Young at risk for diabetes

Young at risk for diabetes

A growing number of Quebec children might have to learn how to inject themselves with insulin some day PHOTO: Eyewire

Daniel McCabe | According to a study by a group of professors from McGill and Université de Montréal, a disturbingly high number of Quebec youngsters seem to be on the fast track towards developing type 2 diabetes.

Epidemiology and biostatistics professor Gilles Paradis recently made a presentation about the research at the annual Conference on Cardiovascular Disease Epidemiology and Prevention held in Texas.

Now back in Montreal, Paradis explains that the study was made possible by a large survey done on the health characteristics of Quebec children in 1999 and funded by the Canadian Institutes for Health Research and the Quebec Ministry of Health. Some 4,000 children and adolescents, aged nine, 13 or 16, have been assessed through questionnaires, blood pressure tests, height and weight measurements, blood analyses and other methods.

Paradis and his collaborators, who include departmental colleagues Jennifer O'Loughlin and James Hanley and Université de Montréal's Marie Lambert, have been poring over that data, hunting for symptoms related to insulin resistance syndrome, a precursor of full-fledged type 2 diabetes. Among the symptoms are increased serum triglycerides, increased blood pressure, obesity and decreased HDL cholesterol -- "the 'good' cholesterol," notes Paradis, that helps remove fatty deposits from the walls of the arteries and offers some protection from heart disease.

"Type 2 diabetes is on the rise in North America," says Paradis. "What is really new is that over the past five years, we've been diagnosing type 2 diabetes in adolescents. That just wasn't heard of before. It used to be called adult onset diabetes" because it was thought to only affect adults.

Prior to developing diabetes itself, individuals spend 10 to 20 years in a pre-diabetic state. The first stage is insulin resistance syndrome. The second is called impaired glucose tolerance, in which blood sugar levels are higher than normal but not high enough to be classified as diabetes.

Paradis says there is no medical consensus about what constitutes insulin resistance syndrome, so the study presents both conservative and more liberal estimates of the numbers of children with the syndrome.

Conservative estimates point to between five and nine per cent of children as young as nine having the syndrome. Less conservative numbers indicate that between nine and fifteen per cent of children have insulin resistance syndrome.

Between five and eight per cent of the general population have some form of diabetes; 90 per cent of these cases are type 2. The numbers from Paradis's study point to the possibility of a troubling upward trend.

Even if many of these kids don't get diabetes, the numbers are still alarming, says Paradis.

"These [symptoms] are also associated with a greater risk for developing certain cardiovascular diseases."

Paradis says the causes of diabetes aren't straightforward. Genetics plays a role. But there are environmental factors that can be dealt with that can lower the risk of developing the disease for individuals.

"Physical activity is the single most important thing children can do in terms of preventing obesity and decreasing the chances for developing type 2 diabetes."

Paradis, who also works for the Montreal public health department, says there has been recent talk in government circles of decreasing the amount of time schoolchildren spend in physical fitness courses. He urges the government not to take this action. "That would be a step in the wrong direction."