Type 2 Diabetes Rising Among U.S. Adolescents

Curbing obesity can help avert a public health crisis, experts say

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By Steven Reinberg
HealthDay Reporter

MONDAY, May 1, 2006 (HealthDay News) -- Some 39,000 adolescents in the United States already have obesity-linked type 2 diabetes, and nearly 2,770,000 more may have blood sugar levels that could spur diabetes and other health problems, researchers report.

"Steps to prevent and treat the substantial number of adolescents who have impaired fasting glucose [blood sugar] from developing type 2 diabetes are required now," said lead researcher Glen E. Duncan, an assistant professor in the Department of Epidemiology, Nutritional Sciences Program at the University of Washington in Seattle. "These steps are well known and well established preventative measures -- namely to increase daily physical activity levels and improve nutrition, and to avoid excess body weight."

The report appears in the May issue of the Archives of Pediatrics & Adolescent Medicine.

In the United States, about 18.2 million people have diabetes, including 210,000 under the age of 20. In addition, studies indicate that a blood glucose level higher than normal but not high enough to be diagnosed as diabetes is common among overweight young people and can lead to diabetes.

"Among adolescents who have diabetes, the majority of cases are still type 1 diabetes," the inherited form of the disease, Duncan said. "However, the prevalence of type 2 diabetes, a condition once seen only in adults, has increased over the past decade," he said

"Roughly 29 percent of all adolescents with diabetes now have type 2 diabetes, and the prevalence of impaired fasting glucose -- a risk factor or precursor to developing type 2 diabetes -- is substantial in this population," Duncan added.

In their study, the Seattle team turned to a national survey of the U.S. population to collect data on 4,370 teens. These adolescents were asked whether they had ever been told by a doctor that they had diabetes.

Among these teens, 0.5 percent had diabetes. In this group, about 71 percent had type 1 diabetes and 29 percent had type 2 diabetes. Duncan's team also tested glucose levels in nearly 1,500 adolescents who had not been diagnosed with diabetes. About 11 percent of these teens had impaired fasting glucose levels.

When these data were extrapolated to include the entire U.S. population, they indicate that 134,071 individuals age 12 to 19 years now have diabetes -- 39,005 with the type 2 form of the disease. Another 2,769,736 adolescents are estimated to have impaired fasting glucose levels.

The latter group is perhaps most worrisome, Duncan said. That's because "there is the potential for a large number of adolescents who currently have impaired fasting glucose to develop type 2 diabetes in early adulthood," he explained. "This is based on the high rate of conversion from impaired fasting glucose to type 2 diabetes seen in adults."

One expert believes a major public health effort is needed to stem the obesity epidemic in the United States and prevent the rise of a generation plagued by type 2 diabetes.

"The clearest evidence of the harms of epidemic obesity comes in the form of rising rates of diabetes in both adults and children," said Dr. David L. Katz, an associate professor of public health and director of the Prevention Research Center at Yale University School of Medicine.

Diabetes has long been recognized as a predictor of cardiovascular disease in adults, and there is little reason to think this will be any different in children, Katz said. "The earlier people develop diabetes, the earlier they will develop its complications. And thus rising rates of diabetes -- particularly type 2 diabetes, known until recently as adult onset diabetes, are a dire concern for the health of our nation," he said.

Type 2 diabetes in children and adults is about dietary and activity patterns, and the effects these have on weight, Katz said. "These are factors we can control," he said. "The time has long since passed to question whether we should be taking steps to stem obesigenic factors in our society, and instead attend to how we should best do so."

More information

For more on type 2 diabetes, head to the U.S. National Institute of Diabetes and Digestive and Kidney Diseases.

SOURCES: Glen E. Duncan, Ph.D., assistant professor, Department of Epidemiology, Nutritional Sciences Program, University of Washington, Seattle; David L. Katz, M.D., M.P.H., associate professor, public health, director, Prevention Research Center, Yale University School of Medicine, New Haven, Conn.; May 2006, Archives of Pediatrics & Adolescent Medicine

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