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Excess weight contributes to increase in Type 2 diabetes among youth

Children and diabetes

Type 2 diabetes is on the rise among children in the U.S. The disease — formerly called adult-onset diabetes — now affects four times as many youth as it did 20 years ago.

The culprit is excess weight, according to the Center for Disease Control and Prevention. Thirty-five percent of teenagers and 18 percent of those 12 and younger are now overweight or obese, having a Body Mass Index of 25 or greater. An estimated one in six of these overweight teenagers now has prediabetes — a blood glucose that is higher than normal, or between 100 and 125 — which frequently leads to type 2 diabetes.

What is type 2 diabetes?

Unlike type 1 diabetes — in which the body produces no insulin at all and lifelong insulin therapy is required — type 2 diabetes occurs when the body fails to properly use or make enough insulin, the hormone that moves blood sugar (glucose) into cells where it is converted to energy. Often, the onset of type 2 diabetes is the result of lifestyle choices. The disease is treated by modifying diet and often requires medication.

How does weight contribute to type 2 diabetes?

The cells of the body have special insulin receptors (insulin receptor substrates) that allow them to take in glucose from the blood stream, store it and convert it into energy. Excess fat hinders the cells' ability to do this, causing glucose to build up in the bloodstream. This condition is called insulin-resistance and is the first step on the road to diabetes.  

Excess fat cells produce a hormone (resistin) and a protein (pigment epithelium-derived factor – PEDF). Both make cells in the body less effective in taking in glucose, and cause the liver and muscles to be less sensitive to insulin, which moves sugar from the blood into cells.

As a result, a greater amount of insulin is needed to maintain blood glucose levels and the pancreas becomes overworked and eventually slows down or stops the release of insulin, eventually leading to type 2 diabetes.

So strong is the connection between obesity and diabetes that a new word, “diabesity,” has been coined by the medical community. 

A dangerous combination for children 

Since obesity and diabetes both contribute to serious health problems, the combination of the two further increases the risk of heart attack, stroke and kidney failure as affected children reach early adulthood. A third of children with diabetes already have high blood pressure and a third have elevated cholesterol, two major risk factors for heart disease. 

Additionally, research indicates that type 2 diabetes progresses more rapidly in youth and that they develop diabetes-related complications faster than their adult counterparts, according to the National Institute of Health.

Youth at the greatest risk?

•    Family history of type 2 diabetes 
•    Being overweight (a body mass index of more than 25)
•    Sedentary lifestyle 
•    Prediabetes (an above-normal fasting blood glucose of 100-125 mg)
•    Abnormal cholesterol and/or triglycerides levels
•    Family history of high blood pressure or cardiovascular disease
•    Nonwhite ancestry 
•    Children entering puberty, due to the body’s hormonal changes 

The solution  

People with prediabetes can help prevent or postpone type 2 diabetes by:

  • Making healthier food choices
  • Getting 30 minutes of daily exercise — in addition to helping control weight, exercise can improve insulin sensitivity, making it easier for the body to convert glucose into energy
  • Losing weight. If your child is displaying symptoms of diabetes, please schedule and appointment or speak with a healthcare provider right away. 

Symptoms may include:

  • Increased thirst and urination
  • Increased hunger
  • Weight loss or abnormal weight gain
  • Fatigue
  • Blurred vision
  • Slow-healing sores or frequent infections
  • Areas of darkened skin
About Salma Makhoul MD

Salma Makhoul, MD, is an endocrinologist with Ascension Medical Group in Wichita, Kansas.