Childhood diabetes — the silent surge

Philip J. Goscienski, M.D.

February 2011

A couple of generations ago most pediatricians were likely to encounter an occasional child with type 1 diabetes. In spite of increased food intake they rapidly lost weight and became obviously ill. Seemingly constant drinking led to frequent urination and some began bedwetting. Without timely medical attention some children fell into diabetic coma. All required insulin in order to survive.

Type 1 diabetes continues to strike children and young adults but today's pediatrician is likely to encounter a much more subtle and slowly progressive form: type 2 diabetes. It develops over months or years and most of its young victims are overweight or obese. A disease that in the past occurred in the fourth or fifth decade of life is now common among teenagers and it afflicts children as young as six years of age. Type 1 disease is not preventable but type 2 diabetes is totally avoidable even among families that have several members with the disease.

In 35 years of pediatric practice that began in the early 1960s I never encountered a child with type 2 diabetes, an experience that I shared with the vast majority of my colleagues. In contrast, the type 2 form now affects half or more of the patients in diabetes clinics of most metropolitan children's hospitals. It is not an exaggeration to state that we are in the midst of an epidemic of type 2 diabetes in young people and the numbers keep getting worse.

In children and adults, the treatment of type 2 diabetes does not always require insulin. Especially in its early stages, proper medication and careful attention to diet and weight loss can result in marked improvement. Unfortunately, by the time the diagnosis has been confirmed there is evidence of damage to blood vessels that leads to complications.

The rapid growth of children demands that blood vessels constantly form and re-form in order to keep up with enlarging muscles, bones and other organ systems. High glucose (blood sugar) levels interfere with this process by altering the structure of proteins. It is no wonder that the dreaded complications of diabetes, blindness, kidney failure, heart disease and even amputations occur early, sometimes before age 30.

Physical inactivity and a diet that is high in refined carbohydrates are the primary causes of type 2 diabetes. These are habits that we must change for the sake of the youngest generation.

Philip J. Goscienski, M.D. is the author of Health Secrets of the Stone Age, Better Life Publishers 2005. Contact him at drphil@stoneagedoc.com.