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Typically, when diabetes hits during childhood or adolescence it comes in the form of type 1 diabetes, an autoimmune disease in which the body does not produce any insulin.

But the growing prevalence of childhood obesity over the past two decades has brought with it an alarming rise in type 2 diabetes among our nation's youth.

Until the 1980s, type 2 diabetes among children was practically unheard of. Since then, however, doctors have reported an increase in the number of children they are seeing who develop this adult disease. But nobody knows exactly how many children have type 2 because it often develops gradually or without any symptoms at all, and children are not routinely tested for it. What's more, children with type 2 are often misdiagnosed as having type 1. Sometimes they are well into their teens or early 20s before a diagnosis is made. Researchers now believe that anywhere from 8 to 45 percent of all children with diabetes may actually have type 2 diabetes.

What Can Happen: A Grim Look at the Future
Sadly, when children develop type 2 diabetes they run the risk of suffering the same serious health complications that plague adults with this disease: heart disease, kidney failure, blindness, amputations and other numerous problems. Recent studies tell us that these complications may be striking kids even faster than they do adults who develop type 2 later in life.

The first generation of children with type 2 diabetes monitored into adulthood paints a grim picture of what lies ahead for young people. A study of 51 pediatric diabetes clinic "graduates" in Canada revealed that, by their 20s and 30s, two had died while on dialysis, three were still being treated for kidney failure, one had become blind and one had a toe amputated. Of 56 pregnancies among this group, only 35 had resulted in live births. Most had severely high levels of A1C, a long-term measure of blood-sugar control, putting them at further risk for serious complications.

Researchers believe that low levels of physical activity-too much time spent watching TV and playing videogames and not enough jumping rope or playing ball-combined with diets high in fat are all contributing to the rise in pediatric obesity, insulin resistance and type 2 diabetes. There is grave concern that the early onset of this disease will mean the lives of these children will be dramatically cut short.

How Do You Know If Your Child Is at Risk?
Typically, children who have type 1 diabetes are not overweight or may even begin to lose weight. They are unusually tired, frequently thirsty and need to urinate more than normal. In contrast, children with type 2 diabetes are most often overweight or obese (more than 20 percent over their ideal body weight), often have a family history of diabetes and belong to a minority group such as Native Americans, African-Americans, Latinos, Asian-Americans or Pacific Islanders. They may not show any outward symptoms of diabetes, even though the disease is already beginning to cause their bodies harm.

What to Do?
Treating children who have type 2 diabetes is much the same as treating adults. Some may require oral medications and insulin injections, but all children who have type 2-or appear at risk for type 2-also need to find a weight-loss and exercise plan that fits their lifestyle and that of their family. Unfortunately, children often have a harder time making these changes than adults, especially if they can't see immediate results from their efforts. The families of children with diabetes, as well as their friends, schools, communities and health-care providers can all play an integral role in providing valuable support. But parents should take heed: obesity in children is not a cosmetic issue. It can destroy more than their self-esteem. Don't let it go go unchecked.

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