About Type 2 Diabetes
Years ago, type 2 diabetes mellitus was also known as adult-onset diabetes for one specific reason. Its association with obese and morbidly obese patients kept it a safe distance from the healthy, active youth. Those days are long gone in what has become a struggle to raise healthy, vivacious children. There are so many factors that weigh into the dilemma of childhood obesity, such as inactivity, overeating, psychological mechanisms, socioeconomic issues and genetics.
Type 2 diabetes is a disorder caused by the convergence of two biologic pathways; there are other less common forms, which will not be discussed here. The first is chronic high blood glucose levels (hyperglycemia) causing the secretion of more and more insulin to control postprandial glucose levels. As more and more insulin is secreted (hyperinsulinemia), the cells upon which they act begin to no longer respond to the large doses in a condition called desensitization. The second pathway is simply that the pancreas does not create enough insulin to normally control circulating glucose levels; this is called insufficiency. The two combine to form a condition called insulin resistance.
In order to answer the question, “How is type 2 diabetes linked to childhood obesity?” it is important to understand the risk factors of diabetes, but understanding obesity is just as important.
It is important to understand all of the problems associated with obesity, specifically that which occurs in children and adolescents. Firstly, a discussion of childhood obesity's causes must take place. The levels of activity in children have diminished greatly from those of 100 years ago. It is difficult to determine the exact causes of this, but computer/video games and other forms of indoor entertainment options are likely assailants; still other reasons could be to blame.
In developed and developing countries, the availability of food—especially processed, empty caloric food stuffs with high levels of fats, sugars, salt and little nutritional value—has ushered in an era of “prosperity” in which nobody should go hungry. Unfortunately, the socioeconomic repercussions of this is that these foods are usually cheaper than nutritious, calorically rich food. Therefore, the diet of poorer children tends to be an excellent predictor of obesity.
Obese patients of any age face a host of cardiovascular complications due to chronic high blood pressure (hypertension), increased circulating blood fats (hyperlipidemia) and fatty deposits within arteries (atherosclerosis). These complications can be compounded by the development of diabetes. Some form of cardiovascular diseases occurs, and ultimately kills, as much as 75 percent of patients who develop type 2 diabetes.
Now that we have a basic understanding of how diabetes works in the body, we must discuss the reasons they occur. As previously stated, a predominant risk factor is that of obesity. Obesity adversely effects all major organ system functions. Increased levels of adipose (fat) tissues, especially coupled with lower amounts of muscular activity, have shown direct correlations with hyperglycemia. Acutely, high levels of circulating blood glucose causes hyperinsulinemia, but as this becomes a chronic, habitual occurrence, desensitization of the cells within metabolic tissues manifests.
As desensitization becomes a regularly appearing condition, the β-cells of the pancreas, those responsible for development and secretion of insulin, begin to secrete less and less insulin over time. Eventually, they will produce little to no insulin. The dysfunction of these β-cells generally occurs before a patient is diagnosed with type 2 diabetes.
American Diabetes Association: Type 2
The Journal of Clinical Endocrinology & Metabolism: Type 2 Diabetes Mellitus: Update on Diagnosis, Pathophysiology, and Treatment
Mahler, Richard J and Michael L. Adler
Journal of Clinical Investigation: Genes and Pathophysiology of Type 2 Diabetes: More Than Just the Randle Cycle All Over Again
Schuldiner, Alan R. and John C. McLenithan
Copeland, Kenneth C., MD et al.
The Journal of the American Osteopathic Association: Type 2 Diabetes Mellitus in Childhood: Obesity and Insulin Resistance
Schwartz, Malcolm S., DO and Anila Chadha, MD
Centers for Disease Control and Prevention: Obesity and Overweight for Professionals
Diabetes Care: Type 2 Diabetes in Children and Adolescents
University of Maryland Medical Center: Diabetes-type 2- Risk Factors
Mayo Clinic: Childhood Obesity: Complications
U.S. Department of Health & Human Services Office of the Surgeon General: The Surgeon General's Call to Action to Prevent and Decrease Overweight and Obesity