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What is diabetes? Simply put,
diabetes is when the your body can not use the sugar or
carbohydrates that you eat,
so that the sugar level in the blood builds up and becomes dangerously
high. High blood sugar damages the millions of tiny blood vessels
all over the body, particularly in the vision area of the eyes and in the
kidneys. The result can be blindness and kidney failure.
 When
you eat foods with sugar in them, an organ in your digestion system
called the pancreas produces a chemical called insulin, which allows your
body to use the sugar for energy. In diabetes this insulin no
longer works properly, so the sugar in the blood builds up. There
are two types of diabetes, called Type 1 and Type 2.
Type 1 Diabetes occurs when the body doesn't produce insulin at all.
Insulin injections are usually necessary with Type 1. Type 2 diabetes,
originally called adult onset diabetes, occurs when the body still produces insulin, but the insulin that is produced no longer seems to work on the body's cells.
In fact, many people with Type 2 diabetes actually have normal to high levels of insulin in their bloodstream: the body just doesn't use it properly.
Type 2 is by far the most common form of diabetes, affecting 90% of those with the disease.
Overweight appears to be one of the main risk factors for Type 2.
Type 2 Diabetes and Overweight in Childhood: As the name implies, the adult onset
type of diabetes (Type 2), until recently, was usually diagnosed long past childhood, typically after the age of forty. Yet today, the disease is being diagnosed more and more commonly in children. This coincides with an increase in
overweight in childhood. According to Dr. Sylvia Arslanian, professor of
pediatrics at the University of Pittsburgh, two out of five of kids in
the United States are now overweight. Many of these
kids run a serious risk of getting Type 2 diabetes.
High blood sugar and high blood pressure from diabetes can damage four parts of your eye:
Retina - the the lining at the back of the eye which senses light coming in
Vitreous - a jelly-like fluid that fills the back of the eye
Lens - at the front of the eye - it focuses light on the retina
Optic nerve - the eye's main nerve to the brain
More than 80 percent of people with type
2 diabetes are overweight. Healthier lifestyles appear to reduce the risk of
type 2 diabetes. Exercise lowers blood sugar.
How do you know if you have diabetes?
While some people experience diabetes symptoms that prompt them to visit their doctors, others feel perfectly healthy until tests reveal that they are diabetic. Nearly a third of all people with
type 2 diabetes are unaware that they even have the disease. Here are some of the more common
type 2 diabetes symptoms: - fatigue
- excessive thirst
- frequent urination
- blurred vision
- a high rate of infections
- wounds that heal slowly
- mood changes
Type 2 Diabetes
Complications Hit
Young Adults Hard
Childhood type 2 diabetes later resulted
in kidney failure, blindness, and death.
The first
long-term study of children with
type 2 diabetes who have grown
to young adulthood shows that
many arc now suftcring from the
same debilitating or fatal com-
plications that were once thought
to strike only older diabetics: kid-
ney failure and dialysis, miscar-
riages. and death.
At the annual scientific ses-
sions ot the American Diabetes
Association. Dr. Heather Dean
reported her findings in children
of the First Nation people iii
Northern Canada.
‘Fhis is the first group coming
through that helps us realize that
type 2 diabetes starting in child-
hood] is a very aggressive dis-
ease, said Dr. Dean, professor of
pediatrics at the University of
Manitoba, Winnipeg. ‘It can
have significant, long-term com-
plications, and only time will tell
how generalizahle these find-
ings are I to other populations
that are at risk of type 2 diabetes
in childhood.’
Dr. Eugene Barrett, the associ-
ations vice president, said, ‘We
anticipate and worry that the
outcomes I that Di’. Dean is] flnd-
log will start to appear in other
populations. Already, he said.
the overall risk for developing di-
abetes has dropped to a younger
age bracket. ‘l’he peaks of risk I 5-
w th s xtl de ade t
life. That’s moved down about 10 years in
the last 1 5 20 years; now the peak risk is
in the fifth decade.
What we’re seeing is the tail of that in
children, especially in minority popula
ons. said Dr. Barrett, professor of pedi-
‘ics and internal medicine at the Uni-
rsity of Virginia, CF .irlottesville.
Since 198n, Dr. Dean and her associates
we maintained a database of First Nation
youth diagnosed with type 2 diabetes he
Fore age 1 7. About 8” of the population
in the provinces of Manitoba and north-
western Ontario have First Nation her
itage, s~ hich is defined by registration un
dcr the Indian Act of Canada.
The First Nation people of this region
are of the Algonquin language group and
speak Cree, Oji-Crcc, or Ojibwa. Of those,
18) of adults aged 20-79 years have type 2
diabetes, compared with 5’
of the general population.
The hepatic nuclear factor-
I ci G319S variant is ass,,~
ated with early-onset type 2
diabetes in Oji-Cree people.
From September to De-
cember 2001, 79 of 86 p(w
pie who were originally di-
agnosed iii the pediatric
diabetes clinic and are now
aged 18 33 years, were In
cated. OF those, consent for interview
and review of medical records were ob
tamed tdr 44 females and 7 males.
All study participants were obese as
children. At diagnosis, all were greater
than 35’o overweight, compared ss tb
norms for age and gender.
Of the 33 patients who had undergone
a medical assessment in the past year, 30
had a hemoglobin A1, value rccot-dcd. Fise
of 30 had an A,~ value of less than 7”,,
which is the tat-get range—while 19 had
high values exceeding 10”,. Eighteen of the
51 patients were prescribed insulin, and 25
crc prescribed oral hypoglycemic ai~’mt
Of the 51 patients, I ~l4’,; have died: 2
sudden deaths on dialysis, 2 from trauma,
and .3 from unrelated illness. The two
deaths on dialysis were women aged 25 31
years. One 26-year-old woman underwent
amputatiotl of one toe. ‘l’hree women
aged 2n, 28, and 29 yeats Ltd been on dial
ysis for 2 months, 1 year, and 6 years, rc
spt’ctiscl’,’. One of the women became
blind at age 26.
help those ho develop the disease in child
hood, although many of the drugs have not
been specifically studied in children.
While First Nation people ,Afi’ican
Americans, and I Iispanics are more prone
to develop diabetes, compared ith other -
populations, it remains unclear exactly’
how many children have type 2 diabetes.
Some clinics in the United States report
that up to 40% of new cases of diabetes
in children are diagnosed with type 2.
Obesity in children and teens is thought
to pla~’ a major role in the development of -
the disease. Ten years a go. Dr. Dean said,
people were concerned about obesity in
children causing ohesits in adults and dis-
ease in adult life. What’s changed is that
obesity in children causes disease in chil
dren and complications in Young adults.”
Indeed, two out of every five children in
the United States are o\erweight or obese,
said Dr. Silva Arslanian, professor of pe- -
diatrics at the University of Pittshut’gh. She
noted that the “beer belly” type of fat dis
tribution “has worse implications for
metabolic complications,
whether that means insulin
resistance or an abnormal
lipid pn file,’’ compared
with fat that gathers
around the hips.
s,. ‘.,stnd that many
children \\ ith t~pu
betes have a hard time
managing their disease in
adolescence because cit
their propensity for tebcl -
liousness and risk - king behavior.
“If you start having ii thctes at age 11 or -
12 and spend 6 or 7 years ‘~ rebellious -
and m. ~ doing what y’ou’re supp Ito do,
0 going to impact your health ‘ouch
worse than if you develop diabetes at ac,e
60,” Dr. Arslanian remarked in her pre- -
sentation at the meeting. ‘you‘re going to
see much younger people starting to have
complications in their most productive
period of life in their 2(is or 30s vs. when
they’ ‘re ‘~‘0 or 5. Its going to be a major
public problem.
Children’s pt’opensitv for sweets and
high-tat. low-fiber foods makes matters
worse, she said. “We have to improve our -
nutrition and hygiene.”
Still, it remains unclear hos\ to best ap
proach the tt’eatmcnt for children with
type 2 diabetes, Dr. Janet Silverstein, pro-
fessor of pediatrics at the Uni\ ersits of
Florida, Gaincs\’illc. said at the meeting.
\\‘h’n do ss c start treating blood prcs -
sure and at ss hat cs ci? \\‘hen do v~ e treat
lipid Irs eN that are high~ At what ag&’ Xt -
WHAT’S
changed is that
childhood obesity
causes disease in
children and
complications in
young adults.hat
While some people experience diabetes symptoms that prompt them to visit their doctors, others feel perfectly healthy until tests reveal that they are diabetic. Nearly a third of all people with type 2 diabetes are unaware that they even have the disease. Here are some of the more common adult onset diabetes symptoms:
<UL> <LI>fatigue</LI>
<LI>excessive thirst</LI>
<LI>frequent urination</LI>
<LI>blurred vision</LI>
<LI>a high rate of infections</LI>
<LI>wounds that heal slowly</LI>
<LI>mood changes</LI>
</UL>
The pancreas is the organ in your
body that produces a hormone called insulin, that is essential for the proper regulation and use of blood sugar.
If the body cannot produce enough insulin, or produces insulin that does not function
properly, then diabetes is the result. The disease is generally classified into one of two main groups.
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