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More than one-third of American children and adolescents are overweight or obese, putting them at risk for a host of health issues, including metabolic disorders and cardiovascular disease. Many of those diseases may not manifest until adulthood, but increasingly physicians are seeing one disease in individuals under age 20—Type 2 diabetes mellitus.

Type 2 diabetes used to be rare in young adults, let alone children. In recent years, however, the burgeoning number of children and adolescents with the disorder has risen to alarming proportions. In 2012, approximately 208,000 teens and young children had Type 2 diabetes. Even more were prediabetic or at high risk of developing diabetes based on blood glucose levels.1

Children in certain ethnic or racial groups have particularly high risk of developing diabetes if they are overweight. These include African Americans, American Indians, Hispanic/Latino Americans, and some Asian and Pacific Islander Americans.

In Type 2 diabetes, the pancreas continues to produce insulin, but cells become more resistant to it. The disease is strongly associated with excess weight and lack of physical activity. More than 80% of Type 2 diabetics under the age of 20 are overweight and 40% meet the criteria for obesity.

The good news is that Type 2 diabetes and prediabetes can be reversed or their complications minimized in many cases by losing weight and increasing physical exercise. Losing just 7% of body weight can make a significant difference in the long-term risk associated with diabetes.

The CDC recommends that children with diabetes follow a healthy meal plan developed by a registered dietitian, diabetes educator or physician. The meal plan should balance the nutritional needs of a growing body with calorie consumption that reduces or prevents obesity and keeps blood glucose levels in the desired range.

A healthy meal plan does not mean a crash diet or deprivation. Successful weight loss and healthy weight maintenance requires changing eating patterns for life. To do that, teens need to develop an understanding of why, when and how they choose certain foods. Do they open a bag of potato chips when they come home from school? If they are told, for instance, to eat grapes instead, they may do it for a while, but if stressed — an exam is coming up, they had a fight with a parent — they will reach for that bag of chips again in many cases. To keep choosing the grapes or other healthy habits, they first need to understand and recognize the habitual patterns they engage in (like reaching for potato chips when stressed). They need to get mindful about what they are doing and why and how those choices will affect them in the short and long term. They also need to make sure they have less energy dense, more nutritionally balanced options on hand.

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