March 3, 2000 (Lake Tahoe, Calif.) -- A surge in type 2 diabetes over the la
March 3, 2000 (Lake Tahoe, Calif.) -- A surge in type 2 diabetes over the last decade has alarmed pediatricians and diabetes experts. This form of diabetes is most common in overweight adults over 45, but now is being diagnosed in 20% of children with diabetes, most of whom are obese.
In order to call attention to the problem, a special report has been published in the March issues of the journals Diabetes Care and Pediatrics. The report, by a panel from the American Diabetes Association (ADA), calls for testing for children who are at risk, accurate diagnosis of those with the disease, appropriate treatment, and possibly prevention in others at risk.
A family history of diabetes is an important risk factor, but the chairman of the panel, Arlan Rosenbloom, MD, tells WebMD, "Type 2 diabetes is increasing in children because of obesity." Rosenbloom is professor of pediatrics at the University of Florida College of Medicine in Gainesville.
The panel recommends testing for type 2 diabetes for any child who weighs more than 120% of the ideal body weight for his or her height and age and who has two or more risk factors. Those risk factors include having a family history of type 2 diabetes in first- and second-degree relatives, belonging to a certain race or ethnic group (American Indian, African-American, Hispanic Americans, Asians/South Pacific Islanders), and having signs of insulin resistance such as obesity, high blood pressure, and increased fats in the blood. Signs parents might notice, especially in children between ages 10 and 19, and bring to their doctors' attention are recent weight loss (even in the obese child), frequent urination, thirst, decreased strength, and fatigue, says Rosenbloom. Type 2 diabetes is most likely in the mid-teen years, but it has been diagnosed in a four-year-old.
There is also a particular kind of skin condition that signals type 2 diabetes. "It is a darkening of the skin around skin fold areas such as the neck, the underarms, the groin, the belly button. There's also a change in skin texture. It looks velvety and is slightly raised," explains Holly Schachner, MD, assistant clinical professor of pediatrics at Columbia Presbyterian Medical Center in New York. She tells WebMD, "Many parents think the darkening is dirt. I've had patients who have gone to dermatologists who don't know what it is and attempt to treat it with creams and lotions."
"What we're seeing now is a preventable disease if we help our children lead a healthier lifestyle," Dana S. Hardin, MD, tells WebMD, pointing out that the number of obese children has doubled in the last six years. "We also need to push our schools and our outreach programs ... to provide [children] with physical activity and healthy diets," she says. Hardin is associate professor of pediatrics at the University of Texas Health Sciences Center in Houston.
None of the experts WebMD spoke with recommend putting children on weight-loss diets. Rather, they suggest encouraging more physical activity; limiting inactivity, such as watching television and playing video games; and cutting back on added sugars in fruit drinks and soda. If overweight children maintain their current weight, eventually, as they grow taller, they will achieve a normal weight for their height.
Vital Information:
- Type 2 diabetes is the form of diabetes that usually occurs in overweight adults older than 45, but its prevalence among children is on the rise, accounting for 20% of all new cases of childhood diabetes.
- Experts believe the reason for the rise in type 2 diabetes among children is the increase in obesity in this population, which has doubled in the last six years.
- In addition to being overweight, a family history of diabetes, belonging to certain racial or ethnic groups, and symptoms of insulin resistance are warning signs that a child should be tested for the disease.
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