Diabetes and Youngsters

Article by Dr Pradeep Gadge, leading Diabetologist, Gadge Diabetes Centre

Diabetes mellitus is a chronic and potentially life-threatening condition characterized by the body losing its ability to produce insulin or beginning to produce or use insulin less efficient. People living with type 1 diabetes have to inject insulin regularly, as must some people with type 2 diabetes. Many people with type 2 diabetes can manage their condition with careful diet, exercise and regular testing. Most people think of diabetes as only a disease with high blood sugar, but it’s not true, it is also important to know that uncontrolled high blood sugar increases the risk of developing a number of serious health problems such as heart disease, blindness, kidney failure. A lot of diabetes patients even lose their foot due to uncontrolled sugar. In addition, people with diabetes also have a higher risk of developing infections. Maintaining blood sugar levels at or close to normal can help delay or prevent diabetes complications.

Until recently almost all children and teenagers with diabetes had type 1, but now younger people are getting type 2 diabetes due to increasing rates of obesity and being overweight. Diabetes is becoming more common among youth. Young people who develop diabetes have a higher risk of health challenges throughout their life. People diagnosed with type 2 diabetes at a younger age, there may be more aggressive development of diabetes complications, including myocardial infarction and microalbuminuria. Diabetes in teenage years tends to be more difficult than at other points in our life. Youth-onset type-2 diabetes is no longer rare. Family history is strong and obesity, metabolic syndrome and acanthosis nigricans (dark, velvety skin patches) are usually seen in young patients with type-2 diabetes.

Children and adolescents with diabetes usually experience common symptoms, (polyuria,  polydypsia, weight loss, blurred vision etc)  but many young adults or children will have only one or two. In some cases, they will show no signs or any symptoms. If a child suddenly becomes more thirsty or tired or urinates more than usual, their parents may not consider diabetes a possibility. Doctors too, since diabetes is less common among very young children, may attribute the symptoms to other, more common illnesses. For this reason, they may not diagnose diabetes at once. It is important to be aware of possible signs and symptoms of diabetes in order to get a diagnosis and treatment as soon as possible. If diagnosis is late and disease management is poor, it leads to people landing up with complications in a hospital emergency.

Uncontrolled diabetes appears to progress faster in young people than in adults. Younger people also seem to have a higher chance of complications, such as kidney and eye disease, earlier in life than people who gets diabetes at the later age. People believe that just because young people with type-2 diabetes don’t need insulin, it is less sinister than type-1, but it’s not so. It’s not an aesthetic issue about weight or a mild metabolic disease. It needs immediate attention and treatment because complications are two to three times higher than for young people with type-1 diabetes.

More than two decades of rapid economic growth has changed Indians’ lifestyles. People eat out more often, and prefer Western-style junk food such as burgers and pizza over traditional lentil and vegetable meals. The changes have brought a sharp rise in obesity, along with lifestyle diseases such as diabetes. They are also more sedentary, using cars and public transportation instead of walking or riding bicycles, and entertaining themselves with television.

Diabetes in children nearly always occurs with obesity, which may contribute to other higher risk like blood pressure and high cholesterol/triglycerides levels.The American Diabetes Association (ADA) recommend testing for children aged over 10 years who do not have symptoms of diabetes but who are overweight (over 85 percentile for body mass index or over 120 percent ideal weight for height) if they have any two of the following risk factors:

• family history of type 2 diabetes
• signs of insulin resistance
• if the mother had diabetes or gestational diabetes while pregnant with the child
• high-risk ethnicity.

Overweight children are at risk of developing type 2 diabetes, as they are more likely to have insulin resistance. Keeping physically active reduces insulin resistance. Eating an balance diet by limiting refined and fried foods helps in maintaining an healthy weight. Change in lifestyle habits remains an important component in the management of the diabetes. Dealing with diabetes during young adulthood can be particularly challenging, but careful management and taking action early can help you maintain health and reduce your risk of developing serious and life-threatening complications later on. So take steps during your young adult years to improve your overall health and well-being.