Traditionally, Type 2 diabetes has been thought of as an older
persons disease. Yet recently, younger adults and even some
children and teens are being diagnosed with Type 2 diabetes, a disease
that affects 16 million Americans and continues to grow at epidemic
proportions.
Emory physicians at Grady Hospitals Diabetes Clinic say the
rising rate of diabetes among younger adults is strongly linked
to obesity. Imad El-Kebbi, associate professor of medicine in the
School of Medicine and a Grady endocrinologist, said he now sees
a growing number of patients in their late teenage years and in
young adulthood.
Were seeing more 20- and 30-year-olds with Type 2 diabetes
than people would have expected several years ago, El-Kebbi
said. A lot of that could be related to the problem of obesity,
which is increasing in the United States and across the world.
In an analysis conducted in 1999 and presented to the American
Diabetes Association National Meeting in 2000, El-Kebbi compared
2,539 younger and older adults with Type 2 diabetes seen at Grady
between 1991 and 1999. He concluded that younger patients were more
obese, had worse glycemic control and did not respond as well to
treatment.
Those same patients, who averaged 25 years of age with a Body Mass
Index of 37.8, needed aggressive treatment to lower their blood
sugar. (Body Mass Index, a ratio of weight to height, is an accepted
measure for obesity; measurements of 30 or above are defined as
obese, and 40 or above is severely obese) Younger age was recognized
as a risk factor for poor control in African American patients in
the Grady analysis.
Diabetes results from the bodys inability to produce or properly
use insulin, which is necessary for the body to burn sugar. High
blood sugar over time damages the bodys small blood vessels
and also can lead to atherosclerosis. Therefore diabetes can damage
the kidneys, nerves and the blood vessels of the heart. Obesity
and sedentary lifestyles often play significant roles in the development
of
Type 2 diabetes. Type 1 diabetes, by contrast, begins when the
pancreas totally loses its ability to produce insulin, usually in
childhood.
Obese childrenespecially those of African American and Hispanic
descentare at increased risk for Type 2 diabetes, and while
Gradys Diabetes Clinic does not serve children or teenagers,
pediatricians at nearby Hughes Spalding Childrens Hospital
(part of the Grady Health System) are treating more children for
the condition.
According to a recent study in the Journal of the American Medical
Association, for example, 21 percent of African American and
Hispanic American children ages 4 to 12 were considered overweight,
as compared to 12 percent of non-Hispanic white children.
El-Kebbi stressed that younger patients with Type 2 diabetes need
aggressive management of the condition.
The best way to lower damage from diabetes, as far as we
know right now, is to bring the sugar down to normal and keep the
blood pressure and cholesterol under control, El-Kebbi said.
All of these issues are extremely important. If its
harder for younger people to lower their blood sugar, that means
[physicians] have to work harder to bring it down. Already more
of our young people are on insulininsulin alone or in combination
with oral medications tends to be the last line of therapy.
El-Kebbi hopes to develop interventions, projects and programs
that would make significant improvements in treating younger diabetes
patients.
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