Diabetes seems to be climbing quickly in U.S. teens
Two years ago, a major survey by researchers with the Colorado School of Public Health in Aurora reported that as of 2001, 0.34 percent of teenagers had been diagnosed with type 2 diabetes. It made that calculation after reviewing data on 1.7 million kids 12 to 19 years old. All had been seen by doctors in Colorado, California, Ohio, South Dakota and Washington state. A new study reviewed data representative of children across the entire United States. It finds that more than twice as many adolescents as in the earlier study — 0.8 percent — now have diabetes.
“To our knowledge, these are the first estimates of diabetes in a nationally representative sample of U.S. adolescents” using the best available markers of disease, the new study notes. These include three different measures of current and past blood-sugar levels in the body. The new estimates of teen diabetes rates also are higher than ever reported. The findings appear in the July 19 issue of JAMA.
Diabetes is known as a metabolic disease. That means it affects how the body processes energy — what most people think of as food. The body uses many different processes to digest what it eats and drinks, turning food and drink into simple sugars. Cells can use that sugar to stay warm, to fuel their activities and to build new tissues.
But in diabetes, especially the type-2 form, the body has trouble using that sugar. A hormone known as insulin is supposed to bring sugar into cells. But insulin cannot work effectively in diabetes. It ends up leaving too much sugar in the bloodstream, where it can ultimately damage tissues. In type 1 diabetes, the body does not make enough insulin, leading to the same problem.
A half-century ago, the type-2 form of this disease seldom showed up in people under 40 to 60 years old. That’s why doctors used to call it adult-onset diabetes. No more. Many kids are developing the disease decades earlier than their grandparents or great grandparents.
Diabetes can lead to blindness. It also can lead to heart disease and poor blood circulation. One complication is that wounds will eventually heal more slowly. If infections set in, tissue death — gangrene — may occur instead of healing. Affected digits or limbs may need to be amputated to prevent the potential spread of gangrene.
Keeping to a special diet or taking medicines can limit the complications of diabetes — but not if people don’t know they are sick. And the new survey found that roughly a third of the diabetic kids had not been diagnosed until they took part in this study. Kids in certain ethnic groups were more likely to be unaware of their sickness. For instance, half of non-Hispanic blacks with diabetes did not know they were sick. The same was true for four in every 10 Hispanics with diabetes.
In addition, a whopping 17.7 percent of U.S. adolescents — one in every six of the teens — had prediabetes. Their bodies showed changes indicating they were on their way to developing the disease. Many had metabolic syndrome. (People with this health condition have an increased risk of diabetes and heart disease.)
The new data come from the National Health and Nutrition Examination Survey, or NHANES. It is carried out by an agency of the U.S. Centers for Disease Control and Prevention in Atlanta, Ga. NHANES researchers survey and give medical check-ups every two years to a cross-section of U.S. residents. The people it enrolls are selected to be representative of the entire United States in age, sex and race. So NHANES’ findings can be seen as a picture of U.S. health generally.
The new findings come from 2,600 teens who were seen by NHANES between the years of 2005 and 2014.
This brief study did not analyze what might account for the apparently growing incidence of diabetes in U.S. teens. However, many studies — including the 2014 youth-diabetes analysis — linked diabetes risk with obesity, a family history of disease and exposure to some pollutants. (Some of those pollutants were linked to obesity, including plasticizers such as phthalates and bisphenol A, pesticides such as atrazine and DDT, and organotin compounds.)
(for more about Power Words, click here)
adolescence A transitional stage of physical and psychological development that begins at the onset of puberty, typically between the ages of 11 and 13, and ends with adulthood.
atrazine A widely used weed killer that can mimic certain hormones, causing toxicity in animals.
bisphenol A (BPA) A building block of polycarbonate plastics and many commercially important resins. This chemical gained widespread public attention when research showed it could mimic the activity of estrogen, a female sex hormone.
blood sugar The body circulates glucose, a type of simple sugar, in blood to tissues of the body where it is used as a fuel. The body extracts this simple sugar from breakdown of sugars and starches. However, some diseases, most notably diabetes, can allow an unhealthy concentration of this sugar to build up in blood.
Centers for Disease Control and Prevention, or CDC An agency of the U.S. Department of Health and Human Services, CDC is charged with protecting public health and safety by working to control and prevent disease, injury and disabilities. It does this by investigating disease outbreaks, tracking exposures by Americans to infections and toxic chemicals, and regularly surveying diet and other habits among a representative cross-section of all Americans.
DDT (short for dichlorodiphenyltrichloroethane) This toxic chemical was for a time widely used as an insect-killing agent. It proved so effective that Swiss chemist Paul Müller received the 1948 Nobel Prize (for physiology or medicine) just eight years after establishing the chemical’s incredible effectiveness in killing bugs. But many developed countries, including the United States, eventually banned its use for its poisoning of non-targeted wildlife, such as birds.
diabetes A disease where the body either makes too little of the hormone insulin (known as type 1 disease) or ignores the presence of too much insulin when it is present (known as type 2 diabetes).
gangrene A condition where too little blood flow to tissues, allowing the tissue to die. Left untreated, gangrene can spread and lead to amputations or even death.
hormone (in zoology and medicine) A chemical produced in a gland and then carried in the bloodstream to another part of the body. Hormones control many important body activities, such as growth. Hormones act by triggering or regulating chemical reactions in the body. (in botany) A chemical that serves as a signaling compound that tells cells of a plant when and how to develop, or when to grow old and die.
incidence The rate or number of times something occurs.
insulin A hormone produced in the pancreas (an organ that is part of the digestive system) that helps the body use glucose as fuel.
marker (in biomedicine) The presence of some substance that usually can only be present because it signals some disease, pollutant or event (such as the attachment of some stain or molecular flag). As such, this substance will serve as a sign — or marker — of that related thing.
metabolic syndrome A health condition made up of any three of the following six problems: obesity, high blood pressure, insulin resistance, high levels of bad fats alongside low good cholesterol, extra blood components that cause inflammation and extra blood components that lead to clots. People with metabolic syndrome have an increased risk of developing diabetes or heart disease.
metabolism (adj. metabolic) The set of life-sustaining chemical reactions that take place inside cells and bigger structures, such as organs. These reactions enable organisms to grow, reproduce, move and otherwise respond to their environments.
National Health and Nutrition Examination Survey, or NHANES A long-running program (begun in the early 1960s), which has been designed to assess the health and nutritional status of adults and children in the United States. NHANES combines both physical (medical) examinations and interviews. It’s run by the National Center for Health Statistics, which is part of the U.S. Centers for Disease Control and Prevention. Each year, the program surveys another 5,000 people who have been chosen to be representative of all ages and races, and of people living throughout the nation.
obesity Extreme overweight. Obesity is associated with a wide range of health problems, including type 2 diabetes and high blood pressure.
organotin A series of tin-based compounds that also contain carbon. Most are toxic and have been used as pesticides.
phthalates A family of chemicals used as solvents and added to plastics to increase their flexibility.
survey (v.) To ask questions that glean data on the opinions, practices (such as dining or sleeping habits), knowledge or skills of a broad range of people. Researchers select the number and types of people questioned in hopes that the answers these individuals give will be representative of others who are their age, belong to the same ethnic group or live in the same region. (n.) The list of questions that will be offered to glean those data.
tissue Any of the distinct types of material, comprised of cells, which make up animals, plants or fungi. Cells within a tissue work as a unit to perform a particular function in living organisms. Different organs of the human body, for instance, often are made from many different types of tissues. And brain tissue will be very different from bone or heart tissue.
A. Menke, S. Casagrande and C.C. Cowie. Prevalence of diabetes in adolescents aged 12 to 19 years in the United States, 2005-2014. JAMA. Vol 316, July 19, 2016, p. 344. doi: 10.1001/jama.2016.8544.
D. Dabelea et al. Prevalence of type 1 and type 2 diabetes among children and adolescents from 2001 to 2009. JAMA. Vol. 311, May 7, 2014, p. 1778. doi: 10.1001/jama.2014.3201.
J. Raloff. “Fat becomes a disease.” Science News for Students. June 21, 2013.
S. Ornes. “Kids with ‘adult’ problems.” Science News for Students. July 2, 2012.
Learn more about diabetes from the American Diabetes Association.
Learn more about diabetes from the Centers for Disease Control and Prevention.