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.)