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Kid's Health (Archive)
Our award-winning Kid's Health Magazine is designed to provide healthful information for your growing child. Please Note: Kid's Health Magazine is no longer being printed. Please visit our blog at http://www.choc.org/blog for the latest articles about your child's health from the experts at CHOC Children's. You can also receive our electronic Kid's Health newsletter in your inbox by subscribing to our mailing list: http://www.choc.org/subscribe

Children With "Adult" Diabetes Face Serious Health Risks

Until a few years ago, type 2 diabetes (adult-onset diabetes) was virtually unheard of in children. In 2002, 20 percent of the children newly diagnosed with diabetes at CHOC had the adult form of this disease. In some communities around the country, that figure is as high as 45 percent.

“And those are just the children we know about, the ones who have been diagnosed. With the clear link between childhood obesity and this disease, there are undoubtedly many more children who are undiagnosed and untreated,” says Susan Clark, M.D., director of the CHOC Division of Endocrinology and Diabetes. “We’re greatly concerned because studies suggest the complications of adult-onset diabetes may set in more rapidly in younger patients. Those complications include heart disease, blindness, kidney failure and limb amputations.”

“Adult” Diabetes in Children Linked to Obesity
Dr. Clark says there are many reasons why this is happening and all are linked to lifestyle. Children lead more sedentary lives these days, but television and videogames are not the only culprits. There are simply fewer safe places for children to play.

“Kids cannot be out unsupervised on the street riding bikes and playing ball like they used to do just one generation ago. Also, many schools have cut back on physical education classes,” Dr. Clark says. “Families are busier, and not everyone can afford a membership to a health club or even the YMCA.”

At the same time, children have easy access to inexpensive fast foods that are high in fats and carbohydrates. According to Dr. Clark, studies have linked the rise in childhood obesity to increased consumption of soda. Each 12-ounce can of soda contains six to eight teaspoons of sugar. Just drinking one can a day for a year is enough extra calories to put on 15 - 17 extra pounds.

“My top recommendation is stop drinking sugar, like sodas. The second is to stop eating “super-size” French fries and potato chips. Junk food puts weight on children, and anything that causes obesity is a risk factor for developing type 2 diabetes. Instead, children need to be eating more fruits and vegetables.”

Prevention Is Critical For Those Most At Risk
Glucose, or blood sugar, provides energy to the cells of the body. Insulin is the hormone secreted by the pancreas that makes it possible for the glucose to leave the blood and enter the cells.

Unlike type I diabetes (juvenile-onset diabetes), which is an immune system disorder, type 2 diabetes is linked to obesity, family history and ethnic origin. Children with Asian, African-American, Hispanic and Pacific-Islander ancestry have a higher risk of developing diabetes. So do children born to mothers who developed diabetes during pregnancy. The risk for diabetes also increases during puberty because of hormonal changes. In type 2 diabetes, the body develops an increasing resistance to insulin as the child becomes heavier. As a result, the body produces more and more insulin to remove the glucose from the blood and allow it to enter the cells. If there isn’t enough, the glucose stays in the blood causing diabetes and putting the child at risk for serious health complications.

“A healthy diet, losing weight, a healthy diet and increasing physical activity decreases the amount of insulin the pancreas must produce. The diabetes will either go away or become much easier to control,” Dr. Clark says. “In families where there is a tendency to be heavy, prevention is all that more important. Exercise and a healthy diet are really the only ways parents can help their children avoid diabetes.”

Why Exercise Matters
Exercise makes the body more sensitive to insulin, so less is needed. It also has the added advantage of reducing stress hormones, which stimulate the body to produce fat.

“We recommend a half an hour of exercise about six days a week. The key is to make it fun,” says Newell McMurtry, R.D., a registered dietitian who works with children at the CHOC type 2 diabetes clinic. “Play basketball, dance or swim. If a child is overweight, a fast walk is good. Just anything that gets your child breathing hard will do it.”

McMurtry suggests additional ways families can develop a more physically active lifestyle:

  • Take a walk on the beach
  • Visit a local park
  • Walk the dog
  • Play tennis, golf or volleyball
  • Ride bicycles, scooters or rollerblade (remember your helmets!)
  • Jump rope
  • Play pingpong

“The biggest thing is motivation. If your child likes to dance, try that,” McMurtry advises. “Some families may already have exercise bicycles or treadmills, which are especially helpful when it is cold and rainy outside. Another idea is fitness videos. Most libraries lend them out for free. Check out a couple and try them before buying one.”

Does Your Child Have A “Dirty” Neck?
If it looks like your child has a dark ring around his or her neck, take a closer look. If the skin feels thickened or velvety, contact your pediatrician immediately. It could be “acanthosis nigricans,” an indication your child has high insulin levels and could develop diabetes. Similar rings may be spotted under the arms or in the groin area.

“We have seen kids whose parents scrubbed their necks until they were bleeding thinking it was dirt. It isn’t. It is increased pigmentation that will only go way by reducing insulin levels,” says Susan Clark, M.D., director of the CHOC Division of Endocrinology and Diabetes. “The way to do that is through a healthy diet, weight loss, exercise and medication.”

CHOC CHILDREN'S PUBLICATIONS
PHYSICIAN CONNECTION ENEWSLETTER
KIDS HEALTH MAGAZINE
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Children's Hospital of Orange County is affiliated with UC Irvine Healthcare and UC Irvine School of Medicine

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