Diabetes rate ‘frightening’ to isles
The state's population mix is very vulnerable to an insulin-resistant form of the disease
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A national study has some disconcerting news for young Asians and Pacific Islanders who are at risk of getting Type 2 diabetes, often regarded as an adult disease that is preventable.
SEARCH for Diabetes in Youth reported in today's issue of the Journal of the American Medical Association that 15- to 19-year-old Asians and Pacific Islanders are much more likely to get Type 2 diabetes than Caucasians of the same age range.
Dr. Beatriz L. Rodriguez, a University of Hawaii John A. Burns School of Medicine professor and principal investigator for the study, said Type 2 diabetes is happening at younger ages because of increasing obesity.
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Type 2 diabetes -- linked to obesity, lack of physical activity and genetic history -- is four times more common among Asian-Pacific Islanders ages 15 to 19 than Caucasian youths the same age.
"Type 2 is traditionally considered a disease of adults, but with increasing rates of obesity, we're starting to see this happening at a younger and younger age," said Dr. Beatriz L. Rodriguez, a University of Hawaii John A. Burns School of Medicine professor.
"It is frightening, especially for population like ours, where the minority (Asian-Pacific Islander) population is at such high risk for developing Type 2 diabetes."
The higher incidence of Type 2 diabetes in Asian and Pacific Islander teenagers is among the findings of a national study, SEARCH for Diabetes in Youth, reported in today's issue of the Journal of the American Medical Association.
The paper is based on 2003-2004 data, said Rodriguez, principal investigator in Hawaii for the study. "Even with these data, we found that the rates are increasing both for Type 1 and Type 2 diabetes, compared with previous data," she said in an interview.
Researchers at the study's six clinical centers estimate about 15,000 children and adolescents in the United States are diagnosed annually with Type 1 diabetes and about 3,700 youths are diagnosed with Type 2 diabetes.
More cases of insulin-dependent Type 1 diabetes also are being reported than they were previously, Rodriguez said.
Type 1, formerly known as juvenile diabetes, is an autoimmune disorder requiring insulin injections for survival because the body's own immune cells destroy insulin-producing cells in the pancreas. Researchers believe it's caused by susceptible genes and an unknown "environmental trigger" or "triggers."
Insulin resistance occurs with Type 2 diabetes, known as adult onset or noninsulin dependent diabetes. Increased youth and adult cases are attributed to obesity, physical inactivity and a family history of diabetes.
"We can definitely prevent Type 2 by preventing obesity and promoting an active lifestyle in children and adolescents and by following a healthy diet," Rodriguez said.
Those habits should be established early with kids so they can develop skills at sports and other physical activities and enjoy them throughout their life, she emphasized.
The U.S. Centers for Disease Control and Prevention and National Institutes of Health began funding the national study in 2000 to increase understanding of diabetes in youth.
Researchers observed differences in the rates of new diabetes cases by race, ethnicity and age, said Beth Waitzfelder, PHRI investigator and co-author of the paper. They estimated overall that 25.5 new cases of youth diabetes occur annually per 100,000 population.
Type 1 diabetes generally was found in children under age 10, regardless of race or ethnicity, Rodriguez said. "As they become adolescents, we start seeing more and more of Type 2."
Asian-Pacific Islanders ages 15 to 19 had 22.7 new cases of Type 2 annually per 100,000 population compared to 5.6 cases for Caucasian youths, she said. "So Type 2 becomes four times more common in Asian-Pacific Islanders than white children."
The highest rates of Type 1 diabetes in all age groups were among non-Hispanic white youths, according to the report.
In 10- to 14-year-olds, non-Hispanic white youths had 32 new cases of diabetes per 100,000 population per year, compared with 8.3 for Asian-Pacific islanders.
About 450 Hawaii youths have been diagnosed with diabetes since the study began, with about 50 new cases per year, Rodriguez said. She is continuing to recruit cases for the study, funded for three more years.
It's important to continue monitoring the prevalence of diabetes to emphasize preventive efforts for Type 2, prevent complications from both forms of the disease and plan for medical needs, she said.
The researchers previously identified high cardiovascular risk factors for youths with diabetes, especially Asians and Pacific Islanders, Rodriguez said. "It is important for physicians to be aware of some of those risk factors and intervene as well."
Ann Albright, director of CDC's Division of Diabetes Translation, said in a news release that the study provided "a clear picture of diabetes burden" among all major racial and ethnic groups.
"These estimates are essential to ultimately design and implement public health efforts to prevent Type 1 diabetes, once prevention strategies are identified, and Type 2 diabetes, and to reduce the risk for both acute and chronic complications of diabetes in youth."
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Understanding and preventing diabetes
Type 2 diabetes, long regarded as a disease striking adults, is afflicting more young people.
Type 1, formerly known as juvenile diabetes, is an autoimmune disorder requiring insulin injections. Researchers believe it is caused by susceptible genes and an unknown "environmental trigger."
Type 2, often considered adult diabetes, is insulin resistant. Increased youth and adult cases are attributed to obesity, physical inactivity and a family history of diabetes.
A national study shows that Asian-Pacific Islanders ages 15 to 19 had 22.7 new cases of Type 2 annually per 100,000 population, compared to 5.6 cases for Caucasian youths.
Doctors say Type 2 diabetes is preventable by avoiding obesity, promoting an active lifestyle and following a healthy diet.
Source: SEARCH for Diabetes in Youth