14 november 2023
We see that there is currently a lot of attention in the media about the increase in type 2 diabetes in children. That is why we ask five questions to internist and specialist in this field Bas Schouwenberg.
1. What is diabetes?
Diabetes, or actually diabetes mellitus, means ‘honey-sweet flow’ and is also called diabetes. The blood sugar (glucose) in your blood is too high, causing you to feel thirsty and urinate a lot. This also causes you to pee out a lot of sugar. In addition, diabetes makes you tired.
Every person produces a hormone: insulin. Your body uses insulin to control your blood sugar. This keeps your blood sugar at the right level to continue functioning properly. If you have diabetes, your own insulin cannot sufficiently control your blood sugar. This means you have too much blood sugar in your blood and not enough in your cells. That (blood) glucose is an important fuel for many cells in your body. A shortage of insulin ensures that glucose cannot reach all cells, while there is too much glucose in your blood.
2. What is the difference between type 1 and type 2 diabetes?
There are several forms of diabetes, but the best known are type 1 and type 2 diabetes.
In type 1 diabetes, something goes wrong with the so-called beta cells in your pancreas that produce insulin. Due to an inflammatory reaction of your defense against your own beta cells (autoimmune reaction), they no longer produce insulin and without insulin your cells do not get fuel. You start to acidify and become seriously ill. This often occurs at a young age (children, young adults) but can occur at any age. Hereditary predisposition plays a role, but it is not a hereditary disease.
We used to call type 2 diabetes adult-onset diabetes, but nowadays it also occurs at a young age and even in childhood. The cause is usually excess weight and too little exercise, which means your body needs too much insulin. Your body becomes less sensitive to insulin due to excess weight and less exercise, we call this insulin resistance.) If your pancreas cannot supply enough insulin and your body actually needs more, you develop diabetes. This used to mainly occur in the elderly, because the pancreas has less reserve capacity, but due to the increase in obesity in the Western world, we are increasingly seeing this at a younger age, even in children. Because your pancreas still produces insulin, but not enough, you don’t get very ill initially. Hereditary predisposition does play a major role and we see type 2 diabetes occurring more often in, for example, people of Surinamese-Hindustani, Turkish and Moroccan descent.
3. Why are we now seeing more type 2 diabetes in children?
In addition to a hereditary predisposition, obesity is the main cause of type 2 diabetes. Because people’s weight has increased, especially in the Western world, the number of people with type 2 diabetes has also increased and we are seeing it at an increasingly younger age. The United States is leading the way in this, but we are now also seeing more and more children with type 2 diabetes in the Netherlands.
4. Why can diabetes be dangerous?
Type 1 diabetes is fatal without treatment. Your body cannot survive for long without insulin, you will burn fats with waste products (ketonic acids) as a byproduct, which makes your body very acidic. This quickly leads to a diabetic coma. But even with treatment, diabetes can cause long-term problems with the heart, blood vessels, kidneys, eyes and nerve pathways. With type 2 diabetes, you do not initially suffer much, but the risk of cardiovascular disease is increased, because there are often other risk factors, such as obesity, less exercise, unfavorable cholesterol and high blood pressure. . Children and young people who develop type 2 diabetes early on are therefore at a very high risk of developing complications later in life.
5. Can you treat diabetes?
Type 1 diabetes must be treated with insulin. Unfortunately, insulin cannot be taken by mouth as a pill and must be injected under the skin with a pen or pump. A patient with type 1 diabetes must, as it were, take over his own pancreatic function and administer insulin to himself with everything he/she eats. With all the modern tools we have, type 1 diabetes can be easily treated, but it is not easy and it demands a lot from a young patient and his/her parents.
In type 2 diabetes, there is no absolute insulin deficiency and lifestyle modification is the main treatment. However, this is not easy, especially if you are not really bothered by your blood sugar. We can also give medications that improve glucose regulation in the body. In recent years we have also been using products that also help you lose weight. Unfortunately, we do not yet know whether all new products for adults are suitable for children. In addition, the new products are often difficult to supply, because they are now extremely popular and are bought by people who only want to lose weight.
Diabetes treatment in the region
Diabetes in children and young adults under the age of 18 is treated in our region at: Villaa collaboration between the Rijnstate hospital, the CWZ and the Radboud university medical center and in the Children’s Diabetes Center Nijmegen.
If you want to follow Bas Schouwenberg on social media, check out his professional account on Instagram and LinkedIn.
2023-11-14 17:41:42
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