Obesity fuels 'tragedy' among kids

By REBECCA WALSH

Doctors in Auckland are treating increasing numbers of severely overweight children suffering a form of diabetes previously found mainly in obese middle-aged and elderly people.

One in 10 diabetic children at the Starship children's hospital now have the highly preventable Type 2 diabetes, which is linked to obesity, poor diet and lack of exercise.

Doctors say the adult disease - previously known as "mature onset diabetes" - was unknown in New Zealand children a decade ago. All child diabetics then had unavoidable Type 1 diabetes, which forces them to take insulin injections.

Dr Paul Hofman, a paediatric endocrinologist at Starship, said most children and teenagers with Type 2 diabetes were Maori, Pacific Islanders or Indians who were significantly overweight. He expected more European children would contract the disease in the next couple of years.

"It's a real tragedy and just reflects the fact we are getting fatter and fatter as a population," he said.

"We need to exercise more, watch less TV, smoke less and eat properly. You do not get Type 2 diabetes in childhood or adolescence if you are not overweight - that's the bottom line."

New Zealand is witnessing a diabetes epidemic which is expected to grow far worse in the next 20 years, costing the health system billions of dollars.

An estimated 115,000 people have been diagnosed with diabetes and the same number are thought to have it without knowing. By 2021, a further 60,000 people are expected to be diagnosed with Type 2 diabetes.

Other key points include:

* About 17 per cent of New Zealand adults are obese, a figure expected to grow to close to 30 per cent by 2011.

* Maori and Pacific Island rates are expected to double to one in every six adults.

* Diabetes costs the country about $170 million a year, but the figure could rise to more than $1 billion a year by 2021.

Professor Wayne Cutfield, director of paediatric endocrinology at Starship, said Japanese research showed a strong link between Type 2 diabetes in children and obesity.

More children in Japan now developed Type 2 diabetes than Type 1 and the Government had started screening children at least twice while at school.

"My prediction is that within the next 10 years we will see more Type 2 diabetes in childhood than Type 1. It's quite a sobering thought."

Dr Robyn Toomath, president of the Society for the Study of Diabetes, said diabetes specialists all had "a handful" of teenage patients with Type 2 diabetes.

"When you develop it at the age of 14 you have all those extra decades of effects. We are extremely anxious we will see a lot of middle-aged people with renal problems, eye problems and amputations as a result of developing Type 2 diabetes in their teenage years."

Diabetes was named as one of the Government's top 13 health priorities in 2000.

As part of the strategy to tackle the problem, it funds one free GP check-up for diabetics, diabetes teams have been set up in district health board areas and retinal screening services are being offered in some regions.

But those working in the field question whether the response is fast enough. They believe spending more now will improve outcomes for individuals and save the country in the long term.

Dr Sandy Dawson, chief clinical adviser at the Ministry of Health, said it was up to individual district health boards to decide the priority and funding assigned to diabetes.

* Type 1 diabetes is an auto-immune condition where the body attacks the cells that make insulin. It is not preventable and the number of people diagnosed with it is increasing about 15 per cent a year. About 10 per cent of diabetics have Type 1 and most people develop it as children or teenagers.

Type 2 diabetes occurs when the body does not make enough insulin or use the insulin it does produce in a healthy way. It can be prevented or better managed with regular exercise, healthy eating and, in some cases, medication.

Further reading
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