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More children
suffer 'adult' diabetes
Experts cite rise in obesity among young
by P. Douglas Filaroski,
July 30, 2002, Jacksonville Times-Union
Ten years ago, it was rare for doctors to see children
with the type of diabetes in which the body ignores or under-produces
insulin.
So rare, Type 2 diabetes was called "adult" diabetes, a serious
illness that inhibits the conversion of sugar, usually later in life,
and damages the eyes, kidneys and heart.
Now, physicians such as Larry Fox see a steady stream of overweight
children with this type of diabetes for whom they prescribe blood
pressure pills and worry about heart problems before high school
graduation.
"The incidence [of diabetes] is rising because obesity among
children is very much on the rise," said Fox, director of the
Northeast Florida Pediatric Diabetes Center at Wolfson Children's
Hospital in Jacksonville. "It's a serious problem."
And a sudden one. So new is the disease among children, the center
did not even exist a decade ago, when Type 2 diabetes -- which
accounts for 90 to 95 percent of all diabetes cases -- was largely
confined to adults.
But as the percentage of overweight adolescents tripled since 1980,
Type 2 diabetes sneaked up on physicians such as Fox, who diagnosed 55
cases last year and is on pace for more this year.
"It's bad news for a number of reasons," said Fox, an
endocrinologist with Nemours Children's Clinic in Jacksonville. "It
reflects the ills of society at large, and the trend towards these
kinds of disease."
People spend less time exercising. Schools don't emphasize physical
education as much as a generation ago. Food makers stress larger,
starchier and more sugary portions.
The health implications are serious.
One researcher in Canada who followed 51 diabetic children into
early adulthood reported alarming results recently.
Heather Dean of the University of Manitoba told the American
Diabetes Association last month that two of the 51 died on kidney
dialysis; three others remained on dialysis and one young woman had
become blind.
Of 56 pregnancies in the test subjects, only 35 resulted in live
births.
Many experts agree on the formula for this illness. Start with a
diet heavy on fast food and high-calorie soft drinks, and add the
exchange of exercise for video games.
The result is more overweight children.
An analysis by the U.S. Centers for Disease Control and Prevention
recently showed that Type 2 cases among children have doubled in 20
years.
The report, published in May in the journal Pediatrics, said the
share of child-hospitalization costs related to obesity and diabetes
increased fourfold.
Diabetes pitfalls
Rebecca Nestor knows the pitfalls of childhood diabetes. Before
being diagnosed, the Jacksonville girl felt as if she was going to
die.
Thirsty, shivering and unable to walk, the 12-year-old's mother
took her to an emergency room.
"She was drinking water, going to the bathroom all the time, and
cold like ice," her mother, Carmelitte Nestor, recalled. "The doctor
said she had blood pressure [three to four times the normal level]."
Fox diagnosed her with Type 2 diabetes, gave her insulin, a kit to
monitor blood sugar and a meal plan to cut down on sugar and
carbohydrates.
Rebecca Nestor had recently returned from Haiti, where she spent
five unhappy years with her father, away from her mother, and eating a
poor diet.
"When my mom left, I just cried," she said.
She often stayed indoors alone, comforting herself with starchy
grits and rice and sugary plantains -- the Haitian equivalent of fast
food.
Rebecca, who is now 14, admits she loves soda, hates sports and
struggles to lose weight.
But she is taking her illness seriously now. Since her diagnosis,
she is trying to stay on her diet and walks about an hour a day.
Rebecca has progressed to where she doesn't need insulin shots
anymore and can take oral medication.
Her mother is betting Rebecca will get healthier. "She is a very
responsible girl," Carmelitte Nestor said. "She acts older than she
is."
Poor prospects
The outlook is not as good for other children.
David Satcher, a former U.S. surgeon general, has called childhood
obesity a national epidemic.
The government this month launched a media campaign called "VERB:
It's What You Do," to encourage kids to find a verb -- run, paint,
sing or bowl -- and stay active.
"We need to get our children away from the PlayStation and onto the
playground," said U.S. Health and Human Services Secretary Tommy
Thompson.
Government figures show 25 percent of children spend at least four
hours a day watching television and three-fourths fail to engage in
physical activity most days.
Three-fourths of overweight and obese adolescents do not change
their habits and remain overweight and obese as adults, officials
said.
"That's the problem," Fox said. "It gets passed from generation to
generation. ... If parents drink soda after soda after soda, they are
not setting a good example."
He suggests that parents help by taking care of themselves, and
provide a model for children to follow.
Turn off the TV. Get out and play. Eat healthier meals at home.
"People need to change their habits," Fox said. "The health of
their kids depends on it."
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