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The number of children worldwide diagnosed with type 2 diabetes is increasing dramatically as a direct consequence of soaring obesity rates among children. In Canada, increased rates of childhood obesity are no exception.
While the main causes of childhood obesity are too much unhealthy food and too little exercise, broader factors such as cultural background, income level and where kids live can also play a role.
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Type 1, type 2—what's the difference?
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Diabetes interferes with the body's ability to produce or properly use insulin, a hormone produced by the pancreas that processes glucose, a sugar the body requires for energy.
Type 1 diabetes: The body makes little or no insulin, and daily insulin injections are required. There is no known cause for this type of diabetes and is not preventable. It is usually diagnosed in people under 30 and represents about 10 percent of diabetes cases.
Type 2 diabetes: The body does not make enough insulin or cannot use it properly. Type 2 diabetes accounts for 90 percent of cases and it can sometimes be controlled by diet and exercise, although oral medication and/or insulin is often needed. Type 2 diabetes is diagnosed mostly in people 40 years or older.
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Why we all should be alarmed
Type 2 diabetes was traditionally referred to as adult-onset diabetes because, until recently, the condition was virtually unknown among children. Now, alarm bells are sounding around the world over its dramatic rise.
According to the Public Health Agency of Canada, "diabetes potentially affects the metabolism of every cell in the body and adversely affects the body's blood supply. Over a period of months or years, it can lead to a wide range of life-threatening and disabling complications."
The good news is that type 2 diabetes is a highly preventable disease.
Many kids today could develop type 2 diabetes
Rising rates of obesity in Canadian kids and widespread inactivity puts all children at risk for developing chronic diseases such as type 2 diabetes.
Dr. Ally Prebtani, an endocrinologist at McMaster University Medical Centre in Hamilton, Ontario, and father of a three-year-old daughter, tries to be a good role model because he worries about the rising number of kids with type 2 diabetes.
"What are kids doing today?" asks Dr. Prebtani. "They play with their cell phones, sit at the computer, watch TV and eat too much junk food. The fact is we have a nation of sedentary children."
Dr. Prebtani worries that he himself may be susceptible to the disease because it's in his family history. "My 65 year old father has type 2 diabetes. I have to try to set a good example for my daughter—we go to the park, camp and hike together. I have to make sure I stick around for her sake."
Dr. Prebtani hopes that more and more parents will get moving with their kids and encourage healthy eating, knowing that for some Canadian children and their families, these lifestyle changes will be easier than for others.
Children in some cultural groups at higher risk
Canada's Aboriginal Peoples |
Type 2 diabetes rates are three to five times higher in Canada's Aboriginal communities than in the general population. In Aboriginal children in North America and Australia, the prevalence rate of type 2 diabetes ranges from 1.3 to 5.3%.
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Reducing risk factors—one Aboriginal family's experience
Mike Delisle, Grand Chief of the Mohawk Council of Kahnawake near Montreal, is well aware of the fact that First Nations people are more at risk for type 2 diabetes. But he was still shocked when his 16 year old son Jacob was diagnosed with the disease after an emergency stay in hospital a year ago.
Jacob's blood sugar had plummeted, he was suffering from extreme thirst and was very lethargic. Jacob was put on four daily doses of insulin. "It was devastating to see a young boy this sick," says Mike. "I still get tears in my eyes just thinking about it."
In addition to his Aboriginal heritage, there were other warning signs that Jacob could be at risk for type 2 diabetes. He has several close family members—including his mother—with diabetes, he was overweight and he didn't exercise much.
The diagnosis spurred Jacob to make some major lifestyle changes. He eliminated pop from his diet, reduced his meal portions and ate more salads. Jacob also became more active, took up lacrosse, and rode his bike everywhere. The result was a remarkable turnaround—within four months, he completely reduced his need for insulin. "He's a different person today, "says Mike. "He never wants to go back to ever being that sick again."
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Other ethno-cultural groups at-risk
People of South Asian, Asian, Hispanic and African descent also have a greater incidence of diabetes.
Children of recent immigrants from high-risk populations are often at an even greater risk for type 2 diabetes when they come to Canada because they no longer have wide access to familiar foods (which may be difficult to access in western grocery stores).
Instead, many adopt the most unhealthy North American diet habits—such as fried foods, sugar laden drinks and eating in front of the TV. Evelyne Pytka, a certified diabetes educator and dietitian at Montreal Children's Hospital teaches new immigrants about healthy lifestyle habits. "Often kids from immigrant families make a drastic change in their eating habits," she says, recalling the case of a teenage girl from India who was opting for chicken nuggets and soft drinks instead of her typical dinner fare of curry and rice.
Pytka also notes that some immigrant families may be challenged to participate in physical activity. "Sometimes their culture doesn't allow them to do certain things—swim in a pool, for example—and it may be difficult to seek out culturally appropriate physical fitness activities."
| "The good news is that type 2 diabetes is a highly preventable disease." |
Growing up in low-income families increases risk
Low income levels can also be a barrier to healthy eating and healthy weights for kids.
"A litre of milk costs $2.00, but two litres of pop is only 99 cents," notes Sharon Zeiler, Senior Manager of Nutrition Initiatives and Strategies with the Canadian Diabetes Association. It's not surprising then, she says, that the more inexpensive pop is often bought instead of milk. "Poverty makes a difference. There's a definite link between people who can't afford to buy healthy food and people who are overweight and obese."
Indeed, children's health can be threatened by both poverty and obesity, according to the National Longitudinal Survey of Children and Youth. As income decreases, the risk of obesity increases.
Living in poverty can also mean that kids are less active. When families struggle financially, their living conditions can prevent them from having an active lifestyle, especially if they live in apartment buildings where there are no yards or neighbourhoods where there are no parks.
Where kids live affects how active they are
Activity is a main factor in maintaining a healthy weight. With more families moving to the suburbs, the opportunities to walk to school, the library or community centre are limited—and so is the chance for daily exercise.
"We are so used to driving everywhere we don't even think about walking," says Ms. Zeiler, who observes that impromptu outdoor play—a pick up game of basketball or street hockey, for example—also happens less often because many parents are fearful of the potential dangers of allowing their kids to play outside unsupervised. And while gym class was once a daily part of school life, funding cutbacks mean there's also less chance for active play at school.
Preventing diabetes in kids-we can all play a role
You can reduce risks at home |
Maintaining a healthy weight and living an active lifestyle are critical factors in reducing the chances of developing type 2 diabetes.
- Eat right: Make healthy food choices by following Canada's Food Guide. Reduce portion sizes and be sure to set a good example by eating healthy yourself.
- Be active everyday: Find ways to keep your family fit-whether it's going for a walk every night after dinner or signing your kids up for organized sports. Active children become active adults.
You can help reduce the risks for all children |
- Make a difference in your neighbourhood: Consider joining or starting a community kitchen to cook nutritious meals. Connect with other parents in the community and take turns supervising children in outdoor play.
- Aim for accessible recreation: Work with policymakers in the community to promote free or subsidized recreation programs for kids.
- Advocate for healthy schools: Encourage administrators to bring back more physical activity as part of the curriculum and develop nutritional guidelines for school lunches.
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This article was written for the 
