A new study published in the May 21 issue of Pediatrics shows a rise in prevalence of a number of risk factors for cardiovascular disease among teens based on NHANES data from 1999-2008. One risk factor that was examined was pre-diabetes and diabetes, which had a prevalence of 23% in 2007-2008 data, based on 8 hour fasting blood glucose tests of teens ages 12-19. This is up from 9% in 1999-2000 data. The study warns that the result should be interpreted with caution as single blood glucose tests in children can be inaccurate. In any case, the upward trend of prevalence of diabetes is alarming, as this medical condition has serious consequences.
There are two types of diabetes seen in children and teens, which have different etiologies. Type 1 Diabetes is a genetic, autoimmune disorder in which a child’s pancreas cannot produce insulin. Type 2 Diabetes involves insufficient insulin production and/or insulin resistance at the cells related to overweight status, poor quality of diet, and inadequate physical activity.
Overview of Physiology of Type 2 Diabetes:
In human physiology and digestion, carbohydrates are consumed, digested and broken down to simple sugar molecules. These are then absorbed from the gut to the blood stream, and circulated throughout the entire body to all the organs and tissues, to be used as a primary source of energy. In response to sugar in the bloodstream, the pancreas releases insulin. Insulin is the critical hormone needed to “open” all cells in the body so that the cells can uptake and utilize sugar from the blood stream for energy.
In Type 2 Diabetes, either the pancreas is no longer able to produce enough insulin to manage all of the sugar in the bloodstream, and/or the cells throughout the body are no longer responding to the insulin knocking at the door. In both cases, sugar is not being utilized properly by the cells and is circulating in higher than normal levels in the bloodstream. This elevated blood sugar level is how diabetes is diagnosed, and is what causes the complications of diabetes. High levels of blood sugar can cause damage to the lining of the blood vessels, or cause “congestion” in the blood vessels. If blood is not flowing properly, then tissues are not being nourished or oxygenated well. If these tissues are in the brain or heart, this can cause stroke or heart attack. In the feet or hands, this causes poor circulation which can cause neuropathy, or tingling and numbness, and eventually circulation can be so poor that amputation is necessary.
Diet and exercise are directly related to both the development and treatment of Type 2 Diabetes
Over time, the pancreas cannot produce enough insulin to keep up with the body’s demands of chronically high blood sugar levels. In addition, cells in the body stop responding to the insulin accompanying high blood sugar levels, also known as “insulin resistance”. Type 2 Diabetes used to be called “adult-onset” diabetes, as it was formerly diagnosed later in life, when metabolism slowed and organ function declined with age. The fact that it is now seen in kids and teenagers is a huge indicator of poor quality of diet and lack of exercise, as seen in the NHANES population sample of the Pediatrics study. It is also directly correlated with the rise of obesity and overweight in kids and teens.
The bigger message of this study is that overweight teenagers may face a difficult road of health problems, if changes to their diet and lifestyle are not made today. Type 2 Diabetes is preventable and often can be managed with diet and lifestyle changes, under medical supervision. Studies have shown that even 10% weight loss (of total body weight) lowers blood sugar levels. Also, exercise directly stimulates the cells to uptake sugar from the blood stream, improving the issue of insulin resistance. If your child or teen is overweight, obese, or has been diagnosed with pre-diabetes or diabetes, do not delay addressing the issue. Meet with a registered dietitian to make a plan to prevent or manage diabetes.