#FAIL: 1 of 3 New Type 2 Diabetes Cases are Children

That’s right…1 out of every 3 new diagnosis of type 2 diabetes are children.

Yes, type 2 diabetes (lifestyle causes) NOT type 1 diabetes, (an auto-immune disease).

Our children are being diagnosed with type 2 diabetes, a lifestyle disease, a preventable disease, caused largely by obesity, at alarming rates.

We are failing an entire generation of children.

We are failing as parents, as educators, as government officials, as clinicians and as a society.

And now the American Academy of Pediatricians is recommending that CHILDREN may now have to start insulin to prevent outcomes like nerve pain, damage to the eyes, kidney failure, amputation and death. 1 This is not hyperbole.  This is fact and its the result of our inability to effectively address the issue of childhood obesity.

According to Janine Sanchez, director at Pediatric Diabetes at the University of Miami, in a quote to the Wall Street Journal “Diabetes is an expensive disease, and complications are even more expensive. We definitely want to make sure that these kids are taken care of, because in the end we are all going to pay for that.”

In other words, we already lost the war, so lets figure out how to live with the results by aggressively medicating these kids.  Frankly, it’s not that different to how we are dealing with climate change.   Ignore the problem until its too late than mitigate the impact rather than solve the problem.  Don’t get me wrong, these children need to be medicated, BUT they shouldn’t have to be.

What do we do about it?

The list of policy and behavioral changes that are required are too enormous to address in a single blog post, but the first step in initiating a sustainable change is to develop communication strategies that speak to both the emotional and the rational side of the key stakeholders.  This requires a combination of humanizing and personalizing the problem plus helping people visualize the impact this will have on our kids and our country.

I have some thoughts on how we can get started.

Localize the effort.   Whether through churches, hair salons, scouting, schools, Facebook or our healthcare providers, we need to speak to people in their communities, in their circles of influence about the impact of poor lifestyle choices on their local community and their children.

Celebrate the successes.  What communities or programs are making an impact on childhood obesity?  We need to identify and celebrate those victories, share those victories with anyone who will listen and replicate what works.

Engage the Physician Community.  Physicians need to speak with their patients and their caregivers about child obesity.  These are tough conversations that are easier to avoid than engage in, but they are important.  But even engaging in conversations about childhood obesity can be difficult, as evidenced by a recent study at Wake Forest which found that 33% of medical students carried with them a bias towards the obese. 2 This is a problem. A paper being published on our website DiabeticLifestyle Pro, David P. Miller, Jr, MD, MS, Associate Professor, Department of Internal Medicine, Wake Forest School of Medicine, comments, “Any prejudice can affect care in a number of ways. Other studies have shown that bias influences doctors’ diagnoses and treatment decisions. Bias also damages trust in the patient-physician relationship. Patients are less likely to confide in a doctor who comes across as cold or judgmental.”  We need to educate physicians on these issues and ensure they are having compassionate but honest discussions with at-risk children and their parents.

Improve Health Literacy. All of these tactics are great, but they will ultimately fail if we don’t improve the health literacy of our nation.  Having recently attended Doctor 2.0 and You in Paris, I am encouraged by the explosion of entrepreneurial activity and academic research attacking the issue of health literacy.  Tools like Clear.MD are leveraging technology to create easy to use tools that help the physician better educate the patient outside of the office.  Vertical Health, of which I am CEO, just launched HealthTxts.com which uses text messages (SMS) to coach patients and their caregivers on managing their chronic disease.  Our programs in diabetes are designed to help people make better choices and adopt healthier behaviors.  We chose SMS so that we would have a solution capable of reaching virtually all adult Americans (>95%).  But we need more than technology based solutions, our schools need a curriculum that educates children of all ages about nutrition and maintaining a healthy lifestyle.

Let me say it again, one third of all new type 2 diabetes cases are children.  This is an epic failure of our society. This is a giant problem that will continue to increase the portion of our GDP that goes to medical care and worse subject a generation of children to chronic disease, diminished quality of life and reduce life expectancy.

 

 

  1. American Academy of Pediatrics http://pediatrics.aappublications.org/content/131/2/364.full
  2. Miller DP Jr, Spangler JG, Vitolins MZ, et al. Are medical students aware of their anti-obesity bias? Acad Med. 2013 May 22.
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