It is always a bit shocking when we discover a new disease, or an old disease in a new population, particularly if it involves children. But that’s exactly what’s happening. Kids are getting adult-onset diabetes in record numbers.
In the early 1900s, lung cancer was almost unheard of. With the advent of modern mechanical cigarette rolling machines, cigarette smoking and lung cancer exploded during the mid-20th century. The correlation was conclusively established in 1950, despite strenuous denials from the tobacco companies ever since. Now the commercial food and drinks industry is helping to injure our children.

Now kids are getting adult-onset diabetes

The major serious illnesses from which we suffer are largely caused by our unhealthy diets and lifestyles. The limited interactions that we have with actual health care providers are not going to establish health in our lives. So it is up to each of us to make the decisions and choices that will determine our medical fate.
This is sadly not true for children. Kids end up eating and drinking what they are given, what other kids are eating, what they get used to, and what is available. Often these food and drink choices are making them sick. As of 2010, one out of three American adolescents is being treated with drugs for a chronic condition.
There are two forms of diabetes (excess sugar in the blood) — Type 1 and Type 2. Blood sugar is controlled largely by the pancreatic hormone insulin, which allows blood sugar to be taken up by liver, muscle, and fat cells. Type 1 or juvenile diabetes usually shows up in young children and adolescents, stemming from the inability of pancreas cells to make adequate functional insulin.
Type 1 diabetes is caused by genetics, exposure to a virus early in life, low vitamin D and omega-3 fatty acids, or exposure to nitrates. With 15,000 new Type 1 cases annually, only 5 to 10 percent of diabetics have this juvenile form of the disease, according to the Centers for Disease Control and Prevention. There is no cure.
    In Type 2 diabetes, the body becomes resistant to the effects of insulin, and the blood sugar goes up. Type 2 usually develops after the age of 40, affecting 8 percent of the United States population, but this number is skyrocketing for those under age 18. We may now have as many as two million kids with adult-onset diabetes.
    Diabetes causes severe, premature cardiovascular disease, vision impairment and blindness, disease of the peripheral and abdominal nerves, and kidney failure.
    “Twenty years ago, it was almost unheard of to see Type 2 diabetes in a child,” said Dr. Thomas A. Wilson, the chief of pediatric endocrinology at Stony Brook University Medical Center. “Now we see lots of it, and the rates are going up.”
    Dr. Wilson sees the rise of adult-onset diabetes as a problem with the child’s social setting. Children are surrounded by poor food and drink choices that drive them toward the disease. The blood sugar problem is often related to weight gain.
    As people gain weight, they require more insulin to keep their blood sugars normal, and the body becomes less sensitive to insulin. This is called metabolic syndrome. Some people have a pancreas that can keep up with the insulin demand, and others don’t.
    When the pancreas falls behind, the blood sugar goes up. First you have a period of carbohydrate intolerance where the sugars are a bit high, and then you move on to full-blown diabetes. Along the way you will have excessive fats accumulating in the liver, or so-called fatty liver, due to high insulin levels. A hemoglobin A1C blood test can tell you about your longer-term blood sugar control.
    It is also important to know your child’s obesity status calculated as the body mass index, or B.M.I. The measure is a calculation of body fat relative to height and weight. You can determine B.M.I. by going to www.nhlbisupport. com/bmi or by asking your nurse or doctor to calculate it for you. A B.M.I. over 25 is overweight and over 30 is obese.
    The average American teenage boy consumes 15 teaspoons of refined sugars per day from soda pop, and the average girl consumes 12 teaspoons. These sugars hit the bloodstream hard, making insulin spike and leading to carbohydrate intolerance. Sugary soft drink production has increased almost tenfold since 1942.
    But if you don’t give your kids soda pop, what do you give them? Well, the first step is not to raise them with a “sweet tooth.” Children who are not given oversweetened food and drinks will find a corn syrup-loaded soda way too sweet. Raise them on real food and fruit with slightly flavored seltzer.
    The second step is substitution. It rarely works to simply deny kids what they want, what they are accustomed to. They can still have a somewhat sweet drink, just substitute whole fruit or healthy juices and cut the juice with fizzy water.
    We should work to eliminate sugar-sweetened drinks in school — this is the policy of the American Academy of Pediatrics and the American Dental Association. Unfortunately, fresh vegetables and fruits are more expensive than sugar-shock foods.
    The prescription of drugs to children for control of adult-onset diabetes has risen 150 percent since 2001. But ignoring poor eating habits and a sedentary lifestyle to rely on a pill is not a proach. William C. Knowler and colleagues studied 3,243 nondiabetic subjects with carbohydrate intolerance over 2.8 years, comparing a sugar-lowering drug (metformin) versus lifestyle intervention.
    The metformin group reduced the progression to diabetes by only 31 percent, but the lifestyle group, which lost an average of seven pounds and exercised 150 minutes per week, cut its rate of diabetes by 58 percent. The results were published in the Feb. 7, 2002, issue of The New England Journal of Medicine.
    Dr. Wilson has been able to take kids off diabetes medication and insulin shots, but it takes a whole change in diet and exercise for the child. “It is a problem of how we live and how we eat these days,” Dr. Wilson told me. “We have to learn to eat to live, not live to eat.” With serious illness looming for many kids, these are words to live by.
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    Questions can be directed to Dr. James N. Dillard at jdillard@ehstar.com.