Monday, April 30, 2012

The Type 2 Diabetes Epidemic Among Young People Is A Calamity Just Waiting To Happen

At first glance, this story that appeared on CBS News over the weekend seems to be yet another depressing reflection on just how few people seem to give a damn that their unhealthy lifestyles are not only slowly killing them but their children as well:
There is a growing epidemic among American children, and now there is a new recommendation on how hundreds of thousands of those kids should be treated.

The problem is type 2 diabetes, and it is a problem that is confounding more doctors, families, and health care professionals every day.

CBS News correspondent Tony Guida reports type 2 diabetes was never seen in young people as recently as 15 years ago. Now it's occurring with alarming frequency. Doctors know that a major risk factor is obesity. Beyond that, they were mostly in the dark about this disease.

"Very little is known about the right way to both prevent it and treat it," said Dr. Robin Goland.

A new study out today in the New England Journal of Medicine finds that the standard treatment for type 2 diabetes in children is ineffective because the commonly prescribed drug Metaformin - effective in adults - has a high failure rate in children. Still, a combination of two diabetes drugs is far more effective in treating young people.

"Two drugs right off the bat, that's an important finding," Goland said.

It is important because type 2 diabetes appears to be more aggressive in young people between the ages of 10 and 17, putting them at great risk for life-threatening illnesses typically associated with seniors.

"We want them to grow up and have healthy lives and not be having heart attacks and strokes at terribly young ages," Goland said.

When it comes to preventing type 2 diabetes, more exercise and a healthier diet are key, but doctors know young peoples' habits are tough to change.

"The first surprise that we saw was, number one, how incredibly difficult it was to effect lifestyle change in these children, in these youth that have type 2 diabetes," said Dr. Kenneth Copeland.
Well, of course it is going to be difficult to effect a lifestyle change in those children. If their parents aren't willing to MAKE them change their habits, its a hopeless cause. Right here I could get up on my soapbox about parental responsibilities and and our mindless teevee-dominated culture that has created a generation of fat, slovenly couch potatoes and blah, blah, blah. If you're looking for that kind of commentary, read Karl Denninger's take.

Instead, I'll boil my reaction down to one very simple observation: what in the hell is going to happen to these kids and their parents when our unsustainable health care system starts to break down within probably the next few years? Not to mention that when energy prices become prohibitively expensive, suddenly these wheezing, waddling fools won't be able to rely on their cars and all of the gadgets that make their lives so effort free. I don't think it takes too much imagination to realize that there are many millions of people who are going to be is deep trouble from a health standpoint long before the collapse finally comes.

Bonus: "I hope that you got fat...'cause if you got really, really fat, you might just want to see me come back"


  1. The good news where I live is bicycle racks are full outside of grocery stores, light rail trains are packed for much of the day, and there is a very active pedestrian advocacy group in town.

    More and more around me see the problem, and are altering their lives to correct it.

  2. Wasn't there some movement a few years ago about not criticizing fat people, so fat people would feel unashamed and just living a different lifestyle? Well, it has reached it's conclusion.

    1. You have to wonder if that campaign wasn't secretly orchestrated by the food industry. Or maybe my cynicism is just getting to be over the top.

  3. I have a running argument with oldest daughter on this topic. She is very thin - 5'6" and about 110 lbs if that I think, and very scornful of obese people.

    Lifestyle and poor diet choices don't tell the whole picture by a long shot, however. There is accumulating evidence - and I predict it soon there will be a landslide - that environmental factors place a huge roll.

    Chemicals from plastics and other sources are hormone disrupters, which in turn affect metabolism. Furthermore, more and more studies are revealing a relationship between exposure to air pollution and obesity and diabetes (as well as heart disease and cancer). And that's not even to mention the pink slime and other junk that is passed off as food.

    One very telling bit of evidence is the correlation between childhood afflictions and the MOTHER's exposure to pollution before she is even pregnant. This includes babies under six months who are obese. Think about that - babies who are nursing or on formula just aren't over eating - they don't do that.

    Something is very wrong.

  4. Oh boy . . . this topic is a real sore spot for me. I've been a nurse practitioner for over 12 years. I have lived this issue on an intimate level with many people. My take? It is a little complex. After all we are all products of our culture. Most people, including health care providers, have a poor understanding of nutrition; grocery stores are about 90% full of stuff we shouldn't put in our mouths; fast food and other restaurants are a big problem (just think of portion sizes!); and yes, many parents are clueless about how to raise healthy children. Then there is the medical system. Providers do not have much time to spend with patients so drugs are prescribed and people are sent on their way getting little helpful instruction about the lifestyle changes they need to make. I have huge gripes with the pharmaceutical industry and their control over medical practice. We have pills for everything, but there are lots of issues with medications like side effects and even that over the long run they may cause more harm than benefit. As a provider I have taken a lot of time over many years to try to help people make lifestyle changes and have found that in most cases I made little difference. As my dad used to say, "You can lead a horse to water, but you can't make him drink." --sometimes I just want to take off my professional hat and tell people that if they do not make serious lifestyle changes, now, they are going to die a crappy death after 10 - 20 years of increasing illness and disability. --would that make any difference? I don't think so, but it would let me get some of my anger off my chest. I am so tired to seeing people die because they do not take care of themselves.
    What is the answer? This is going to sound awfully cynical, but here's my take: Civilization is collapsing and the sooner the better for any chance of the environment surviving (although I really think it's too late for that - think Fukushima and climate change); yes, so many people will not survive without grocery stores and modern medicine, but . . . if there is a living planet with some humans in the future, they will be living off the land and there will be no more obesity or type 2 diabetes. Meanwhile, off I go to collect some yummy wild edible spring greens to have with venison stew.
    Note to Gail: I agree with you in that we should not be scornful of fat people, but you are also providing them with way more excuses than is even necessary. Face it, people eat crap and a lot of it and they do not move their bodies much = really fat people.
    Note to Bill: I've been a long time reader, even from LATOC. Love your writing. Thank you.

  5. Yes i agree with Dawn here in that is it is a complicated situation,....... i know for myself i have had to become a food Nazi because stores mix real food in with *food products* and people just don't realize how far it has gone without time and study to work through it. But yes... the creaking medical system is not going to cope and the tragedy is... no one cares.

  6. As a parent of a 4 year old and a 5 year old, I know all to well how easy it is to give in to allowing mccrap food, whether via the drive thru or via the grocery. It is hard work being consistent and getting them to understand good food is what we need and it comes first, and treats like candy are the occassional thing. But my wife and I work hard at it, and my kids are healthy.

    What I see with the girl across the street, who is nearly double the weight of my son despite being barely an inch taller, is that her parents give in to her all the time, and it isn't just food. They yell at her but seldom actually punish. She can talk her way out of anything and everything. If you ask them, they work hard and swear it must be a thyroid thing with her. But it is a matter of not making her fill her tummy with healthy things, and then she gorges on candy or deserts.

    Ironically, when she comes over to play or have dinner with us, she eats the good stuff, she listens to me and doesn't spend much time trying to change my mind, and she gets her ass out there and plays with the kids running around. As soon as her mom or dad come over, she morphs, and I can't stand her. Otherwise, she is a good kid with us.

    I see this stuff all the time, but that example is up close and personal. My guess is 90% of the kids it is the parents not doing their job, maybe 10% there are environmental or heritary factors that are the primary issue. Maybe not that high, maybe more 95/5, but it is the point. Most parents with a kid that is obese, and not behaving, it is the parents not knowing what they are doing. There used to be a show called nanny 911 that really showed just how easy it is for parents to fall into that rut.

    And for the record, my kids do watch tv and play video games. Just not very much, and never consecutive days. They do everything your mainstream kid does, just it is limited, and we control when, rather than them just doing such things.