This is diabetes awareness month - Is type 1 in US and European children also increasing?
Nov. 8 - Will anyone be trained to manage your child's diabetes during school hours? See the Parade Magazine's November 8, 2009 article, "A Troubling Trend in Diabetes," by Dr. Ranit Mishori. The article reports that the incidence of new cases of type 1 diabetes (juvenile diabetes) in those under age 5, is expected to double by 2020, according to the authors of the new new study published in The Lancet, a British medical journal.
The recent British study reported that the trend is predicted to become within ten years a doubling of cases of type 1 diabetes in children. Various articles report the situation is similar in the USA.
What's the Economic Cost of Diabetes?
According to the CDC's, website on Diabetes Statistics and Research, the estimated "economic cost of diabetes in 2007 was $174 billion. Of this amount, $116 billion was due to direct medical costs and $58 billion due to indirect costs such as lost workdays, restricted activity, and disability due to diabetes."
The CDC also reported that, "People with diagnosed diabetes incur average expenditures of $11,744 per year, of which $6,649 is attributed to diabetes. People with diagnosed diabetes, on average, have medical expenditures that are approximately 2.3 times higher than what expenditures would be in the absence of diabetes. Approximately $1 of $5 health care dollars in the United States is spent caring for someone with diagnosed diabetes, while approximately $1 of $10 health care dollars is attributed to diabetes."
Right now the current statistics on diabetes are the following, according to the Centers for Disease Control and Prevention (CDC). However, the CDC's statistics do not specify which type of diabetes has been polled, type 1 or type 2, or whether the statistics combined both forms, nor does the CDC predict the trends of diabetes in the next ten years. What the CDC reports on the frequently answered questions site, are the following statistics:
Among Americans aged 20 years or younger, less than one-quarter of 1% (about 186,300 people) have diabetes.
Among Americans aged 20 years or older, 10.7% (23.5 million people) have diabetes.
The prevalence of diabetes is greater among older people. Among Americans aged 60 years or older, 23.1% (12.2 million people) have diabetes.
For more statistics, see CDC's National Diabetes Fact Sheet 2007 National Estimates on Diabetes from the Centers for Disease Control and Prevention (CDC).
Type 1 diabetes is an inflammatory, autoimmune disease, thought to be environmentally caused. See the video, True Life Story: Type 1 Diabetes. Why is the incidence of it increasing so rapidly? The person in the video explains how type 1 diabetes developed in young adulthood after her third pregnancy. She thought it was gestational diabetes, that usually disappears after pregnancy is over, but in this case, it didn't go away.
See: American Diabetes Month - American Diabetes Association. What you can do, according to the American Diabetes Association is to inspire others to join the movement by sharing your personal story. Visit stopdiabetes.com and join us on Facebook and Twitter to learn about all the exciting ways to be a part of the Stop Diabetes movement. Invite your family, friends, and co-workers to join this effort as well.
See the article based on the study, published in The Lancet, June 13, 2009. Vol. 373 No. 9680 pp 2027-2033, "Incidence trends for childhood type 1 diabetes in Europe during 1989-2003 and predicted new cases, 2005-2020: a multicentre prospective registration study."
The study concluded that, "if present trends continue, doubling of new cases of type 1 diabetes in European children younger than 5 years is predicted between 2005 and 2020, and prevalent cases younger than 15 years will rise by 70%."
The study also reported that, "adequate health-care resources to meet these children's needs should be made available." What in the environment is causing the type of diabetes that children will never grow out of, unless there's a cure waiting in the future?
The incidence of type 1 diabetes is going to double from levels of four years ago in a little more than a decade, if present trends continue, according to that recent study published in The Lancet. See: data from the EURODIAB study published online in the Lancet. But what is the validated evidence for the trend predictions?
What evidence is there that the same trend is occurring in the USA? See the study published Sept 3, 2009 in PLoS One, 4(9):e6873, "Increasing incidence of pediatric type 1 diabetes mellitus in Southeastern Wisconsin: relationship with body weight at diagnosis." The conclusion of the USA study reported, "annual incidence of T1DM increased two-fold at CHW over the 10-year study period.
The majority of the increase was observed in the youngest age groups, which also appeared to be the heaviest. This research adds to the growing literature supporting the hypothesis that excess weight gain during childhood may be a risk factor for early manifestation of type 1 diabetes (T1DM).
Also see "Explosive increase in type 1 diabetes predicted," published May 27, 2009 in Cardiobrief. The article, "Diabetes Increasing More Rapidly In UK Than In USA - Wellsphere," is of interest because it reports that the study published in the UK's "A Journal of Epidemiology and Community Health," suggests a 74% increase in Type 2 diabetes in the UK. But what about type 1 diabetes in children in the USA? See, "As America Earns Failing Grade, American Diabetes Association Launches Movement to Stop Diabetes," published in Medical News Today, Nov. 5, 2009,
Start by Ending the Myths
The article published on Nov. 5, 2009 in Medical News Today reports, "Americans earn a failing grade on diabetes awareness." The article is based on survey results released Nov. 5, 2009 by the American Diabetes Association.
Why American responses failed is a question that can be answered by remedial education about what really causes diabetes in children or adults. In general, according to that article, "Americans earned a 51% when asked a series of questions about a disease so common that it strikes every 20 seconds."
The solution to the problem is to address the myths about diabetes. It's the old folkloric tales and misinformation that keeps circulating. But maybe the cure is in folkloric medicine, if proved safe by science, for type 2 diabetes reversals.
Type 1 diabetes in children is there forever, unless science comes up with a treatment for a pancreas that stops making insulin. Time won't help while diabetes in children, the life-long type 1 variety is on the rise in the USA as well as in Europe.
November is American Diabetes Month®. What the American Diabetes Association is doing, is starting a promotional campaign, actually, a new movement that's called: Stop Diabetes(SM). Americans are encouraged to join the movement to Stop Diabetes and put an end to diabetes' physical, emotional and economic toll on the U.S. See the American Diabetes Month Fact Sheet (PDF)
How does the average parent put an end to diabetes? Is it in the environment or at the table? Or could it be a medical routine, exercise, or the chemicals in household items?
What can the average consumer do? For a beginning, start with education about what diabetes is, both types of diabetes, and how children get it, in the various ways from genetics to environment. You start by ending the myths. Look at the myths debunked in the article, "As America Earns Failing Grade, American Diabetes Association Launches Movement To Stop Diabetes." It's in Medical News Today, Nov. 5, 2009.
Diabetes isn't caused by eating sugar. Type 1 diabetes is caused by genetics and unknown factors that trigger the onset of the disease. Type 2 diabetes is caused by genetics and lifestyle factors. The goal for science is to find the unknown factors that are said to be environmental by scientists, but so far, no one is pointing a finger to exactly what in the environment causes the genetic predisposition for diabetes type 1 to develop in children or adults under age 40.
Could it be a virus? Could it be the stress of a particular pregancy? If you ask two different adults what caused their type 1 diabetes, one will say, having polio as a child and ten years later having a baby at age 19. Another will say, it developed after a third pregnancy. The scenario might be different in each case.
One parent of a 7-year old girl with type 1 diabetes reports that the diabetes started in her child after a bitter divorce and custody battle. The mother went back to nursing school, the father beat up the mother in front of the child, and the diabetes developed soon after that. (The mother remarried within 2 years). But what seemed to cause the diabetes---the stress, the environment, or a lowered immunity from depression?
These are some of the problems researchers have to consider when trying to find out what in the environment contributed to the genetic predisposition for type 1 diabetes --the stress of pregnancy or fighting the polio virus in childhood in the early 1950s in the case of the woman getting type 1 diabetes at age 19 or 20 with her second pregnancy? The cause still is unknown. The goal right now is to involve the public in education about diabetes.
Being overweight does increase your risk for developing type 2 diabetes. Eating too many calories or large portion sizes from sugar and fat, can contribute to weight gain. If you have a history of diabetes in your family, eating a healthy meal plan and regular exercise are recommended to manage your weight, according to
According to another recent article published in USA Today magazine, "More kids have diabetes, fewer schools have nurses," many schools are falling short of the full-time school nurse. As the number of full-time school nurses decline, the number of children being diagnosed with both type 1 and type 2 diabetes are increasing.
Can schools successfully adapt to the needs of these kids, which the federal Americans with Disabilities Act requires they do? Most schools are adapting, but some schools are feeling pressured and not prepared, or are falling short. See the American Diabetes Association (ADA).
The incidence of among very young children will double from 2005 levels in a little over a decade if present trends continue, a new study shows. Just when you were worried about the causes of type 2 diabetes in children due to nutrition and environment, scientists find that type 1 diabetes also in increasing in children, but why? See the WebMD article, "Type 1 Diabetes May Double in Young Kids."
Environmental influences are driving the trend. The recent British medical journal, The Lancet looked at new cases of type 1 diabetes in European children, which is increasing at about 4% annually, with higher rates of increase for chidren under age 4. The type 1 diabetes rates for girls are higher than for boys.
The problem is that by 2020, scientists predict that the rates of type 1 diabetes in children will double. And the trend is similar for the USA. Why is the rate of type 1 diabetes in children increasing faster now than just a few years ago?
All evidence points to environmental causes. Which changes or environmental triggers are causing the increase? And can researchers separate causes of type 2 diabetes from type 1 in children? Juvenile diabetes, called type 1 results when the body makes little or no insulin. Children have to take insulin life-long, manage their blood sugars, and test their blood glucose levels frequently throughout the day, at school or anywhere else. Type 2 diabetes in children is usually the result of a diet and weight problem combined with lack of exercise, and stress or genetic predisposition to type 2 diabetes exacerbated by a type of nutrition.
For more information, check out the site for SEARCH for Diabetes in Youth Study, which is following children with type 1 and type 2 diabetes in different areas in the U.S. in an effort to better understand diabetes trends in non-adults.
SEARCH is a multi-center study funded by the CDC (Center for Disease Control and Prevention) and NIDDK (National Institute of Diabetes and Digestive and Kidney Diseases). The study focuses on children and youth in the U.S. who have diabetes, according to its webiste.
It is expected that the six clinical centers located in California, Colorado, Hawaii, Ohio, South Carolina, and Washington will invite approximately 9000 children and youth who have been diagnosed with diabetes to participate in this study. Data from these children and youth will provide more information and help us better understand diabetes.
According to its website, the study goals are to (1) identify the number of children and youth under age 20 who have diabetes, (2) study how type 1 diabetes and type 2 diabetes differ, including how they differ by age and race/ethnicity, (3) learn more about the complications of diabetes in children and youth, (4) investigate the different types of care and medical treatment that these children and youth receive, and (5) learn more about how diabetes affects the everyday lives of children and youth who have diabetes.
The SEARCH study will provide valuable information to researchers and health care providers in an attempt to find ways to treat and increase knowledge about diabetes in children and youth. See the SEARCH article in PDF format, "Who Has Diabetes?" Can a school nurse handle any medical problem that arises during school hours? According to 2007 National Center for Education Statistics, 30% of schools have a part-time nurse, and 25% have no nurse.
What's type 2 diabetes in children about? Those with fatty liver and higher triglycerides are more likely to be resistant to the action of their own insulin. This means that their bodies don't regulate blood sugar properly, which can lead to type 2 diabetes. See: Arterial damage found in teens and young adults with obesity or type 2 diabetes.
Over time, high sugar levels damage large and small blood vessels, leading to heart disease, stroke, nerve damage, amputations, blindness and kidney disease. See the article, "Fat liver, not belly, may be the best indicator of health problems."
In contrast type 1 diabetes, called insulin dependent diabetes mellitus (type 1) diabetes starts in childhood or young adulthood, is sometimes called juvenile diabetes, and is an inflammatory autoimmune disease of the pancreas, resulting in a lack of insulin. See Johns Hopkins Medical Institutions Autoimmune Disease Research Center. People under the age of 40 usually are diagnosed with type 1 diabetes, although children and people under 40 can also have type 2 diabetes, but not both together.
Type 2 diabetes can be helped by a first line approach of nutrition change and exercise or weight loss if the person is obese. Type 1 diabetes can occur in those who are not necessarily obese because it has that autoimmune, inflammation-related origin. Also helpful is the book, How Nutrigenomics Fights Childhood Type 2 Diabetes & Weight Issues (2009).
With Type 1 diabetes, the disease often starts in childhood and affects more Caucasians than African-Americans. The male-to-female ratio is 1:1. The big question for scientists is why is type 1 diabetes predicted to double in children over the next decade? And what's the environmental causes of it--prenatally or in early childhood? At what stage in life between infancy and age 40 will type 1 diabetes most often begin?
Facts About Diabetes
• Nearly 24 million Americans have diabetes.
• Of those, the number diagnosed: about 18 million.
• Diagnosed with type 1 diabetes: 5% to 10%.
• People with pre-diabetes: about 56 million.
• The cost of diabetes: $174 billion a year.
• Diabetes is a group of serious diseases characterized by high blood glucose levels that result from defects in the body's ability to make or use insulin.
• A leading cause of death in the USA, diabetes can lead to debilitating or fatal complications, including heart disease, stroke, blindness and kidney disease.
• More than 65% of people with diabetes die from heart disease or stroke.
• Diabetes can cause heart attacks earlier in life.
Source: American Diabetes Association and Centers for Disease Control and Prevention
Template newsletter (doc)
American Diabetes Fact Sheet (Spanish, PDF)
Template newsletter (Spanish, doc)
These publications were sources for the CDC's frequently answered questions website.
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