Obesity & Type 2 Diabetes: A Growing Epidemic in Children

What is Diabetes?

There are two major types of diabetes: Type 1 and Type 2. Both Type 1 and Type 2 diabetes cause blood sugar levels to become higher than normal. However, they do this in different ways.

• Type 1 diabetes (formerly called insulin-dependent diabetes or juvenile diabetes) is an autoimmune disease which occurs when the child’s immune system starts to destroy its own insulin-producing cells in the pancreas. Because the pancreas is not able to produce insulin, children with type 1 diabetes need insulin to help keep their blood sugar levels within a normal range.
• Type 2 diabetes (formerly called non-insulin-dependent diabetes or adult-onset diabetes) is different. In contrast to someone with Type 1 diabetes, someone with Type 2 diabetes still produces insulin. But the body doesn’t respond to the insulin normally. Excess weight and obesity can cause the insulin to not work correctly. When the insulin does not work correctly, glucose is less able to enter the cells and do its job of supplying energy (doctors call this insulin resistance). This causes the blood sugar level to rise, making the pancreas produce even more insulin. Eventually, the pancreas can wear out from working overtime to produce extra insulin. Then, the pancreas may no longer be able to produce enough insulin to keep a person’s blood sugar levels within a normal range.

In past years, children typically got Type 1 diabetes, which occurs when the child’s immune system starts to destroy its own insulin-producing cells in the pancreas. Type I diabetes is not related to obesity or to dietary intake of sugars.

Type 2 diabetes, the obesity-related form in which the body does not respond to insulin normally, was seen in adults. Children did not typically get Type 2 diabetes; thus it was called adult-onset diabetes.

With rising cases of childhood obesity, children are now getting Type 2 diabetes, and the numbers are increasing rapidly.

Signs and Symptoms of Type 2 Diabetes

The symptoms of type 2 diabetes aren’t always obvious and they can take a long time to develop. Sometimes there are no symptoms. It’s important to remember that not everyone with insulin resistance or type 2 diabetes develops these warning signs, and not everyone who has these symptoms necessarily has Type 2 diabetes.

But a child or teen who develops Type 2 diabetes may:

• urinate frequently. The kidneys respond to high levels of glucose in the blood by flushing out the extra glucose in urine. A child with a high blood sugar level needs to urinate more frequently and in larger volumes.
• drink a lot of liquids. Because the child is peeing so frequently and losing so much fluid, he or she can become very thirsty. He or she drinks a lot in an attempt to keep the levels of body water normal.
• feel tired often because the body can’t use glucose for energy properly.

Sometimes, children and teens with Type 2 diabetes, insulin resistance, or obesity may also develop thick, dark, velvet-like skin around the neck, armpits, groin, between fingers and toes, or on elbows and knees – a cosmetic skin condition called acanthosis nigricans.

What to do if I think that my child might have Type 2 diabetes

If you think that your child might have adult-onset diabetes, it is important to seek medical care quickly. Diabetes is a chronic condition that if not properly treated or diagnosed can lead to poor cardiovascular health, strokes, amputations, kidney damage, and blindness.

The initial treatment typically used in children is insulin shots because Type 2 diabetes is often more severe in children than it is in adults. Occasionally, medications taken by mouth can be used which help the insulin work better if the diabetes is caught early. All treatments are aimed at promoting excellent blood sugar control.

Since exercise and weight loss both help insulin to work better and thus to control blood sugars better, both exercise and weight loss can in essence ‘cure’ diabetes in some patients. However, type 2 diabetes will always return with weight gain and with reduction in exercise.

A child or teen with Type 2 diabetes may need to:

• eat a healthy diet to help achieve a normal body weight while getting the nutrients needed to grow and develop. Doctors may recommend a low-salt or low-fat diet, especially if the child has conditions such as high blood pressure or abnormal blood fat levels.
• participate in physical activity regularly. Exercise helps increase the body’s response to insulin, and it helps the body burn more calories, which can promote the loss of excess body fat.
• get to and maintain a normal body weight.
• monitor blood sugar levels regularly.
• take insulin or other medications which help the body respond to insulin more effectively.
• work closely with their doctors and diabetes health care team to help achieve the best possible control of their diabetes and be monitored for signs of diabetes complications and other health problems that occur more frequently in children with Type 2 diabetes.

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