The first long-term study of children diagnosed with type 2, or “adult-onset” diabetes, shows that as young adults, many suffer from severe complications, including kidney disease, miscarriages, and death.
The study, though small, is ringing alarm bells for researchers here at a meeting of the American Diabetes Association, giving weight to predictions that a growing incidence of type 2 diabetes in children could have catastrophic health consequences in years to come.
Type 2 diabetes is the most common form of the disease, affecting at least 90% of the more than 17 million Americans with diabetes. It is associated with obesity, lack of exercise and genetics, and, until about 20 years ago, almost never occurred in teens or children.
Unlike type 1, or juvenile, diabetes, type 2 is most often detected in middle age or older, but it is increasingly being found in children, especially among ethnic minorities, and has become a “dramatic and very alarming fact of our lives,” says Eugene Barrett of the University of Virginia, vice president of the diabetes association.
Because it is new in children and many doctors don’t look for it, many cases may be overlooked, experts say. In communities where there is a large Hispanic, Native American or black population, as many as 50% of newly diagnosed children have type 2, Barrett says.
Heather Dean, professor of pediatrics at the University of Manitoba in Winnipeg, Canada, who presented her study on Saturday, found a high rate of diabetic complications in a group of 51 Native Americans, now ages 18 to 33, who had been diagnosed with type 2 diabetes before the age of 17. She reported:
- Three are on dialysis because of kidney failure.
- One became blind at 26.
- One had a toe amputated.
- Of 56 pregnancies, only 35 resulted in live births.
- Two died of heart attacks during dialysis. Another five died of causes unrelated to diabetes.
Because her study was small and involved a genetically distinct group, Dean says, the findings can’t be applied to all children with type 2 diabetes. And, she says, the outlook may improve, thanks to advances in the treatment of diabetes in the past 15 years.
“We’ve become much more aggressive in our treatment strategies,” she says. “My sense is the future is more optimistic, but this is the first group, and this helps us to realize this is a very aggressive disease with very serious long-term complications.”
The reasons for the increase in children are not entirely known, but many experts believe inactivity, overeating, and genetics are coming together to create a public health time bomb set to go off over the next two decades.
“Obesity is pulling the trigger,” says pediatrician Silva Arslanian of the University Of Pittsburgh School Of Medicine. “Rates of obesity in children are escalating like a rocket. Two of five children are overweight, and some races are even more prone to be overweight.”