Type 2 diabetes Teens Have Higher Complication Risk Then Type 1’s

Young people with type 2 diabetes are more likely to have high blood pressure and signs of kidney damage than their counterpart who have type 1 diabetes, even though type 2 diabetic have had the disease for a much shorter time. The findings underscore the importance of screening children for complications when they are diagnosed with type 2 diabetes. They also suggest that it may make sense to look for these complications in children who are simply at risk of the disease, "because early treatment may reverse complications," Dr. Maria Craig of The Children’s Hospital at Westmead, Sydney, and her colleagues in Australia report.

In type 1 diabetes, also called early-onset diabetes or juvenile diabetes, the immune system destroys the cells that produce insulin. Type 2 diabetes develops when the body loses its ability to respond to insulin, and is associated with being overweight and inactive. Formerly seen almost exclusively in adults, type 2 diabetes is becoming increasingly common in children.

Craig’s group investigated the prevalence of diabetes-related complications among young people with both types of the disease. They looked at 1,433 patients with type 1 diabetes and 68 with type 2 diabetes, all under 18.

On average, type 1 patients had been diabetic for 6.8 years, compared with 1.3 years for type 2 diabetes. Type 2 diabetics had their blood sugar under better control, on average, than the type 1 patients.

However, microalbuminuria – a protein that signals kidney damage when found in the urine — was detected in 28 percent of the type 2 diabetes patients compared with 6 percent of those with type 1. Thirty-six percent of type 2 diabetes patients had high blood pressure, compared with 16 percent of type 1 diabetes patients.

The only complication that was significantly more common in the type 1 patients was retinopathy, a progressive damage to the small blood vessels inside the retina that can cause blindness, which was diagnosed in 20 percent compared with 4 percent of the type 2 group.
Diabetes Care, June 6, 2006.

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DID YOU KNOW:
Children with diabetes and the metabolic syndrome have a honeymoon period associated with obesity early in life: The progressive autoimmune destruction of insulin-secreting cells of the pancreas begins years before the clinical manifestations of type 1 diabetes become apparent. The natural course of the disease is often characterized by transient restoration of the beta-cell function following the initiation of insulin therapy. This period is often referred to as the “honeymoon period”. This period was the focus of a study showing that partial remission is a common event and that young age and severe disease at presentation are associated with decreased residual beta-cell function, which, in turn, is reflected by a lower incidence of partial remission.. In a study on obese children, approximately one quarter of children had the metabolic syndrome. As expected, the metabolic syndrome was associated with several non-traditional risk factors for cardiovascular disease, supporting the view that chronic subclinical inflammation may be part of the metabolic syndrome. This finding adds further significance to strategies aimed at preventing weight gain and insulin resistance early in life. International Journal of Obesity (London),30 (627-633)