November is National Diabetes Month. According to the Centers for Disease Control & Prevention (CDC), 1 in 10 Americans has diabetes (keep in mind that most of those numbers are adults with Type 2 diabetes). With the aging and fattening of America, the number of adults diagnosed with diabetes has more than tripled in the last 20 years. In my own practice, it used to be a rare that I would see an overweight child with Type 2 diabetes (classically, an adult problem). I am now seeing quite a few overweight teens (I had a 9-year-old the other day), with Type 2 diabetes. The question is, “Is there anything I can do to help prevent it in my children (and myself)?”
Type 1 diabetes (classically, the childhood, insulin dependent form) is believed to be an autoimmune problem. This means the body’s own immune system attacks itself. We generally believe there isn’t anything anyone can do to necessarily prevent Type 1 diabetes. Type 2 diabetes (classically, the diabetes associated with older, overweight people who have burned out their pancreas) is a different story. If we prevent an individual from becoming overweight, we can often prevent the onset of Type 2 diabetes.
Type 2 Diabetes:
Risk factors that you can change:
- Being overweight
- Not being physically active (at least 3 times a week).
- Poor diet
Risk factors you can’t change:
- Age, older than 45 years
- Immediate family with Type 2 diabetes
- African American, Hispanic or Latino, American Indian or Alaskan Native, Pacific Islander
- Ever having gestational diabetes (or a baby who weighed more than 9 lbs.) puts you at higher risk of Type 2 diabetes later in life.
Should I have my kid tested?
During every well-child check, we are supposed to screen your child for signs/risks of diabetes. Your pediatrician may not come right out and say he or she is “screening for diabetes,” but a few simple questions and examination findings can help a doctor identify patients who need further workup. If the answer is “yes” to any of these questions, your pediatrician will likely suggest some blood work to investigate further. Your pediatrician will look at:
- Your child’s BMI (body mass index). Is the BMI elevated? This tells a doctor if your child is overweight/obese.
- Your child’s diet. Does your child have a poor diet and/or eat too much? How is your child’s fluid intake? (if it’s excessive, it may be a sign of Type 1 diabetes.)
- Is there a family history of diabetes (especially first-degree relatives)?
- Does your child have other medical conditions that increase his or her risk of diabetes (e.g., cystic fibrosis, polycystic ovarian syndrome, hypercholesterolemia)?
- Is your child’s blood pressure elevated?
- Does your child have any physical symptoms (e.g., acanthosis nigricans—patches of dark, thick skin especially in areas like the neck and arm pits).
As always, if you are concerned about your child, make sure and talk to your doctor about it. For additional, specific information on diabetes, see the previously posted articles: