The virulence of Type 2 diabetes in children is yet another reason to fight childhood obesity.
A study of diabetes in overweight and obese youngsters bears an ominous warning about future health care trends in this country. It found that Type 2 diabetes, a new scourge among young people, progresses faster and is harder to treat in youngsters than in adults. The toll on their health as they grow older could be devastating.
Only two decades ago Type 2 diabetes was called “adult-onset diabetes” because it was seldom found in young people, who suffered primarily from Type 1, in which the patient’s immune system destroys cells that make insulin, a hormone needed to control blood sugar levels. Type 2 — thought to be brought on by obesity and inactivity in many people — has increased alarmingly and accounts for almost a fifth of newly diagnosed cases in young people.
Obesity increases the risk of many chronic diseases. And some 17 percent of American children from age 2 to 19 are now considered obese, roughly half the rate of obesity among adults.
The new study, published in The New England Journal of Medicine, tested three ways to attain durable control of blood sugar in youngsters between the ages of 10 and 17. None worked very well. Almost half of the 699 youngsters had to add daily shots of insulin within a few years to lower their blood sugar. Metformin, the standard drug used to treat Type 2 diabetes in children, failed to control blood sugar in more than half of the children. When lifestyle changes, including one-on-one counseling on how to lead a healthy life, were added to metformin, the results were only marginally better.
When a second drug was added, the results were significantly better. But the two-drug treatment still failed in 39 percent of the recipients, and the added drug, Avandia, has been linked to heart attacks and strokes in adults.
The findings are especially ominous because poorly controlled diabetes can lead to heart disease, stroke, blindness, amputations and kidney failure. The longer one has the disease, the greater the risk, so the fact that children are starting so young bodes ill for their futures.
Some experts suggest that young patients at risk of diabetes need to be detected earlier and treated more aggressively. But the long-term goal should be prevention of obesity and of diabetes.
Congressional Republicans, meanwhile, are bent on dismantling health care reforms that could greatly assist in curbing the obesity epidemic. The Republican-dominated House last month narrowly passed a bill that would eliminate the Prevention and Public Health Fund, established under the reform law, in part to pay for lowering the interest rate on subsidized student loans for a year.
The fund is already providing grants to state and local governments to help pay for programs to fight obesity and prevent chronic diseases, including diabetes, in the community, the workplace and among minority groups that have high rates of both obesity and diabetes. Killing off this program would be hugely costly to Americans’ health, and future health care costs. There is no explanation for this move, except for the usual anti-health care reform demagogy.
Source: NYTimes.com, No Longer Just ‘Adult-Onset’