Friday, 4 October 2013

Broad Topic: Lifestyle Diseases

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Narrowed Topic: Factors that Contribute to the Development of Type 2 Diabetes in Children and Adolescents

Essay:
            “Type 2 diabetes is a slowly progressive disease that begins as a problem of insulin resistance in the body” (Dudek, 2007, p. 571). Insulin is the hormone in the body that controls the level of sugar in the blood. The inability of this hormone to carry out its normal function will result in a condition called hyperglycemia or high blood sugar (diabetes) (World Health Organization [WHO], 2012). The prevalence of type 2 diabetes among the pediatric population and teenagers has seen a rapid increase in recent years. According to Copeland, Becker, Gottschalk, and Hale (2005), the disease that was once diagnosed in adults only “has become very common among children aged 6-11 years and adolescents aged 12-19 years” (p. 181).  In a small country like Jamaica, about 10,000 children below the age of 15 years of age are living with diabetes. These figures has sparked many public concerns as diabetes and its related complications induce a high cost on health care, which will eventually have an impact on the country’s economic growth (Ministry of Health, Jamaica, 2011). The rising incidence of type 2 diabetes in children and adolescents can be attributed to obesity, physical inactivity and unhealthy eating patterns.

                        Obesity is one of the major risk factors for the development of type 2 diabetes in children and adolescents. The occurrence of obesity among children aged 6-11 and adolescents aged 12-19 in the United States of America were 4.2 and 4.6% in 1963-1970 compared to 15.3 and 15.5% in 1999-2000 (Bloomgarden, 2004). This alarming increase in figures strongly suggest that the increasing rate of type 2 diabetes among this population is as a direct result of obesity, since the more adiposity (fat) that is present, the more likely it is that insulin resistance will occur. Insulin resistance is the decreased capacity of the insulin- sensitive cells in the body to react to insulin production.  In such case, the pancreas will be required to produce more insulin to compensate for this resistance (Copeland, et al., 2005). This excessive production of insulin will eventually result in pancreatic failure, furthering complications. According to Shaw (2011), fat cells produce a protein that “leads to the development of type 2 diabetes” (para. 2). Shaw further stated that this protein will cause the body to become “desensitized to insulin” (para .3).

                        Secondly, the less active children and adolescents are, the greater the chance of them having type 2 diabetes. In contemporary society, physical activity among the young is slowly decreasing. As mentioned by Ponder, Sullivan and Mcbath (2000), children are more inclined towards technological entertainment such as television and computer games. It was stated that about 53% of children ages 2-18 years in the United States “have a television set in their bedroom” (p. 95). After school hours, children may go off to watch television for many hours, while eating snack until bedtime. Programs that facilitate physical activity for the young are not readily available and if they are can be very expensive for parents (Ponder, et al., 2000). This lack of physical activity results in increased fat storage and eventually obesity. According to Gardner (2007) exercise facilitates the burning of surplus sugar in the blood and causes the cells to become more responsive to insulin, which will control blood glucose levels. From this argument, it can be deduced that exercise plays a vital role in the delay or prevention of type 2 diabetes in children, while the lack of exercise does the opposite; increases the risk.

                        Finally, the consumption of unhealthy foods on a regular basis by children and adolescents is another factor that leads to the development of type 2 diabetes in this population. In recent years, processed or ‘fast foods’ has become the favourite among pediatrics and adolescents. This is as a result of the lack of time and energy that most parents have to prepare a full healthy meal for their children (Ponder, et al., 2000). Foods such as pastries, breads, cakes and snacks are highly processed and essentially has lost most of their fiber content, gained a lot of high fructose corn syrup in most cases as well as Trans fatty acids (Sotir, 2010). 

According to Sotir (2010) fiber is a significant component of a healthy diet as it functions to keep blood glucose and insulin levels at equilibrium in the body. They are digested and absorbed at a slower rate than fiber less foods and they cause less sugar to be in the blood after eating, thereby putting less pressure on the pancreas to produce more insulin. Processing methods, damage whole grain products and cause them to have a higher glycemic index. Glycemic index measures the rate at which glucose levels rise in the blood. Since most processed foods do not provide fiber, the resultant effect would be type 2 diabetes. High fructose corn syrup is essentially used to “sweeten any processed food” (Sotir, 2010, para. 6). This kind of syrup when consumed over a prolonged period is used by the liver and stored as fat, and is evidently associated with type 2 diabetes. Sotir (2010) asserted that “high fructose corn syrup powerfully promotes insulin resistance” (para. 6). Trans fatty acid is another product of food processing, mainly found in potato chips, salad dressings and crackers which are among the favourite foods of young children and teenagers. As mentioned by Sotir (2010) , Trans fatty acids reduces the reactivity of body cells to insulin, by altering the normal function of insulin receptor sites, causing a buildup of sugar in the blood. Since type 2 diabetes is associated with many serious complications, children and teenagers can do themselves a favour by avoiding or reducing the intake of these types of food.

                        As the saying goes “an ounce of prevention is better than a pound of cure”. The risk factors for type 2 diabetes in children and adolescents are many but the three most important ones are obesity, physical inactivity and unhealthy eating patterns. However, the likely occurrence of type 2 diabetes in this vulnerable population can definitely be reduced by encouraging them to take part in physical activities at their school, at least two times per week, be it sports, dance, etc. In addition, they should be provided with healthier meal options, as well as plenty water.












References
Bloomgarden, Z.T. (2004). Type 2 diabetes in the young: The evolving epidemic. Diabetes Care, 27(4), 998-1010. doi: 10.2337/diacare.27.4.998
Copeland, K. C., Becker, D., Gottschalla, M., & Hale, D. (2005). Type 2 diabetes in children and adolescent: Risk factors, diagnosis, and treatment. Clinical Diabetes Journal, 23(4), 181-185. doi: 10.2337/diaclin.23.4.181
Dudek, S. G. (2007). Nutrition essentials for nursing practice (5th Ed.).United States of America: Lippincott Williams & Wilkins.
Gardener, K. (2007, December 5). Fight Chronic Disease with Exercise. The Jamaica Gleaner. Retrieved from Jamaica-gleaner.com/gleaner20071205/health/health 6 html
Ministry of Health, Jamaica. (2011). Act on diabetes now. Retrieved from www.moh.gov.jm/general/latest news/1-latest-news/498-act-on-diabetes-now
Ponder, S.W., Sullivan, S., & Mcbath, G. (2000). Type 2 diabetes mellitus in teens. Diabetes Spectrum, 13(2), 95. Retrieved from journals.diabetes.org/diabetesspectrum/00v13n2/pg95.htm
Shaw, J. (2011). How obesity causes diabetes. Retrieved March 03, 2013, from www.livestrong.com/article/17608-obesity-causes-diabetes/


Sotir, L.J. (2010). A processed food diet: The major risk factor for type 2 diabetes. Retrieved March 03, 2013, from www.whole healthandnutrition.com/article.php?article=29
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