Diabetes Simplified: Growing Up Too Quickly
Looking at juvenile type 2
By Wil Dubois
Some kids just can't wait to grow up. I was one of those. I didn't really like being a kid and couldn't wait to get on with life. But some things are better left until later in life—take type 2 diabetes, for instance.
Back in the day we had a form of diabetes called juvenile diabetes. We now call it type 1 because we recognize it's an autoimmune disease that, while often being diagnosed in juveniles, can actually hit at any age. I'm type 1 and it didn't hit me until age forty. The other kind of diabetes, now called type 2, is a disease of insulin resistance that was historically seen only in people in middle age and older. But as it turns out, type 2 is an equal opportunity scourge as well. Just in the last decade juvenile type 2 has not only been recognized and studied, but come to be feared.
Wait a second… who is "juvenile?"
In medicine, juvenile is an old-fashioned word for any person between infant and adult. Nowadays, we tend to use a three-age stratification for patients: Infant, children, and adolescents. Between birth and one year old you're an infant, childhood runs from one year to puberty, followed by adolescence right up to the day you can register to vote. Biologically, while adolescence starts at puberty, age 10 is often used as the default age to keep things simple.
But for today, let's just agree that we are talking about a type of diabetes that historically wasn't seen in the human population until age 40 that's now being seen in people under the age of 18.
Who's at risk?
Not too surprisingly, the risk factors for developing type 2 as a juvenile are similar to those for adults: Being overweight, having a family history of diabetes, and having a beautiful skin color (Hispanic/Latino, American Indian, Alaska native, African American, Asian American, or Pacific Islander). But listen up, you white kids, your pale skin doesn't give you a free pass, you could be at risk if you are heavy and have some people with diabetes hanging out in your family tree.
Oh and there's one other risk factor for type 2 in young people, and that's being female. Sorry, girls, I know, being a young female is tough enough in the first place without this on your plate, but that's the way it is.
How big is this new problem?
As always happens with diabetes statistics, our latest information is woefully out of date. In 2009, we were seeing a hair over 5,000 new cases per year of type 2 diabetes diagnosed in people under the age of 18 (while in the same year, nearly that many adults were diagnosed with type 2 diabetes every day). That also makes type 2 in young people a much smaller population than type 1, which strikes over 18,000 new kids a year; but the worrisome fact is that the young type 2 population has been dramatically expanding year by year.
Type 2 in kids is usually seen in the age ten and up crowd, but the youngest child yet to be diagnosed with juvenile Type 2 was a three-year-old Texas girl.
Screening and prevention
This new face of type 2 diabetes is serious enough, and now common enough, that the American Diabetes Association recommends screening for type 2 diabetes in all children over the age of ten who are overweight and have two more of the following risk factors: A family history of diabetes, one of the pretty skin colors we just mentioned, any signs of insulin resistance, or a mother who had gestational diabetes.
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As I mentioned in an earlier post, one of the benefits that made it cost-effective for me to go with the real healthcare (HSA) plan rather than the phony (HRA) plan is that my company is now covering "preventative" medicines at $0 copay. The formulary for these, as stated by CVS/Caremark (my pharmacy benefits provider), covers all test strips, lancets, and control solutions. I dutifully get my doctor to write up prescriptions for all of my testing needs, submit...