Medical students (and by extension doctors and then their patients) are taught that Type 1 Diabetes is worse than Type 2. Turns out, at least some of the time, that’s wrong.
Type 1 diabetes – also called Insulin Dependant diabetes or “juvenile onset diabetes” – is what young kids get. They develop antibodies which attach their own pancreas, the insulin-producing cells stop working, they produce no insulin and they get very sick. Before the discovery of insulin in 1921, Type 1 diabetes was an early death sentence. Now, it commits the patient to a lifetime of sugar testing and insulin injections.
Type 2 diabetes – Non-Insulin Dependant diabetes or “adult onset diabetes” – is classically associated with overweight, inactive middle-aged patients. In fact we see a wide variety of people with Type 2 diabetes and not all fit that mould, but it is true that lack of exercise and excess weight do make the likelihood of developing diabetes much greater. However there is probably also a gene which makes the condition more likely, though not inevitable, in many patients.
With the progressive increase in obesity in society we are seeing increasing numbers of diabetics, and in particular Type 2 diabetes at younger and younger ages. Whereas even a generation ago, we never saw Type 2 diabetes in teenagers or children, now about 1/3 of kids who develop diabetes have type 2.
Frighteningly – and against traditional teachings – it turns out Type 2 is much more dangerous in kids than Type 1. Research at Royal Prince Alfred Hospital in Sydney shows the death rate for teens with adult-type diabetes is double that of those with juvenile-onset diabetes. They also develop more severe complications, develop them sooner and do so even if their sugar control after diagnosis is the same as the Type 1 patients.
There are lots of theories as to why that might be – perhaps the genetic predisposition that allowed Type 2 diabetes to develop might be the cause of the complications, or perhaps the lifestyle issues which triggered the diabetes are the cause.
In any event, the study (care.diabetesjournals.org/content/early/2013/07/09/dc12-2455.abstract) noted that most treatment offered to adults with diabetes (particular types of cholesterol and blood pressure medications) are not normally given to kids because most research excludes children from drug trials. But something needs to be done to help these kids. And foremost, is trying to prevent diabetes in the first place.
Whilst we can’t do anything about the genetic factors, it’s critical for parents, doctors and society at large to look at the lifestyle choices and behaviours that may cause diabetes and that can be altered to improve our kids overall health.