Type-2 diabetes complications strike young adults

The first long-term study of young adults who developed type 2 diabetes as children provides alarming evidence of the long-term health effects of childhood obesity. Many of these young people – members of the First Nation people in Northern Canada – now have the same debilitating or fatal complications that were once thought to strike only older diabetics: kidney failure and dialysis, miscarriages, and death. The findings in this population show that type 2 diabetes can have significant, long-term complications. The association’s vice president, noted that the risk of diabetes has been shifting to younger age groups. They anticipate and worry that the outcomes/findings will start to appear in other populations. Since 1986, her associates have collected data on First Nation youth diagnosed with type 2 diabetes before age 17. The First Nation people of this region are of the Algonquin language group and speak Cree, Oji-Cree, or Ojibwa. Of those, 18 percent of adults aged 20-79 years have type 2 diabetes, compared with five percent of the general population.

In late 2001, the researchers located 79 of 86 people who were originally diagnosed in the pediatric diabetes clinic; their current ages ranged from 18 to 33 years. A total of 44 women and seven men agreed to participate in the study; all were obese as children and were greater than 35 percent overweight at diagnosis, with a mean body mass index of 31. Of 30 patients who had a hemoglobin A1c value recorded during a medical assessment in the past year, 19 had a level exceeding 10 percent. Five had a level below seven percent, which is the target value. Also, 18 of the 51 subjects were prescribed insulin, and 25 were prescribed oral hypoglycemic agents. Of seven subjects who had died, two had sudden deaths on dialysis, two died from trauma, and three died from unrelated illness. The two deaths on dialysis were women aged 25-31 years.

One 26-year-old woman underwent amputation of a toe. Three women aged 26, 28 and 29 years had been on dialysis for two months, one year, and six years respectively, one of them also became blind at age 26. There were 56 pregnancies among patients, but only 35 live offspring. Of the pregnancy losses, 16 were in the first 20 weeks. There were two stillborns. Most of the fetal deaths were preceded by significant complications during pregnancy that often appeared related to poor diabetes control. First Nation people, African Americans and Hispanics are known to be more prone than other populations to diabetes, but it’s unclear exactly how many children have type 2 diabetes. Some US Clinics report that up to 40 percent of new cases of diabetes in children are type 2 disease. Ten years ago, people were concerned about obesity in children causing obesity in adults and disease in adult life. What’s changed is that obesity in children causes disease and complications in young adults.

Indeed, two out of every five children in the United States are overweight or obese, said by a professor of pediatrics at the University of Pittsburgh. You’re going to see much younger people starting to have complications in their most productive period of life – in their 20s or 30s vs when they’re 70 or 75. It’s going to be a major public health problem.