People who develop adult-onset diabetes as children – a once-unknown condition whose prevalence is rising rapidly -can have severe and occasionally fatal complications as early as in their twenties, the Washington Post reports. The problems, according to research on a group of about 80 Cree and Ojibway children in central Canada, include not only early death, but also kidney failure, blindness and high rates of miscarriage and stillbirth.
“This form of diabetes causes serious disease in these young adults,” said Heather Dean, a pediatrician from the University of Manitoba who presented the findings at a meeting of the American Diabetes Association in San Francisco. “What we don’t know is if there’s anything unique to this population that makes them different from Hispanic children in San Antonio or black children in Cincinnati.” Adult-onset diabetes in children is an emerging problem worldwide, linked to the epidemic of obesity and the adoption of a high-sugar, high-fat Western diet. Other studies of diabetic children have shown that at the time of diagnosis, many have detectable, although not obvious, organ damage. The Canadian study, however, is the first to describe specific complications in a group of diabetic children who have grown up.
If the ominous findings are borne out by research elsewhere, the implications are clear. The growing number of adolescents with diabetes must control it aggressively with lifestyle changes and medical treatment, or risk permanent disability in young adulthood.
In the Canadian study, Dean and her colleagues followed 86 adolescents diagnosed with adult-onset diabetes before age 17. The first were enrolled in the clinic’s database in 1986, and patients were added as they were diagnosed. About 80 percent are female, and a similar fraction are overweight.
Last fall, the physicians were able to find or obtain records on 79 of the original 86. Of that number, seven had died, all of them young women. Of the survivors, 51 agreed to be interviewed. Three of those 51 had kidney failure and were on dialysis, and one was also blind. Another person had part of a foot amputated. There had been 56 pregnancies, with 13 early and three late miscarriages and two stillbirths.
Dean said it is clear in retrospect that treatment “wasn’t aggressive enough.” But she said little is known about this form of the disease, and only one of the oral diabetes medicines used in adults has been tested in children. The biggest obstacle in treatment, though, was persuading young people to change the way they live. Obesity greatly increases the chance that a person will become diabetic. Losing weight and exercising can cause the condition to disappear, in some cases.
“It takes generations to change lifestyle habits,” Dean said. “One can’t say, ‘I’m going to prescribe no pop and no chips’ and have the person change their diet tomorrow. It doesn’t happen that fast.”
