In recent years, health experts have noted rising rates of diabetes among the general population and in adolescents.
Should parents be concerned? To find out, we spoke with Dr. Paula Newton, director of pediatric endocrinology at the University of Maryland Center for Diabetes and Endocrinology at the University of Maryland Medical Center Midtown Campus, and Dr. Debra Counts, chief of pediatric endocrinology at The Herman and Walter Samuelson Children’s Hospital at Sinai.
Two types of diabetes exist: Type 1 and Type 2. According to Newton, “Type 1 diabetes is an autoimmune condition where your immune system—which is supposed to fight germs, bacteria and things that make you sick—instead starts attacking (your pancreas). Your pancreas can no longer make insulin.” As a result, a person’s blood sugar increases. To address this increase, a person must treat this condition with insulin.
“Type 2 diabetes is more related to weight, exercise and diet,” Newton says. “When people are diagnosed with Type 2 diabetes, often their pancreas can still make insulin—and often makes an increased amount of insulin—but it is still not enough to keep…blood sugars in the normal range.” This type of diabetes, Newton says, is usually initially treated with insulin. However, “as the blood sugars improve and (patients) make lifestyle changes, many can decrease the amount of insulin required and can utilize more oral medications.” Counts notes that medical researchers indicate that if individuals with Type 2 diabetes can lose 10% of their body weight, Type 2 diabetes can reverse itself.
Risk factors and health consequences
Risk factors for diabetes depend on the type. Newton points out that people with Type 1 diabetes have a greater likelihood of having a family member with other autoimmune conditions. People with Type 2 diabetes are more likely to have a parent or other close member of the family with insulin resistance or
Type 2 diabetes.
In addition, Newton says, “The risk of Type 2 diabetes (differs with) race and ethnicity, with American Indians, African Americans, and Latinx (individuals) being most at risk.”
Age also contributes to risk. “Type 2 diabetes is more common in people over age 10 and those … in puberty as compared to younger children,” she says. Finally, a major Type 2 diabetes risk factor is lifestyle. Weight gain, lack of exercise and eating high-calorie and high-fat foods in large amounts are contributing factors.
Unfortunately, Newton explains, Adolescents who have Type 2 diabetes are at increased risk for metabolic conditions such as high cholesterol and high blood pressure as well as “complications of persistent high blood sugars such as visual impairment, kidney disease and neuropathy (numbness, weakness and pain in the feet and legs).”
According to Newton, 1 in 400 people younger than age 20 have Type 1 diabetes. “The incidence in minority populations (African American and Latinx communities) has shown a slight increase over the past several years,” Newton says.
Counts explains that since the beginning of the COVID-19 pandemic, a significant increase in Type 1 diabetes among children of all ages has occurred. “The virus seems to affect the immune system in some people, triggering … insulin-dependent diabetes.”
Newton says that even prior to the pandemic, the number of Type 2 diabetes in the under-20 U.S. population was increasing at an alarming rate.* Locally, the University of Maryland Medical Center has noted a “statistically significant increase in … children and adolescents less than 20 years of age newly diagnosed with diabetes (over the last year),” with most of this increase driven by an increase in the rate of Type 2 diabetes.
Counts says that this alarming increase in Type 2 diabetes in adolescents is due to “the increase in … obesity in our teens,” caused by decreased physical activity and increased caloric intake.
Prevention and screening
The Centers for Disease Control and Prevention reports no known prevention methods for Type 1 diabetes. However, doctor recommendations, blood sugar monitoring and regular health checkups can help individuals manage it.
On the other hand, several lifestyle changes can help prevent Type 2 diabetes. Counts advises, “The best things parents can do to prevent Type 2 diabetes is help their adolescents get more active (such as walking together as a family) and … eat a healthier diet.”
Newton adds, “Kids are more likely to want to participate when their grownups are involved” and recommends that the whole family contribute to meal planning. Choose fruits and vegetables in lieu of high-calorie, high-fat foods. Sleep is important, and Newton reports that a consistent eight to 10 hours a night is optimal for children.
*Source: “Youth-Onset Type 2 Diabetes Consensus Report: Current Status, Challenges and Priorities,” Kristen J. Nadeau et al, Diabetes Care, Sept. 2016, 39(9), 1635-1642, DOI: 10.2337/dc16-1066