
Symptoms of Type 2 diabetes, according to the Mayo Clinic, include increased thirst and frequent urination, increased hunger, weight loss, fatigue, blurred vision, slow-healing sores or frequent infections, and areas of darkened skin. These signs often develop slowly, sometimes over years, making it difficult to identify.
“It’s very sad to me that we are having to discuss Type 2 diabetes in youth. This used to be essentially unheard of,” says Dr. Joshua Tarkoff, a pediatric endocrinologist at Nicklaus Children’s Hospital.
“The results of having Type 2 diabetes are potentially devastating,” he says. “There are increased risks of cardiovascular disease as well as other complications from diabetes, such as kidney disease, eye disease and nerve damage. Also, most children are at increased risk of non-alcoholic fatty liver disease, which is one of the fastest-rising causes of liver dysfunction. It has a huge impact on quality of life for the child.”
Tarkoff attributes the sugar content found in most foods and drinks as the leading factor for the rise of Type 2 diabetes in youth. “The problem is that sugar is hiding in 74 percent of packaged foods and that there are at least 61 different names for sugar. It is really hard to avoid unless you are reading labels,” he says.
As for why certain ethnicities are more prone to the disease, he says, “There are certainly ethnic groups that suffer from higher risk of diabetes and obesity. While in the past their genetic makeup may have been beneficial for times of famine, in today’s “obesogenic” environment of relatively plentiful food quantities and less activity, it is a recipe for disaster.”
“Children should be getting exercise every day,” he says. “We used to be able to rely on the schools to make sure that children are getting a reasonable amount of activity. Unfortunately, for many reasons, exercise in school is too often limited or non-existent.”
Andi Jacobson, a certified diabetes nurse educator at Joe DiMaggio Children’s Hospital in Hollywood, teaches families about living healthier lifestyles as part of her job.
She’s been at the hospital for over two decades and says she’s seen a significant increase in kids and teens being diagnosed with diabetes.
She believes technology aids in a sedentary lifestyle, which could lead to health complications. “When you go to the restaurant look around – how many people are interacting? Usually when you interact and you eat, it takes a little longer to digest the food,” she says. “But if you’re interacting with your cell phone, it’s very different.”
She says portion sizes and eating at the right times are important. “Hormones play a factor, too,” she says. “Insulin is a hormone. In puberty, one has more insulin resistance and there are other hormones that affect blood sugar.”
Where to turn for help
UHealth – the University of Miami Health System: http://pediatrics.med.miami.edu/endocrinology
Baptist Health South Florida’s community health and wellness programs: https://baptisthealth.net/en/education-events/pages/default.aspx
Division of Pediatric Endocrinology at Nicklaus Children’s Hospital: https://www.nicklauschildrens.org/medical-services/endocrinology-and-diabetes
Division of Pediatric Endocrinology at Joe DiMaggio Children's Hospital: https://www.jdch.com/services/endocrinology
American Diabetes Association: www.diabetes.org
Centers for Disease Control: www.cdc.gov/diabetes/prevention/.