Overweight adults are not the only ones at risk of developing type 2 diabetes.

This chronic disease can also occur in overweight children, especially when they reach puberty. In fact, it is at this critical period in their growth and development that overweight children are at greatest risk of developing diabetes.

“During puberty, the body produces a range of hormones to physically transform the child into an adult. These hormones also raise blood glucose levels as they act against insulin, whose action is to reduce blood glucose,” says Assoc Prof Fabian Yap, Head and Senior Consultant, Paediatric Endocrinology Service, KK Women’s and Children’s Hospital (KKH), a member of the SingHealth group.

What are the symptoms of type 2 diabetes in children?

The symptoms of type 2 diabetes are the same for children and adults. These include:

  • Excessive thirst and passing of urine
  • Weight loss in spite of a good appetite

However, some children may be totally asymptomatic, mentions A/P Yap.

At KKH, 20-25 children are diagnosed with type 2 diabetes every year; of these, about 20 per cent are not obese and 20 per cent are asymptomatic. Girls have been found to be more prone to diabetes than boys.

A worrisome aspect of childhood diabetes is that, as children will live much longer with the chronic disease, they have a higher risk of long-term complications.

Over time, diabetes can damage the small blood vessels in the retina, kidneys and nerves resulting in blindness, kidney failure and sensory loss. It can also damage the large blood vessels resulting in heart disease and loss of blood supply to the limbs.

Why are overweight children at risk for type 2 diabetes?

Just like in adults, the risk factors for type 2 diabetes in children include:

  • Sedentary behaviour
  • Overeating and excess body weight
  • A family history of obesity, diabetes, high blood pressure and high triglycerides

Excess body fat is associated with higher levels of free fatty acids (FFA) in the circulation, explains A/P Yap. Elevated levels of FFA can stimulate the liver to release more glucose and cause the pancreas to produce less insulin. To make matters worse, excess muscle fat reduces the muscle cells’ response to insulin.

All these factors combined raise the level of blood glucose in the bloodstream of an overweight child, which leads to diabetes.

Ref: T12