Dramatic Rise in U.S. Kids Hospitalized for Type 2 Diabetes

Study authors lay the blame on the obesity epidemic

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By
HealthDay Reporter

SATURDAY, May 5, 2007 (HealthDay News) -- In another sign of the alarming childhood obesity epidemic in the United States, researchers report a 200 percent increase in the number of children hospitalized for type 2 diabetes.

Type 2 diabetes, which used to be called adult onset diabetes because it was rarely seen in children, is typically diagnosed in patients who are overweight. Left untreated, it can lead to such complications as heart disease, blindness, nerve damage and kidney damage.

The dramatic increase in pediatric type 2 diabetes occurred nationwide between 1997 and 2003, according to the study by researchers at New York University School of Medicine.

"The rapid rise in childhood obesity is now common knowledge," said Dr. David Katz, director of Yale University School of Medicine's Prevention Research Center, who was not involved in the study. "Increasingly, so is the concurrent rise in type 2 diabetes in children -- a generation ago, this condition did not exist. What is now called type 2 diabetes was called adult onset diabetes until quite recently."

"Epidemic childhood obesity has transformed a chronic disease of mid-life into a pediatric scourge," Katz added.

For the study, Dr. Rhonda Graves, a pediatrician, and her colleagues used data from nationwide hospital discharge records from 1997, 2000 and 2003. They compared the trends in hospitalization rates, length of stay and costs for children with type 2 diabetes and type 1 diabetes.

They found that rates of hospitalization for type 1 diabetes increased 15 percent between 1997 and 2003, while rates of hospitalizations for type 2 diabetes increased 200 percent.

"These findings, based on hospital records of a nationally representative sample of hospitals in the U.S.A., indicate that type 2 diabetes is increasingly becoming a pediatric illness that results in hospitalizations. It is associated with a very serious number of co-morbidities and complications which may have profound health implications both in childhood and in adulthood," Graves said in a prepared statement.

Graves' team also found that hospitalizations for type 2 diabetes were 1.3 times more likely for boys than girls. Children 9 to 12 years old had the highest rates of hospitalization.

The researchers also found that black, Hispanic and Native American children were at greatest risks of increasing hospitalizations.

The researchers also found that children hospitalized for type 2 diabetes were hospitalized longer than children with type 1 diabetes. Type 1 diabetes is a disease caused by the body's inability to produce insulin, and it's not related to obesity. Insulin is a hormone that converts blood sugar to energy for cells.

The findings were expected to be presented Saturday at the annual meeting of the Pediatric Academic Societies, in Toronto.

"The dramatic increase in hospitalizations for type 2 diabetes in children reported here confirms this trend and further demonstrates that it affects ethnic minorities disproportionately," Katz said.

The National Cholesterol Education Program considers diabetes such a potent risk factor for heart disease that, in adults, treatment guidelines essentially equate the two, Katz noted.

"There is no reason to think this will be any different in children. If 7- and 8-year-olds can get adult onset diabetes, 17- and 18-year-olds can start getting heart disease. I personally know of a 17-year-old boy, with early onset obesity and type 2 diabetes, who has already had a triple coronary bypass. If current trends persist, cases like his could become the rule rather than the rare and terrible exception," Katz said.

Graves thinks much more needs to be done prevent obesity in children.

"As pediatricians, we must learn to recognize the signs and symptoms of type 2 diabetes, and, in turn, educate the next generation of young physicians to be aware of this ever-growing epidemic and how best to prevent and treat it," she said. "Equally important is our duty to further explore the mechanisms causing health disparities in this new and profoundly serious child health problem."

One expert, however, thinks that this striking increase in hospitalization for children with type 2 diabetes needs to be viewed with some skepticism.

"There is a side of me that wonders if these children were diagnosed correctly," said Dr. Larry Deeb, the president for medicine and science at the American Diabetes Association. "Type 2 diabetes is rare in 9- to 12-year-olds. That's the age group that has the highest incidence of type 1 diabetes."

Deeb, a pediatric endocrinologist, noted that type 2 diabetes wasn't recognized until 1997. "The increase in type 2 diabetes seen here may be a function of more recognition rather than more of it," he said.

More information

For more information on type 2 diabetes, visit the American Diabetes Association.

SOURCES: David Katz, M.D., M.P.H., director, Prevention Research Center, Yale University School of Medicine, New Haven, Conn.; Larry Deeb, M.D., president, Medicine & Science, American Diabetes Association, Alexandria, Va.; May 5, 2007, presentation, Pediatric Academic Societies annual meeting, Toronto

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