Type 2 Diabetes in Kids on the Rise
By Jeff Balke
Let's Not Sugarcoat It
It was a case that shocked the world last year. A 3-year-old Houston girl was diagnosed with Type 2 diabetes, making the 77-pound child – with a body mass index in the top 5 percent – the youngest known sufferer from the disease. The parents of the toddler had taken her to the hospital after becoming concerned about her extreme thirst and frequent urination – both classic Type 2 symptoms. The findings of the case were presented at the European Association for the Study of Diabetes, in Stockholm, in September 2015, where it gained international attention.
The occurrence of the disease at such a young age is disturbing – and unfortunately, something that could become more common, according to Dr. Nunilo Rubio Jr., a pediatric endocrinologist affiliated with Children’s Memorial Hermann Hospital. “These days we are seeing a slow but steady increase in the incidence of Type 2, or insulin-resistant, diabetes in children due to the prevalence of overweight and obese children in this country,” he says.
Did you know?
Type 2 diabetes in on the rise. By 2050, one in three people will have diabetes, according to the American Diabetes Association.
Diabetes is a relatively well-known illness, yet it’s still misunderstood. Type 2 is most common in adults and is “mainly seen in overweight populations,” according to Dr. Rubio, and involves the body’s “resistance” to insulin action. With proper management, it can be controlled and possibly even reversed. Type 1, however, is an autoimmune disease that’s typically diagnosed at an early age and must be managed throughout a sufferer’s lifetime. “In Type 1 diabetic patients, their immune system made a mistake,” explains Dr. Rubio, “and made antibodies against the islet cells of the pancreas, which are responsible for making insulin.” As a result, patients must receive insulin injections to regulate blood sugar levels.
Taken together, the two types of diabetes are the seventh leading cause of death in the U.S., with more than 29 million Americans suffering from the disease. An estimated 208,000 U.S. children have diagnosed cases of diabetes, according to data from the American Diabetes Association, and while Type 1 is still most common among them, Type 2 is rising. Newly diagnosed cases of Type 2 diabetes among children has grown from less than 5 percent in 1994 to about 20 percent in recent years.
Part of the reason for the increase is that cases of Type 2 diabetes in children are being caught earlier, which, of course, is a good thing. “I think there is now more increased awareness of the problem of overweight and obese children and Type 2 diabetes,” says Dr. Rubio, “and schools are getting more proactive in checking for symptoms.” Schools now screen for acanthosis nigricans – darkening and/or thickening of the skin in the neck and folds of the body associated with insulin resistance – and can refer parents to doctors when necessary. “We are getting more and more consults for evaluation and management of obesity so we can intervene very early,” Dr. Rubio adds.
Of course, the best way to stamp out Type 2 diabetes in children is to instill good habits. Nearly one in five children in America are overweight or obese. “Eating a healthy diet and encouraging an active lifestyle usually keeps the weight in a healthy range,” Dr. Rubio explains. “Visits to the pediatrician – who can measure height and weight and calculate body mass index on a regular basis – are very helpful.”
As for the Houston 3-year-old who made headlines, doctors determined that her diet was high in fat and calories. Both her parents were also severely overweight, although they had no history of the disease, and doctors helped educate them on proper diet. With oral medication and improved eating habits, the child’s disease was reversed.
The Perfect Plate
Defining Proper Daily Portion Serving Sizes
Most of us know that growing children should eat well-balanced meals containing each of the five food groups. But how much should they be consuming? The truth is, the answer depends on the child’s age, sex and level of physical activity, which is why choosemyplate.gov is an excellent resource for personalized portion-size advice. These are the general daily recommendations for children ages 4 to 8:
1 to 1 ½ cups of fruit or 100 percent fruit juice, or 1/2 to 1 cup of dried fruit.
1 ½ cups of raw or cooked vegetables or vegetable juice, or 2 ½ cups of raw leafy greens.
5 ounces – 5 slices of bread, or 2 ½ cups of cooked rice or pasta.
2 ½ cups of milk, soy milk or yogurt, 3 ounces of natural cheese, or 4 ½ ounces of processed cheese.
4 ounces – 4 ounces of fish, meat, or poultry, 1 cup of cooked beans, 4 eggs, 4 tablespoons of peanut butter, or 2 ounces of nuts or seeds.
Children's Memorial Hermann partnered with Houstonia Magazine to publish this article, which includes parenting tips and advice from the affiliated physicians from McGovern Medical School at UTHealth. Not all affiliated physicians are Memorial Hermann employees.