Formerly known as “adult-onset diabetes,” the moniker was dropped over the past decade when children as young as six started getting it. These days, one in four Canadians either has diabetes or its precursor, pre-diabetes — when your blood glucose (sugar) levels are higher than normal — and an increasing number of them are children. “Type 2 diabetes is the epidemic of the 21st century,” says Bernard Zinman, director of the Leadership Sinai Centre for Diabetes and professor of medicine at the University of Toronto. “By 2030, almost half a billion people will have it — no one is immune.”
Type 2 diabetes is a chronic condition that affects the way your body metabolizes sugar, its main source of fuel. Either your pancreas stops producing enough insulin — the hormone that controls how much sugar gets into your cells — or your body simply resists insulin. The reason for the rise in diabetes is simple, Zinman says. Obesity. “Our risk has increased with unhealthy food choices, supersized portions and more time spent in front of screens, less time exercising,” he says. “As our caloric intake goes up, so does our weight and our diabetes risk.” Basically, the more fatty tissue you have, the more resistant your cells are to insulin. Other risk factors include ethnicity (being of Aboriginal, Hispanic, Asian or African descent), high blood pressure, where you carry your weight (around your abdomen is bad) and having a family history of the disease.
As sugar builds up in a diabetic’s bloodstream, they may feel constantly thirsty, develop slow-healing sores and their vision may become blurred as fluid is pulled from the tissues around their eyes. Eventually, diabetes can affect major organs, causing kidney failure, heart disease, nerve damage and blindness. “The fact that type 2 diabetes is occurring in children is frightening, because we know the biggest risk factor for complications is duration,” says Zinman. “We may start seeing people having heart attacks in their 30s.”
But the news isn’t all bad. “Just because you have diabetes doesn’t mean the disease will inevitably progress, especially if you make lifestyle changes early on,” he says. Some people can manage their blood sugar with diet and exercise alone, others need insulin therapy. “When it comes to lifestyle changes, it’s not about being on a diet — that’s short-term,” Zinman says. “You have to live differently. The food in your cupboards can’t be what it used to be and you need to get involved in a regular exercise program — at least 30 minutes of aerobic exercise five days a week.”
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Physical activity helps control weight and makes cells more sensitive to insulin. There’s also a case for eating more slowly. In 2012, researchers in Lithuania found that not only does it help with weight loss, but people who eat too quickly are two-and-a-half times more likely to have type 2 diabetes. What you eat matters, too — the Mayo Clinic recommends having at least 14 grams of fibre for every 1,000 calories you consume because fibre helps control blood sugar levels. (For example, a banana gives you about three grams of fibre and a three-quarter cup of whole wheat pasta gives you five.)
One of the latest discoveries from a 2012 study out of Columbia University Medical Center in New York found type 2 diabetes progresses more rapidly in children and is harder to treat. “It’s tough for kids to understand the need for permanent lifestyle changes — they really need a supportive family environment that can address those changes as a team,” says Sue Pedersen, an endocrinologist in Calgary. “The most effective way for kids to make healthy changes is if their parents do, too.”
One positive outcome of the diabetes epidemic is that it has led to new research. A 2012 study published in the New England Journal of Medicine found bariatric surgery can send diabetes into remission — some patients were able to stop taking insulin three days after the procedure. Zinman is also involved in a new study to test a procedure that may slow the progression of the disease. His strategy is to give diabetics who have been diagnosed for less than seven years four concentrated insulin injections every day for a month. (Diabetics normally wouldn’t be treated with insulin until later in their condition, usually as more of a last resort, at which point they need it every day for the rest of their lives.) “We wanted to see if we could rescue the pancreas by providing insulin early on,” Zinman says. “We were able to put diabetes into temporary remission in many of the patients.”
The real 411 on type 1 diabetes
What it is
A chronic condition in which the immune system destroys cells in the pancreas, making it unable to produce insulin. It used to be called juvenile diabetes, but now that kids are also getting type 2 that moniker has been dropped.
Who gets it
Believed to be genetic, about 10 percent of people with diabetes have type 1; it’s usually diagnosed in adolescence.
The same as type 2 — heart disease, nerve damage, kidney failure and blindness.
How to treat it
Daily blood glucose monitoring, maintaining a healthy weight and insulin injections.
A version of this article appeared in our October 2012 issue with the title "The diabetes dilemma" (p. 38). For more discussions on Kids' Health, join the discussions on our Health community boards!