Type 2 Diabetes Takes Toll on Teens

Doctors need to use more aggressive measures to treat, prevent disease, experts say

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By
HealthDay Reporter

THURSDAY, May 24, 2007 (HealthDay News) -- 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, two diabetes experts say.

Their article appears in the May 26 issue of The Lancet.

"The complications associated with adolescents' type 2 diabetes seems to behave differently than in children and adolescents with type 1 diabetes," said article co-author Dr. Orit Pinhas-Hamiel, of the Pediatric Endocrinology and Diabetes Department 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, Pinhas-Hamiel said. "We need to develop improved approaches to awareness and early treatment of type 2 diabetes and associated abnormalities."

These complications, including high blood pressure, kidney disease, eye disease and problems with blood fat levels, may already be present when type 2 diabetes is diagnosed, while they rarely exist at the onset of type 1 diabetes, noted Pinhas-Hamiel and her colleague Dr. Philip Zietler, from the Department of Pediatrics at the University of Denver.

"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," Pinhas-Hamiel said.

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 black males, aged 13 to 21, with undiagnosed diabetes, met the criteria for high blood sugar and diabetic coma, the authors added.

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 reported.

Pinhas-Hamiel thinks 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 said. "Type 2 diabetes mellitus in children and adolescents is associated with significant morbidity and mortality."

One expert thinks 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," said Dr. David L. Katz, director of the Prevention Research Center at Yale University School of Medicine.

This study confirms another suspicion that even greater dangers are around the next corner should current trends persist, Katz said.

"In adults, type 2 diabetes is a potent risk factor for cardiovascular disease and other complications, from kidney failure to nerve damage," Katz said. "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 said.

"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," Katz said.

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," Dr. Stanley Mirsky, of Lenox Hill Hospital in New York City and a board member of the Juvenile Diabetes Foundation, said in a statement.

"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," Mirsky said.

More information

For more information on diabetes, visit the U.S. National Institute of Diabetes and Digestive and Kidney Diseases.

SOURCES: Orit Pinhas-Hamiel, M.D., Pediatric Endocrinology and Diabetes Department, Sheba Medical Center, Tel-Hashomer, Ramat-Gan, Israel; David L. Katz, M.D., M.P.H., director, Prevention Research Center, Yale University School of Medicine, New Haven, Conn.; Stanley Mirsky, M.D., Lenox Hill Hospital, New York City, and board member, Juvenile Diabetes Foundation; May 26, 2007, The Lancet

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