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The Rise of Diabetes in Children

Since the 1980s, the number of kids being diagnosed with type 1 and type 2 diabetes has been increasing, with Type 1 up at a rate of about 3 to 5 percent per year and Type 2 at a rate of about 5 to 8 percent. That may not sound like much, but it’s startling when you consider that twice as many kids are diagnosed with types 1 and 2 diabetes today than were diagnosed 20 to 25 years ago. 

Type 1 and type 2 diabetes share the same underlying defect—an inability to use insulin in a manner that keeps blood sugar from rising too high—but they arise out of almost opposite processes. Type 1, which used to be known as juvenile diabetes, is an autoimmune disease in which the body attacks its own cells—namely, the beta cells of the pancreas—destroying their ability to make insulin. Although it is not clear whether the first type of diabetes is hereditary or not (only about 10 percent of those with type 1 diabetes have a family history of the disease), it was found that some children inherit the disease more than others and research is still underway on this subject. In type 2, formerly known as adult-onset diabetes, tissues that need insulin to take up glucose (such as the liver, muscles and fat) become resistant to insulin’s presence. The insulin-producing cells respond by going into overdrive, first making more of the hormone than normal and then losing the ability to keep up with the excess glucose in the blood. Some people end up unable to make insulin at all.

Symptoms and Risk Factors of Type 1 Diabetes 

The signs and symptoms of type 1 diabetes in children usually develop quickly, over a period of weeks. They include:

• Increased thirst and frequent urination
• Extreme hunger
• Weight loss
• Fatigue
• Irritability or behavior changes
• Fruity-smelling breath
• Blurred vision
• Yeast infection (girls with type 1 diabetes may have genital yeast infections. Babies can develop diaper rashes caused by yeast).

Although the condition can develop at any age, according to parents advisor Lori Laffel, M.D., chief of the pediatric, adolescent, and young adult section at Harvard Medical School’s Joslin Diabetes Center,”we’re seeing it at younger ages than ever before and more toddlers and preschoolers are being diagnosed”. Experts believe that environmental factors like children’s reduced exposure to germs may be partly to blame (a theory known as the hygiene hypothesis). Sometimes, a child develops diabetes after being exposed to a virus like the ones that cause mono (Epstein-Barr) or hand-foot-mouth disease (which includes viruses such as Coxsackie). “Reduced exposure to early-childhood infections may alter certain children’s immune response, leading to the autoimmune attack on the body’s insulin-producing beta cells,” says Dr. Laffel. “It could also be that excessive childhood weight may add other stresses to beta cells.” 

Risk factors for type 1 diabetes in children include:

• Family history: Anyone with a parent or siblings with type 1 diabetes has a slightly increased risk of developing the condition.
• Genetic susceptibility: The presence of certain genes indicates an increased risk of developing type 1 diabetes.
• Race: In the United States, type 1 diabetes is more common among non-Hispanic white children than among other races. 

• Certain viruses: Exposure to various viruses may trigger the autoimmune destruction of the islet cells.
• Diet: No specific dietary factor or nutrient in infancy has been shown to play a role in the development of type 1 diabetes. However, early intake of cow’s milk has been linked to an increased risk of type 1 diabetes, while breast-feeding might lower the risk. The timing of the introduction of cereal into a baby’s diet also may affect a child’s risk of type 1 diabetes.

Symptoms and Risk Factors of Type 2 Diabetes 

Type 2 diabetes in children may develop gradually. About 40 percent of children who have type 2 diabetes have no signs or symptoms and are diagnosed during routine physical exams.

Other children might experience:

• Increased thirst and frequent urination
• Weight loss.  However, weight loss is less common in children with type 2 diabetes than in children with type 1 diabetes.
• Fatigue
• Blurred vision
• Slow-healing sores or frequent infections. Type 2 diabetes affects your child’s ability to heal and resist infections.

Risk factors for type 2 diabetes in children 

Researchers don’t fully understand why some children develop type 2 diabetes and others don’t, even if they have similar risk factors. However, it’s clear that certain factors increase the risk, including:

• Weight: Being overweight is a primary risk factor for type 2 diabetes. The more fatty tissue children have — especially inside and between the muscle and skin around the abdomen — the more resistant their bodies’ cells become to insulin. The association between obesity and type 2 diabetes is even stronger in youth than in adults.
• Inactivity: The less active your child is, the greater his or her risk of type 2 diabetes. Physical activity helps your child control his or her weight, uses glucose as energy, and makes your child’s cells more responsive to insulin.
• Family history: Children’s risk of type 2 diabetes increases if they have a parent or sibling with the disease.
• Race: Although it’s unclear why, people of certain races are more likely to develop type 2 diabetes.
• Age and sex: Many children develop type 2 diabetes at the start of puberty. Adolescent girls are likelier to develop type 2 diabetes than are adolescent boys.
• Birth weight and gestational diabetes: Low birth weight and being born to a mother who had gestational diabetes during the pregnancy are both associated with a higher risk of developing type 2 diabetes.

In Jordan, according to the National Center for Diabetes, Endocrinology & Genetics, the number of people with diabetes under the age of 18 years was as many as 10,000 (2005), with as many as 20% undetected (2016).

How can we protect our children?

The following habits can help your child stay on track:

• Awareness: Be aware of this disease, its symptoms, risk factors and your own family history.
• Plan your meals. Consider the amount of calories children need to grow. In general, three small meals and three snacks a day can help meet calorie needs. Many children with type 2 diabetes are overweight. The goal should be a healthy weight by eating healthy foods and getting more activity (60 minutes each day).
• Help your child learn how much food is a healthy amount. This is called portion control.
• Have your family gradually switch from drinking soda and other sugary drinks, such as sports drinks and juices, to plain water or low-fat milk.
• Workout together as a family or with friends. Frequent and regular physical exercise (150 minutes of moderate intensity aerobic activity per week) is recommended for people of all ages as it boosts the immune system and helps protect against conditions such as Diabetes. In fact, it is known to cut the risk of major chronic illnesses/diseases by up to 50%. Healthy activities include a multitude of sports; fast paced walking, light jogging, bike riding, aerobics, playing doubles tennis or badminton.
• You are the dietitian; if your child has diabetes, design a meal plan for your child. A registered dietitian can help as well. No food is off-limits. Knowing how different foods affect your child’s blood sugar helps you and your child keeps it in target range.

Surprising facts:

• “25% of children do not participate in free time physical activity.” How about your children? Keep them moving, jumping, and running.
• “Snacking leads to an additional 200 calories for kids per day” keep snacks as healthy as possible.
• “The more time kids spend watching TV, the more likely they are to gain weight.” Imagine when that’s coupled with juice or a snack!
• “45% of children diagnosed with diabetes have Type 2 diabetes due to being obese or overweight.” Keep that in mind since diet is a lifestyle
• “Drinking just one can of (non-diet) soda per day can raise the risk of developing type 2 diabetes by 22%.”