Last Updated: 2002-06-17 10:09:46 -0400 (Reuters Health)
By Melissa Schorr
SAN FRANCISCO (Reuters Health) - Children who develop type 2 diabetes may suffer a disproportionate share of diabetes-related complications later in life, researchers reported here Saturday at the American Diabetes Association's annual meeting.
"This is an aggressive disease," said study author Dr. Heather Dean, professor of pediatrics at the University of Manitoba in Winnipeg, Canada. "Ten years ago, people were concerned that obesity in children would cause obesity in adulthood and disease in adult life. What's changed is that obesity in children causes disease in children and complications earlier."
Doctors have been concerned that the rate of type 2 diabetes, once thought of as "adult-onset" diabetes because it struck in adulthood, has risen sharply worldwide among children in the past two decades. In some clinics and among some especially vulnerable ethnic groups, doctors are reporting that as many as 40% of new cases of diabetes they are diagnosing among children are type 2.
Type 2 diabetics lose the ability to respond to insulin, the hormone that helps the body to use sugar for energy. This can lead to a build-up of sugar in the blood that can have serious consequences, including damage to the blood vessels and organs.
While certain ethnic groups, such as African Americans and Native Americans, seem to be more vulnerable to developing type 2 diabetes at a young age than whites, the main cause most likely is the rise in obesity among children, researchers said.
Most concerning is whether the development of diabetes as younger age will mean a greater chance of developing serious complications of diabetes, such as kidney failure, amputation of limbs and blindness.
Dean reported findings from one of the first long-term follow-up studies of children with type 2 diabetes who were listed on a registry beginning in 1986. She examined the medical records of 51 patients diagnosed with diabetes before age 17 who were now 18 to 33 years old and consented to an interview. All were members of First Nations, or native Canadians, who have a higher rate of developing type 2 diabetes than white Canadians.
Of the patients contacted, two had died while on dialysis, two had died of trauma and three had died of unrelated causes. Three of the patients were currently on dialysis, one of whom had become blind, and another had a toe amputation. Of 56 pregnancies among the patients, only 35 resulted in live births.
Among the 33 patients who had a medical check-up in the past year, Dean found, tests indicated that two-thirds had poor blood sugar control.
"I'm shocked by these findings, but I'm not surprised," noted Dr. Silva Arslanian, a professor of pediatrics at the University of Pittsburgh School of Medicine in Pennsylvania. These poor outcomes may be due to the teens' sense of fatalism and denial of their disease, she said. "Being rebellious and not doing what you have to do is going to impact your health," she said.
But despite these poor outcomes, Dean noted that advances have been made in treating young people with diabetes that may mean better outcomes for children currently being diagnosed with the condition. "We're been more aggressive in treatment," she observed, "so the future is more optimistic."
http://www.reutershealth.com/archiv...617elin016.html