Diabetes: the New Epidemic

When most people think of diabetes, they usually either think of young kids with Type 1 diabetes or older, overweight adults with Type II diabetes.

Now though, with the childhood obesity epidemic, there has also been a big increase in the number of children with Type II diabetes, which used to be thought of as adult onset diabetes.

Diabetes means just one thing-a high sugar level. While there are many conditions and problems associated with diabetes, such as obesity and heart problems, the disease itself is defined only by plasma glucose levels. Diabetes is a disease of glucose metabolism. Many people with diabetes have no clinical symptoms. The diagnosis of diabetes is based on one of two tests; the fasting plasma glucose test or an oral glucose tolerance test. It is important to remember that diabetes is not defined by obesity or its complications; nor is it defined by a urine test. 

Type II diabetes is 10 times more prevalent in America than Type 1 and its economic impact is much greater. It is one of the most common chronic conditions in the United States. Since, at the beginning, there are no obvious symptoms, many Type II cases are not diagnosed. Those with the disease don’t have an absolute deficiency of insulin since their pancreas does make some.

Type II diabetes is associated with obesity and with aging. It is a lifestyle-dependent disease, and has a strong genetic component. The problem seems not so much in insulin production, but that when the insulin reaches its target cells, it doesn’t work correctly. Most Type II diabetic patients initially have high insulin levels along with high blood sugar. However, since sugar signals the pancreas to release insulin, Type II diabetics eventually become resistant to that signal and the endocrine-pancreas soon will not make enough insulin. These people end up managing the disease with insulin and they need much higher doses because they are resistant to it.

It is not high blood sugar that is the disease process of diabetes, but complications from the high blood sugar. A major problem faced by doctors is that some people with high blood sugar feel fine; it’s hard to treat diseases that are asymptomatic since most people don’t want to take a pill for something that they don’t feel bad about.

Genetic factors combine with environmental factors to cause diabetes; diet and exercise can control diabetes. Over the past five years there has been a four-fold increase in Type II diabetes in kids.

What are the factors that will predict the incidence of diabetes in a cohort of children? Family history, obesity, and high plasma insulin are the main indicators; insulin resistance is a predictor of type II diabetes, even if a child feels fine at the time he or she is tested. Also, when a child is exposed to high sugars in utero the child has an eight-fold greater risk of getting diabetes as a teenager.

Most Americans are alarmed at the rising cost of medicine, now add to this the increase of complications in children with diabetes and we are in for a real ride. Health care will suffer an even greater burden with more sick people and less money available to fund an already over burdened system.

The time is now to start talking. The CDC attributes the rise in Type II diabetes to children and adults exercising less and eating more junk foods. These poor health habits transform into type II diabetes which can lead to blindness, strokes, heart attacks, kidney failure and skin breakdown just to mention a few.

Children today are not getting the recommended 30 minutes a day of exercise. Instead they are eating junk food and sitting in front of the TV or a computer for hours on end. We need to educate the public at large on the need for healthier food and more exercise to change our current structure and environment. This fight must go national until it reaches every man, woman, and child. Let’s all join in this effort to fight against the new epidemic that threatens our great nation.

By Gail Barton R. N.
Child Care Nurse Consultant
Child Care Resource and Referral - SDA 16