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Diabetes and Kids Type 1, Type 2, Gestational...


The world of diabetes can get complicated. In honor of Diabetes Awareness Month, let's look at the facts.

We've all seen the headlines: "Kids' Poor Diets and Lack of Exercise Can Lead to Type 2 Diabetes." And we've heard conflicting terms: "adult-onset diabetes," "juvenile diabetes," "type 1," "type 2." Today's parents grew up in an era when we never heard of a child getting type 2 diabetes. No wonder these headlines are so bewildering!

According to the U.S. Centers for Disease Control (CDC), in 2007 (the most recent data available), about 186,300 children and teens in the U.S. had diabetes (type 1 or type 2). However, many kids have undiagnosed diabetes as well, according to the CDC.

Confused? Here's help.

TYPE 1 DIABETES

This type of diabetes is usually diagnosed in children and young adults. It was previously known as juvenile diabetes. In type 1 diabetes, the body does not produce insulin, a hormone needed to convert sugar (glucose), starches and other food into energy.

According to the Juvenile Diabetes Research Foundation, symptoms may occur suddenly and include one or more of the following:

° extreme thirst

° frequent urination

° drowsiness, lethargy

° sugar in urine

° sudden vision changes

° increased appetite

° sudden weight loss

° fruity, sweet or wine-like odor on breath

° heavy, labored breathing

° stupor, unconsciousness

Treatment for type 1 diabetes involves checking blood-glucose levels with a tiny bit of blood from a skin prick and then administering insulin or other medications via injections or an insulin pump.

TYPE 2 DIABETES

Type 2 diabetes is a bit more complicated to diagnose. With type 2, either the body does not produce enough insulin or the cells ignore the insulin. Type 2 diabetes is more common in African Americans, Latinos, Native Americans, and Asian Americans/Pacific Islanders, as well as the older population in general. But, it is on the rise in children, teens, and young adults.

Experts believe that the increasing amount of obesity and the low level of physical activity among many young people, as well as exposure to diabetes in the womb (when the mother has gestational diabetes), may be major contributors to the increase in type 2 diabetes during childhood and adolescence.

Children and teens diagnosed with type 2 diabetes are generally between 10 and 19 years old, obese, have a strong family history for type 2 diabetes, and have insulin resistance.

It's hard to detect type 2 diabetes in children because:

° It can go undiagnosed for a long time,

° Children may have no symptoms or mild symptoms, and

° Blood tests are needed for diagnosis.

Type 2 diabetes symptoms may develop slowly. In fact, you can have type 2 diabetes for years and not even know it, according to the Mayo Clinic. Look for:

° increased thirst and frequent urination

° increased hunger

° weight loss

° fatigue

° blurred vision

° slow-healing sores or frequent infections

° areas of darkened skin

According to the American Diabetes Association, the first treatment for type 2 diabetes is often meal planning for blood-sugar control, weight loss and exercising. Sometimes these measures are not enough to bring blood sugar down near the normal range. The next step is taking a medicine that lowers blood-glucose levels.

A DIFFICULT DIAGNOSIS

In people with type 1 diabetes, things are pretty clear cut: the pancreas no longer makes insulin, and the person needs insulin shots to use glucose from meals. People with type 2 diabetes, however, make insulin, but their bodies don't respond well to it. Some people with type 2 diabetes need to take insulin to help their bodies use glucose for energy. As with type 1, checking blood-glucose levels with a monitor is important.

"Type 2 diabetes is extremely complex," says Memphis, Tenn. pediatric endocrinologist A. Jay Cohen, M.D., session moderator at a recent meeting of the American Association of Clinical Endocrinologists. "The rapid rise in obesity, physical inactivity, and the consumption of excessive calories seems to have led to the epidemic of children with type 2 diabetes."

The National Institute of Health is conducting two clinical trials to identify the children at risk for type 2 diabetes and to demonstrate the effectiveness of lifestyle intervention among youth. The first trial is following a group of about 6,400 children from sixth through eighth grade to determine if modifications in exercise programs and nutrition at school can reduce their risk. Researchers are tracking the youths' body mass indices (BMIs), fasting-glucose levels and fasting insulin levels to show the health benefits of lifestyle adjustments. The second trial is exploring the best treatment options for children with type 2 diabetes.

INSPIRATION FOR KIDS

While parents listen to doctors and try to find the right care for their kids with diabetes, kids of a certain age may be most influenced by 16-year-old Nick Jonas of the Jonas Brothers, who was diagnosed with type 1 diabetes nearly four years ago.

Jonas says when he was diagnosed with type 1, he didn't know anything about it and had never met anybody with diabetes. That's all changed now. Young people with diabetes are among his most passionate fans, and he has even written a song, "A Little Bit Longer," to share his experience with the disease.

"So many fans with diabetes, from all over the world, share their stories and thank me for being an inspiration to them," Jonas said in a recent statement. "It's important for them to know that they motivate and inspire me as well." He has also created the "Nick Jonas' Dog Tag Program" (kids skip the medical-ID bracelet in favor of the dog tags). The program has raised $75,000 for the Jonas Brothers' Change for Children Foundation to fight diabetes. To learn more, visit www.nickssimplewins.com and click on "Nick's Dog Tags."

For more information on diabetes visit:

° Juvenile Diabetes Research Foundation: www.jdrf.org

° American Diabetes Association: www.diabetes.org

Sources: American Diabetes Association, the National Institute of Health's National Diabetes Information Clearinghouse, U.S. Centers for Disease Control, Juvenile Diabetes Research Foundation, Jonas Brothers' Change for Children Foundation

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