Type II diabetes mellitus (T2DM) , is when the body does NOT produce enough insulin at the right time in response to a rising blood sugar, and when insulin action is impaired. This results in elevated blood sugar levels.
Most people know this as adult-onset diabetes mellitus, a condition more commonly seen among overweight middle-aged individuals with a family history of T2DM. It is a lifestyle disease, a consequence of years of unhealthy habits like sedentary living, constant exposure to stress, and a diet of processed foods and refined carbohydrates.
Since the mid-1990s, the incidence of T2DM has been on the rise worldwide across ethnicities, paralleling the epidemic of pediatric obesity. T2DM now accounts for up to 45% of new cases of diabetes in the pediatric population according to Susana P. Campos, MD from the Section of Endocrinology, Department of Pediatrics of a top hospital in the Philippines, the Makati Medical Center (MakatiMed). “Other risk factors include having a family member with T2DM, clinical features of insulin resistance (hypertension, dyslipidemia, polycystic ovary syndrome, acanthosis nigricans) and maternal gestational diabetes.
Although there is a genetic susceptibility to the development of T2DM, the recent rapid increase in the prevalence of T2DM, cannot be due to increased gene frequency and altered gene pool, and Dr. Campos highlights the importance of environmental factors.
Type 1 diabetes mellitus on the other hand results from autoimmune destruction of the pancreatic beta cells and absolute insulin deficiency, necessitating the administration of insulin by subcutaneous injections at the time of diagnosis. Often enough, the distinction between T1DM and T2DM is difficult, especially in obese children and adolescents.
Dra. Campos further warns that Diabetes Mellitus is a difficult disease to live with as it requires modification of diet, monitoring of blood sugar levels, regular exercise, use of pharmacologic agents (insulin for T1DM and metformin, dipeptidyl peptidase inhibitors of glucagon like peptide 1 mimetics for T2DM), and constant reminders about long term complications of uncontrolled blood sugar. The chronic complications of diabetes mellitus include accelerated development of cardiovascular disease, end-stage renal disease, visual loss, nerve damage, slow wound healing, and dementia.
Sylvia Estrada, MD, Section Head of the MakatiMed Section of Pediatric Endocrinology raises the psycho-emotional and financial impact of Diabetes Mellitus on the patient and the entire family. “Some may feel they are a burden to their family or that it was their fault. Others may not like changes being made to their diet or being constantly asked about what they ate or if they took their medicines. And then there is the fear of needles and doctor visits. The expenses incurred can also be overwhelming to some families.
Both Drs. Campos and Estrada, emphasize that the PREVENTION of T2DM —should be the primary objective.
Avoid overweight and obesity in our children and adolescents. Here are four things you should know and can do to prevent or alter the course of a genetic susceptibility to T2DM
Eat healthy. Introduce more 5 daily servings of fruits and vegetables into your diet and avoid sugary-sweet drinks. Practice portion control. Shop for food and ingredients with your kids so they participate in picking the food they eat. Teach the adolescents how to read food labels so they can make healthy choices on their own.
Get active. Even if your child isn’t overweight, regular exercise helps the body utilize insulin better. It also controls blood pressure and lifts the spirits. Aim for 30 to 60 minutes daily, but don’t be regimented or strict—make it fun and be involved! Shoot hoops, walk or bike in the neighborhood, play tag or catch. Limit recreational screen time (cellphone, gadgets, laptops, etc.) to less than 2 hours per day.
Spot the symptoms. Remember four Ts,” Toilet (Does your child pee often? Do you see ants near the toilet?), Thirst (Is he or she always drinking, yet never satisfied?), Tired (Does he or she experience fatigue?), and Thinner (Have they lost a weight without trying?).”
Patches of thick, dark, and velvety skin found at your child’s nape or armpits, known as acanthosis nigricans, is a symptom of insulin resistance. Slow healing and easily infected wounds may result from high blood sugars
Manage diabetes together as a family. Adopt healthy eating habits for the entire family. Parents should be role models for their kids. If children see their mom and dad eating fruits and vegetables and actually enjoy it while avoiding chips, chocolates and soft drinks——they will follow their parents’ example
Be there for your child or teen as they meet the challenges of diabetes care. Make sure they feel your support and presence as they adjust to their medical condition. Reassure the family member with diabetes that they should not allow diabetes to control their lives; they should take charge and control their diabetes. There is solid research evidence that if their diabetes is well controlled, with lifestyle change, compliance with blood sugar monitoring, prescribed medications, the guidance of a medical expert, and the love and help of family, they can still live happy, healthy, normal lives.”
For more information, please contact MakatiMed On-Call at +632.88888 999, email mmc@makatimed.net.ph, or visit www.makatimed.net.ph.
