It seems like practically every day brings a new reason to worry that we're accidentally killing our children with newfangled diseases and ensuring the downfall of our society. Obviously, the growing rates of obesity found in children have long been a concern, but now a new study has found that type 2 diabetes, one of the diseases most commonly associated with obesity, is actually far more dangerous for young people than doctors previously realized. It turns out it progresses more rapidly in kids and is harder to treat, leading to potentially deadly consequences for these kids once they hit adulthood. This is bad news for just about everyone—except maybe the owners of companies who make insulin.
Type 2 diabetes used to be seen almost exclusively in adult patients, but beginning in the 1990s it began to pop up in children, and now it's becoming ever more prevalent as childhood obesity rates have increased. It's still not incredibly common, but between 2002 and 2005 (the last year for which data is available), there were 3,600 new cases in children. What's especially disturbing about this uptick in cases is that the disease behaves differently in the child population than it does in adults. Dr. David M. Nathan, who is the director of the diabetes center at Massachusetts General Hospital and authored this new study, says, "It's frightening how severe this metabolic disease is in children. It's really got a hold on them and it's hard to turn around." Well, that's more than a little terrifying.
Dr. Nathan's study is actually the first of its kind, simply because type 2 diabetes never existed in children before. The study looked at nearly 700 children (ages 10 to 17) at medical centers around the country over a four-year period. What the researchers found was that the oral medication (metformin) that is typically used to treat type 2 diabetes in adults stopped working in about half of the young patients after just a few years. That meant they had to start taking daily shots of insulin as well in order to keep their blood sugar under control. This was shocking to the researchers, since the oral medicines usually work quite well for adults.
This spells real trouble for young patients with type 2 diabetes because if you're not able to control your disease well, it can mean significantly higher risk of heart disease, kidney failure, eye damage, nerve damage, and even amputations later in life. The risk of these problems increases the longer you have the disease; so because these kids are getting it so young, they could be at risk for these types of trouble fairly early in adulthood. Says Dr. Nathan, "I fear that these children are going to become sick earlier in their lives than we've ever seen before." So, in other words, in a few decades our country could be looking at a huge number of people in need of complicated and costly procedures like dialysis.
What's strange is that it's not clear why type 2 diabetes is more difficult to control in young people. The researchers believe it might be related to the fact that kids are growing quickly, and their hormones are changing as well. But regardless of why it's happening, the important thing for children who've already developed it is to treat it as aggressively as possible and manage it carefully.
Unfortunately, that's easier said than done for many of the young people who end up with type 2 diabetes. Most of the kids in the study were from low-income families and most were also from minority groups—which is also true of the adult diabetic population. Dr. Phil Zeitler, one of the other authors of the study, said that many of the kids lived in single parent or guardian homes, had a family history of diabetes, and often they had relatives who'd experienced kidney failure or amputations as a result. He calls it a "challenging population" mostly because, "They're wrapped up in a lot of family chaos." Of course, that means they've got plenty to contend with on top of trying to meticulously manage a very serious disease.
While there are other treatments available for type 2 diabetes in adults, none of them have been tested on kids, and there's no guarantee they'll be any more effective than the ones examined in the study. Thus, while it would be great to find a more effective treatment for childhood cases of type 2 diabetes, the most obvious solution, in an ideal world, would be to keep kids from ever developing the disease (and adults, too, for that matter). Though doing that would pretty much involve finding a cure for the obesity epidemic, which so far hasn't looked too likely.
Obesity-Linked Diabetes in Children Resists Treatment [New York Times]
Image via Andy Dean Photography/Shutterstock.