Type
2 Diabetes Tough on Teens
With the incidence of type 2 diabetes and its complications
among young people on the increase worldwide, aggressive measures are needed
to treat and prevent the disease, says a study reported in The
Lancet.
"The complications associated with adolescents' type 2 diabetes
seems to behave differently than in children and adolescents with type 1 diabetes," says
article co-author Dr. Orit Pinhas-Hamiel, at Sheba Medical Center in Tel-Hashomer,
Ramat-Gan, Israel.
These complications may be present at the time of diagnosis,
and their rate of progression may be higher than in children and adolescents
with type 1 diabetes, says Dr. Pinhas-Hamiel.
"We need to develop improved approaches to awareness and
early treatment of type 2 diabetes and associated abnormalities," she says.
These complications, including high blood pressure, kidney
disease, eye disease, and problems with blood fat [cholesterol and triglycerides]
levels, may already be present when type 2 diabetes is diagnosed, while they
rarely exist at the onset of type 1 diabetes, notes Dr. Pinhas-Hamiel.
"In addition, studies to date suggest that early onset of
type 2 diabetes is associated with a more rapid progression of these complications
compared with adolescents with type 1 diabetes," notes Dr. Pinhas-Hamiel.
Moreover, psychiatric problems are also associated with
type 2 diabetes. In a study in Philadelphia, one in five such teens suffered
from conditions such as depression, obsessive-compulsive disorder, or other
psychiatric conditions.
Another study found that the deaths of seven young African-American
males, ages 13 to 21, with undiagnosed diabetes, met the criteria for high
blood sugar and diabetic coma, the authors add.
Type 2 diabetes also puts unborn infants at risk. In a Canadian
study of 51 pregnant adolescent girls with type 2 diabetes, only 35 had live
births, and the pregnancy loss rate was 38 percent, the authors report.
Dr. Pinhas-Hamiel and her colleague Dr. Philip Zietler,
at the University of Denver, believe that adolescents with type 2 diabetes
should be screened for signs of these complications when they are first diagnosed.
"In addition, there is a need for well-established guidelines
for the initiation of antihypertensive and anti-lipid treatments for adolescents
with type 2 diabetes," she says.
Dr. Pinhas-Hamiel says that in type 2 diabetes in children
and adolescents there is an association with significant illness and death.
One expert says this review confirms that type 2 diabetes
in teens has become a serious public health problem.
"Recent studies have confirmed what most of us have long
suspected, that the rate of what used to be called adult onset diabetes is
rising rapidly in children and adolescents," says Dr. David L. Katz, at Yale
University School of Medicine.
This study confirms another suspicion that even greater
dangers are around the next corner should current trends persist, says Dr.
Katz.
"In adults, type 2 diabetes is a potent risk factor for
cardiovascular disease and other complications, from kidney failure to nerve
damage," explains Dr. Katz. "There is every reason to expect, and now findings
to confirm, that these relationships hold in youth as well.
“When formerly adult onset diabetes develops in 7-year-olds,
the threat of heart disease in 17-year-olds clearly looms," he says. "Anyone
who was waiting for an even more strident alarm before accepting that epidemic
obesity and type 2 diabetes in our children is a public health crisis of the
first order - this is it.”
Another expert thinks that overweight adolescents who lead
a sedentary life need to be tested for diabetes.
"Here we have a situation where we are not examining our
youngsters for diabetes, and they already have complications present or developing," says
Dr. Stanley Mirsky, a board member of the Juvenile Diabetes
Foundation.
"We have to test these kids that spend all their time in
front of the televisions or computers eating junk food instead of being outside
exercising and eating right, especially when there already is a family history
of diabetes," says Dr. Mirsky.
Always consult your physician for more information.
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