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Colorado State University, Global Campus *
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225
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Medicine
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Apr 3, 2024
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Juvenile Type II Diabetes Mellitus, A Growing Epidemic
Introduction Project Description:
Type II non-insulin dependent diabetes mellitus results from peripheral and hepatic insulin resistance and beta-cell failure (Flint A., Arslanian S., 2011). The pancreas in Type II
diabetes mellitus does not have the ability to produce and secrete enough insulin to respond to the body’s food intake, thus leading to an increase of glucose in the blood (Hui H., Tang G., Go V.L.W., 2009). Over the past couple of decades, there has been an alarming rise in juvenile Type II non-insulin dependent diabetes mellitus. This has been correlated to the increase in obesity amongst the pediatric population. The American pediatric population has seen a thirty-three percent increase in cases of Type II DM over the past decade and accounts
for eight to forty-five percent of new cases (Kaufman). It was also discovered that this disorder is affecting certain ethnic and racial groups more than others. Current research has found that African American, Mexican American, Native American, and Asian American populations have a higher rate of having the disorder than Caucasian Americans (Kaufman). This research project aims to investigate the causes of the increase in pediatric Type II DM, the physiological effects of the disorder on the populations affected, and to understand why those particular ethnic and racial groups have higher incidences of Type II DM compared to others. My future career goal is to become a physician assistant and practice primary care medicine in underserved communities. This project fits into my career goals because studies have found that the raise in Type II DM among children was largely found in underserved populations, and I plan on working specifically with these communities. In addition, as a primary care PA, part of my responsibility will be to help my patients understand the importance of preventative medicine, living a healthier lifestyle, which all leads to the reduction of preventative disease. The project will allow me to gain a better medical perspective of that particular disorder and the population that it is affecting so that I can help treat them and hopefully decrease the prevalence of this preventable disease. Many of the diseases that are affecting our society today, such as hypertension and high cholesterol, are very preventable, and knowledge and education on those diseases and how to live a healthier lifestyle will help to decrease the prevalence of those diseases. Thesis: Once prevalent in older adults, Type II non-insulin dependent diabetes mellitus has become a growing epidemic not just in the United States, but globally. It is 1
hypothesized that the rise in Type II DM among the pediatric population is due to the increase in childhood obesity, exposure to diabetes in-utero, and endocrine-disrupting chemicals. Ethnic and racial differences in the increase in juvenile Type II DM is hypothesized to be due to differences in healthcare access, as well as, the access to knowledge of this particular disorder that certain communities are receiving.
Alternative thesis 1: The growing epidemic of juvenile Type II DM can be attributed to a number of factors. It hypothesized that education on preventative measures of certain disorders, how to maintain a healthy lifestyle, and access to resources are the primary factors that led to an increase in pediatric Type II DM. Alternative thesis 2: Studies have indicated that certain racial and ethnic groups have more of a prevalence of juvenile type II DM. It is hypothesized that cultural practices, lack of nutritional knowledge, and children today focusing mostly on technology rather than being
physically active are the cause for the rise of pediatric Type II DM.
MCDB Biological Literature Review: In this section, I will discuss the causes of this particular disorder and possible treatment plans, as well as, options for children with Type II DM. The rise in pediatric Type II DM has been found to be due to a number of factors. According to the University of Minnesota School of Medicine, the increase in this disease can be attributed to the increase in
obesity among children in our society, exposure to diabetes in-utero, family history of Type II DM, and the consuming of high density, low nutrient foods and drinks (University of Minnesota). Currently, there are only a few pharmaceutical treatments for pediatric patients with Type II DM. More research for pharmaceutical treatment options for pediatric Type II DM need to be conducted, but metformin is the current form of pharmaceutical treatment for children with juvenile Type II DM. One of the main concerns is that today’s children are very sedimentary. In addition, the rise in fast food consumption, and eating non-nutritious meals certainly have affected our youth, and have caused an increase in Type II DM. According to Dr.’s Flint and Arslanian, the best treatment plan for this disease is a life style change (Flint A., Arslanian S., 2011) by eating healthier, and being more active. Pharmaceutical forms of treatment are considered to be a last resort form of treatment. Epidemiology/ Populational Perspectives: In this section, I will discuss the prevalence and occurrences of Type II DM among children. Currently, 4.1 per every 1000 children between the ages of 12-19 are diagnosed 2
with Type II DM (Fagot-Campagna A., Narayan K.M., 2001). Studies have found that pediatric Type II DM is occurring mostly in underserved populations. The occurrence of Type II DM in children was also found to be more prevalent in African American and Mexican American communities at 70-75% of the new cases (Kaufman F., 2002). It is believed that dietary habits in these communities are a correlation for why these particular ethnic and racial groups have such a large prevalence of Type II DM. For this section, I would like to further explore that to better understand the cultural divide. Social and Ethical:
In this section, I will discuss the economic and social implications of Type II DM among children. Research studies have found that children living in certain economic brackets were found to be more prone to Type II DM. In addition, in underserved populations, there is a lack of access to healthcare facilities that will provide medical knowledge of this preventative disease to families. Children today are also more sedimentary
(Vivian et. al, 2011), aiding in the prevalence of juvenile Type II DM. In this section, I would also like to address the question: how can the economic factors that contribute to Type
II DM be overturned so as to decrease the prevalence of type II DM in these communities? Conclusion: Over the years, there has been a drastic increase in the prevalence of children with Type II diabetes mellitus. Once thought of as a disease for adults, has now transcended into the pediatric population. Studies have shown that this epidemic is not just a domestic issue, but a global one. Children throughout the world are displaying increased prevalence of this disorder. This project looks to explore the reasoning behind the rise of juvenile Type II DM, as well as, research why certain racial and ethnic groups are more prone to this disorder than others. In my opinion, one of the surprising discoveries that I found while researching this topic was the fact that the sources indicated there was little information on pharmaceutical treatments for juvenile Type II DM. While I believe that pharmaceutical treatment options should be explored, this disease is very preventable and access to knowledge of preventable illnesses and how to maintain a healthier lifestyle would be essential to treating this growing epidemic. It is hypothesized that the rise in Type II DM among children today is due to an increase in childhood obesity, exposure to diabetes in-utero, and endocrine-disrupting chemicals. Ethnic and racial factors are also contributing factors to the increase in juvenile 3
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Type II DM. The growing prevalence of this illness could also be attributed to differences in healthcare access, as well as, the quality of education of this disease that people are receiving.
References:
Fagot-Camapgna, A., Narayan, K.M. (2001). Type 2 diabetes in children: exemplifies the growing problem of chronic disease. British Medical Journal, 322(7283): 377.
Flint, A., Arslanian, S. (2011). Treatment of type 2 diabetes in youth. American Diabetes Association. Retrived from http://care.diabetesjournals.org/content/34/Supplement_2/S177
Hui, H., Tang, G., Go, V.L.W. (2009). Hypoglycemic herbs and their action mechanisms. Chinese Medicine, 4, 11. doi: 10.1186/1749-8546-4-11
Kaufman, R. F. (2002). Type 2 diabetes in children and young adults: “a new epidemic.” American Diabetes Association.
Retrieved from http://clinical.diabetesjournals.org/content/20/4/217
University of Minnesota. (2013). Type 2 diabetes. Retrieved from http://www.epi.umn.edu/let/nutri/disparities/t2.shtm
Vivian, M. E, Carrel L. A, Becker T. (2011). Identifying children at risk for type 2 diabetes in underserved communities. Diabetes Educ
, 37(4): 5
19-527. doi:
10.1177/0145721711406139
4