Diabetes in Adolescents

LITERATURE REVIEW.
In the world, children at every age are becoming more susceptible to various health adversities. These diseases are preventing children from reaching their full potential, limiting how well they grow and develop. Diabetes, which when thought about years ago, was only associated with the elderly. However, in the last 30 years, diabetes have been associated with children including babies. In an attempt to go beyond commonly shared assumptions about the up surge in adolescent diabetes, studies already conducted focused on everything; investigating sociological explanations, biological aspects, lifestyle choices as well as others to find a reason for this epidemic.
Puberty is a period of rapid and radical physical, psychological and social change during which a child, in physiological terms, becomes an adult capable of reproduction. Adolescence refers as much to the psychosocial characteristics of development during puberty as to the physical changes. Adolescents with diabetes, who need to adhere to a complex medical regimen based around self-care throughout this period of development, face a series of particular and considerable challenges.(Court,1998).
According to the Centre of Disease Control and Prevention website; it states that 151,000 people below the age of 20 years have diabetes. Former Health Minister of Trinidad and Tobago, Jerry Narace said there was cause for concern as there was a rise of diabetes in teens and young people, this was published in the Newsday Newspaper in 2009 in an article entitled "Narace: More TT teens getting diabetes." (Carol Matroo,2009). Diabetes is an illness in which the blood glucose control mechanism has partially or completely broken down. Diabetes alter the blood glucose levels in the body causing a swinging effect which is of great danger to the body.
There are two types of diabetes, Medical News Today states that Type 1 Diabetes" The body does not produce insulin. Some people may refer to this type as insulin-dependent diabetes, juvenile diabetes, or early-onset diabetes. People usually develop type 1 diabetes before their 40th year, often in early adulthood or teenage years. Type 1 diabetes is nowhere near as common as type 2 diabetes. Approximately 10% of all diabetes cases are type 1. Patients with type 1 diabetes will need to take insulin injections for the rest of their life. They must also ensure proper blood-glucose levels by carrying out regular blood tests and following a special diet. Between 2001 and 2009, the prevalence of type 1 diabetes among the under 20s in the USA rose 23%, according to SEARCH for Diabetes in Youth data issued by the CDC (Centers for Disease Control and Prevention).''(2003). Type 2 diabetes is caused since the body does not produce enough insulin, there is a malfunction of the pancreas. This type of diabetes is not prominent with adolescents, it is typically found in persons over the ages of 40. In a study conducted by JDRF in the US , they released a statement that the prevalence of Type 1 Diabetes in people under age 20 rose by 23 percent between 2001 and 2009. Jefferey Brewer the President of JDRF said " This alarming growth in T1D, if unabated, means the prevalence of the disease would double for every future generation, resulting in massive new health care spending in federal entitlement programs and the private health care market"(2012).
Type 1 Diabetes is the most common form of diabetes in children:90-95% of under 16s with diabetes have this type (Weissberg-Benchell J,2009). This means that the pancreas in these children weren't working. They are therefore insulin dependent. This may be a very traumatic and transitional part of their life, since most children have a phobia of needles, on a daily basis, sometimes twice a day these children would have to stick themselves.
"Type 2 diabetes has been seen for the first time in young people as seen in Europe and America", writes Professor Stephen Colaguir, author of the book Diabetes in Children and Adolescence.(2006). It also goes on to say that this is probably caused by the increasing trend towards obesity in our society.
A study conducted in Europe reported that children with type 2 diabetes are generally between 10-19 years of age, obesity is also a main factor for this outbreak. It also states that having a strong family history of type 2 diabetes and being insulin resistant are also some explanations for this trend. The study also goes on to declare that those affected by type two diabetes belong to all ethnic groups, but is more commonly seen in non-white groups. American Indian Youths have the highest prevalence of type 2 diabetes. In the 15-19 age groups, the current prevalence were: 50.9 per 1000 were Indians, 4.5 per 1000 were Americans and 2.3 per 1000 were Canadians.
The West Indian Medical Journal, in an article entitled "The epidemiology of diabetes mellitus in Jamaica and the Caribbean" (2010) states that a study conducted in Port of Spain, St. James found that diabetes was more prevalent in the Indo-Trinidadians; 23% among females and 20% among males. The statistic for the Afro-Trinidadians were 17% for females and 8% among males. This study also attributed obesity as the main factor associated with the prevalence of diabetes.
The Diabetes Education Research and Prevention Institute (2010), has highlighted the significant increase in the prevalence of diabetes and obesity in school children. This study which tested 67,000 school children aged 5-17 years in Trinidad for urine testing during 2009, found that in testing 100,000 children, 10 children with Type 2 diabetes and 19 children with difficulty in handling ingested glucose were detected. The survey also revealed that many of the children had undiagnosed type 2 diabetes in their family. Since diabetes is associated with obesity, it is important to take the necessary steps to prevent obesity and deteriorating health in adolescents. The report also goes on to say that the prevalence of diabetes were due to various reasons including; genetic factors, lack of exercise, unhealthy eating patterns or a combination of these factors. Due to the poor eating habits of our culture, this leads to our organs and systems becoming less effective as they begin to malfunction for example the pancreas stops producing insulin.
The Trinidad and Tobago's Express Newspaper in an article entitled " T&T’s children falling to diabetes scourge" featuring the past President of the Diabetes Association of Trinidad and Tobago, Mr. Carlton Phillip who divulges that in 2007 the association recorded 200 children with diabetes and by 2009 the figure grew to 350. In June 2012 the recorded figure described by him as 'ballooned out' to 613 for that year so far.
In order to curb the outbreak of diabetes the Ministry of Health launched its "Fight the Fat-T&T Wellness Revolution" in 2012. The Fight the Fat program was produced to bring awareness and encourage the citizens in Trinidad and Tobago to become physically active as it reduces the risk of chronic diseases. This led to the citizens, both young and old who participated in a 5k race and a Trini Food Makeover Cookout Competion, in which members of the public as well as the various Regional Health Authorities competed for more than $35,000 in prizes. Dr. Faud Khan told Trinidad and Tobago's Guardian Newspaper that 55% of people in Trinidad and Tobago were obese, just 5% less than the rate in the US. He said that a major concern was the obesity rate in children which seems to be on a rise. "Sugar is the main problem we are facing right now...we are trying to get people to reduce the amount of sugar they consume on a daily basis," Khan said.
Diabetes being ranked the number two killer in Trinidad and Tobago as stated in the Trinidad and Tobago's' Express Newspaper(2012) and knowing that the genetic factor to stop the onset of diabetes in adolescents. With the right diet and physical activity as published plays a significant part in adolescents contracting diabetes, decisions must be made by adults by many studies, the onset of diabetes in adolescents can be prevented.