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July 25, 2006 -- Children and teens who develop type 2 diabetesdiabetes may face a higher risk of life-threatening kidney diseasekidney disease and early death than people diagnosed as adults.
Those are the findings from a study of a very high-risk Native American population, published in the July 26 issue of The Journal of the American Medical Association.
The researchers found that adults with diabetes who were diagnosed before age 20 (early onset) were nearly five times as likely to develop end-stage kidney disease as those diagnosed in their 20s and beyond.
The early-onset group was also twice as likely to die of health-related causes in early adulthood or middle age as diabetes patients with adult-onset disease; they were three times as likely to die of such causes as those without diabetes from the same population.
Worldwide Rise
Study researcher Robert G. Nelson, MD, tells WebMD there has been a sixfold increase in diabetes rates among children and young teens living in the southwestern Native American community in the past four decades.
During this period, the population has had one of the highest obesityobesity rates in the nation. As a result, it was among the first communities in the U.S. to see large numbers of type 2 diabetes cases in children and teens.
This study is one of the first to examine the long-term outcomes among people who develop type 2 diabetes before reaching adulthood.
"This is a growing problem around the world," Nelson says. "I have seen 25-year-olds with diabetes on dialysis machines in the Western Pacific. We used to call [type 2 diabetes] adult-onset diabetes, but we don't anymore, for obvious reasons."
Numbers Aren't Known
It is not clear how many children and teens in the U.S. have type 2 diabetes. But pediatric endocrinologist Larry Deeb, MD, says it is obvious the numbers are skyrocketing.
A recently published national study found that the number of type 2 diabetes drug prescriptions written for children doubled between 2002 and 2005.
Another recent study predicts nearly half of all children in North and South America will be overweight by 2010, a jump from about a third today. As obesity increases, so will type 2 diabetes, Deeb says.
"I would certainly call childhood obesity and type 2 diabetes in children an epidemic," he tells WebMD.
Early-onset type 2 diabetes led to "substantially increased complication rates and mortality in middle age," Nelson and colleagues write in their study.
"Anyone who thinks early diabetes is no big deal or that young age is protective against the ravages of this disease needs to get over it," says Deeb, who is president-elect for medicine and science of the American Diabetes Association.
SOURCES: Pavkov, M.E. The Journal of the American Medical Association, July 26, 2006; vol 296: pp 421-426. Robert G. Nelson, MD, PhD, Diabetes and Arthritis Epidemiology Section, Phoenix Epidemiology and Clinical Research Branch, National Institute of Diabetes and Digestive and Kidney Diseases, Phoenix. Larry Deeb, MD, pediatric endocrinologist, Tallahassee, Fla.; spokesperson, American Diabetes Association. Express Scripts, "National Study Reveals Doubling in Type 2 Diabetes Prescriptions Among Children." Associated Press, "Study: Child Obesity Expected to Soar Worldwide," March 7, 2006.