Studies Say Diabetes Abounds In Obese Children But Awareness Is Lacking
With the increasing prevalence of type 2 diabetes in children, are parents and children getting the message that being overweight can lead to the disease? Several new studies suggest otherwise, finding rising health problems in obese children and concluding that childhood obesity can go unnoticed by both parents and children. Although Eric Espensen, DPM, has not seen an increased number of children who have type 2 diabetes, he notes that Minh Mach, MD, an endocrinologist colleague, has seen such an increase and lectures on the rising incidence of type 2 diabetes in youth. Dr. Espensen urges parents to be aware of health complications that can occur in their children. “The most important thing to emphasize to parents is both awareness, which includes signs and symptoms such as ketoacidosis and hyperglycemia, and complications that result from poor control,” advises Dr. Espensen, the Director of the Providence Diabetic Foot Center at the Providence St. Joseph Medical Center in Burbank, Calif. Which complications are being discovered in overweight children? One study, presented at the Annual Scientific Sessions of the American Diabetes Association (ADA), observed 1,700 eighth-graders in Texas, California and North Carolina, and found 40.2 percent had pre-diabetes. In addition, 49.3 percent of the children had body mass indexes (BMI) above the 85th percentile of their ages and some had diabetes, hypertension and raised levels of cholesterol and lipids, according to the trial, sponsored by the Studies to Treat or Prevent Pediatric Type 2 Diabetes Study Group (STOPPT2D). Researchers note that being overweight and having problems with cholesterol, blood pressure or blood glucose can also place children at risk for cardiovascular disease if the children do not improve nutrition and become more physically active. Many parents and children may be unaware of problems with their weight, according to the British Early Bird Study, which was also presented at the ADA meeting. The study is in the fourth year of a 12-year observance of a randomly selected group of 300 children, starting at an average age of 4.9. These children visit a hospital every six months and are tested via a battery of parameters, including BMI, metabolic rate, physical activity and fasting blood sugar, according to the ADA. This study revealed that 51 percent of children underestimated their weight while just 17 percent overestimated it. An ADA report on the study noted that some parents also underestimated their children’s weight as well as their own. According to the study, one-third of the parents of obese girls and one-half of the parents of obese boys rated their children’s weight as “about right.” The study adds that one-third of the mothers and one-half of the fathers who were either overweight or obese also rated their own weight as “about right.” Another study, which was recently published in The New England Journal of Medicine, assessed 439 obese, 31 overweight and 20 non-obese children and adolescents. Researchers discovered that half of the severely obese children had metabolic syndrome and found an increased risk of cardiovascular disease in such children, according to the study. How Can You Encourage Compliance? With the health risks of obesity becoming more documented, how can one facilitate compliance to a good nutrition regimen to prevent complications such as diabetes? Educating children is the key, according to Dr. Espensen, who says DPMs can encourage compliance by increasing children’s awareness of the potential complications of being overweight. Dr. Espensen also recommends encouraging patients to take advantage of the diabetes support groups and educational programs at local hospitals. One group at his facility is open to those newly diagnosed with diabetes meeting those who have had the disease for a long period of time. He notes the ADA also has similar educational chapters. “It also allows youths to hear firsthand about some of the devastating complications of diabetes,” says Dr. Espensen of the meetings. Francine Kaufman, MD, a co-author of the aforementioned study involving 1,700 eighth-grade children, says she will be implementing a three-year program to assess the benefits of improving nutrition and physical activity in school environments. Dr. Kaufman, Chairwoman of STOPPT2D, says the program will attempt to change children’s perceptions of health norms.