- Diabetes mellitus in children and adolescents
THE 21st CENTURY has witnessed society take massive strides in medical science. Yet massive epidemics and viruses persist, taking millions of lives every year. It seems that the ills of human bodies exceed the knowledge we have to treat them, and diseases evolve even as medicine progresses. Diabetes, in particular, has turned into a hugely prevalent malady, currently affecting hundreds of millions worldwide and increasing in scope daily. Once thought to be chiefly a disease affecting adults, diabetes has recently been discovered to have a tremendous impact on youth as well.
What is diabetes?
Diabetes is an illness that occurs when blood glucose, or blood sugar, is higher than average. According to the Korean Diabetes Association (KDA), in 2014, about 4.8 million (13.7%) Koreans were affected by it. Furthermore, 3 out of 10 people diagnosed with diabetes were not aware of their condition prior. Almost half of the people diagnosed were obese or hypertensive, and one-third had hypercholesterolemia, albuminuria or decreased renal function. Of those, 89% of the diagnosed were seeking medical treatment, but 11% remained untreated. One might think it does not correspond to oneself, but nearly 1 out of every 7 South Korean adults have diabetes. To be exact, more than 30% of seniors ages 65 and above have diabetes. Due to these circumstances, the disease is often mistakenly categorized as an illness only for adults.
As much as people do not know much about diabetes, they are also not aware of the different types. The two commonly existing types of diabetes are type 1 diabetes (T1D) and type 2 diabetes (T2D). T1D accounts for 5% to 10% of cases while T2D accounts for 90% to 95% of all cases. T1D involves a malfunction in the making of insulin, a hormone that helps glucose get into cells to produce energy for our bodies. Unfortunately, as T1D entails a total lack of insulin, there is no complete recovery from it. The more common T2D prevents human bodies in either making or using insulin sufficiently. T1D is the more common type of diabetes found in children and adolescents and was formerly referred to as juvenile diabetes. T2D used to be called non-insulin-dependent diabetes mellitus (NIDDM) or adult-onset diabetes. However, the number of children and teens with T2D is rapidly rising. If diagnosed with T2D, kids’ bodies cannot utilize insulin the right way, leading to insulin resistance and ultimately, insulin deficiency. Over time, the pancreas starts producing less and less insulin which leads to a build-up of sugar in their bloodstream. This lack of insulin causes a variety of health effects, such as heart disease, loss of vision, strokes, anxiety, depression, chronic kidney disease and nerve damage*.
According to the South Korea National Health Insurance Service, the total number of diagnosed patients in South Korea grew from 1,665,495 in 2006 to 2,523,950 patients in 2015—an increase of 52%. Meanwhile, the number of diabetes patients under 19 grew from 4,076 in 2006 to 5,338 in 2015—an increase of 31%. As South Korea’s population grew only 5.3% during that timeframe, the dramatic increase in people affected by diabetes isn’t proportional. Diabetes is less commonly found in children and teenagers, so the majority generally find little reason to be concerned about the disease. With rising rates of diabetes in children, however, youth can no longer afford to remain apathetic.
Unfortunately, inevitable cases of diabetes do exist. Diabetes is a hereditary disease that goes down the genetic pyramid from one generation to the next, creating a medical history of diabetes within families. Thus, teenagers with diabetic parents or close family members are much more prone to having the metabolic disorder.
When factoring out the genetic factors of the disease, a majority of diabetes cases comes down to a lack of self-care. Controlling diet, health and lifestyle is vital to both preventing the disease and stalling its effects if already diagnosed. Poor management of diet in particular causes bodies to wear down in no time; human bodies need essential minerals and proteins to function properly. Living in a consumer society of the 21st century, kids are surrounded by sugary and fatty foods. Thus, many kids do a poor job of consuming a well-balanced diet during their formation years, leading to an increased propensity of contracting diabetes. A factor directly linked to adolescent diabetes is obesity, as excessive weight gain hinders the body from responding properly to insulin. However, according to Hong CH’s research, a researcher at Korean Pediatrician Society, only 28.1% of the Korean adolescent population get educated on nutrition and dietary habits. Not having a proper understanding of a healthy lifestyle, children and teenagers spend their time cooped up in school, spending their free time stuck in front of their computers and smartphones. Of course, parents must also be held accountable to educate their kids.
Throughout the years, the number of kids actively playing outdoors has been decreasing. Physical test scores clearly show the health decline. The average 50-meter run in high school has slowed down from 9.7 seconds to 10 seconds. The standing long jumps have also decreased, from 165.1 cm to 163.2 cm. “Kids are getting bigger from eating more, but grow weaker from lack of exercise. They spend too much time in front of computers,” an Education Ministry official states at a national conference. Having this sort of lifestyle is hazardous as it leads to increased chances of high blood sugar early in life. Active physical activity is vital for blood glucose management and overall health. Exercise helps increase mitochondrial density, insulin sensitivity, oxidative enzymes, compliance and reactivity of blood vessels, lung function, immune function, cardiac output** and importantly, decreases the likelihood of contracting diabetes.
Pressure and challenges
"He tells people that he’ll be dead soon anyway so it doesn’t matter what he does, and that seems to be his whole attitude really….so I’ve given up now, I might as well not say anything… he just doesn’t want to do it, he doesn’t want to know…. I feel like I’m watching him kill himself, and there’s nothing I can do about it, absolutely nothing,” quotes a mother in an interview with InDependent Diabetes Trust (IDDT). Students diagnosed with diabetes struggle emotionally coping with their medical conditions and with the perceptions of other people, feeling insecure about attending school. Teenagers tend to refuse admitting their condition to their peers, considering being diabetic shameful, and many children burst out crying at having to take insulin shots.
Based on an anonymous survey of diagnosed students by the KDA, 30.3% of students at schools in South Korea secretly take insulin shots in bathroom stalls to avoid any questions or attention from their classmates. In a society where conformity is the norm, these kids face daily anxiety, fearing that they’d be considered “abnormal.” Not only do diagnosed students receive pressure from their friends, but kids also think of themselves as burdens on their families, having to cope with constant monitoring and checkups on insulin in-takes.
A helping hand
In November 2017, the South Korean government implemented a “Diabetes Protection in Kindergartens and Schools” policy after considering the growing issue of diabetes in youth. The new law requires schools to have yearly health screenings and stricter regulations regarding health checkups. Nurse rooms are being built in schools, and school nurses are being instructed on diabetes guidelines to prevent students from taking their shots in bathrooms. Yet, perhaps the most important help diabetic students can receive is emotional support from their peers and community. Diabetes is not an ephemeral disease but a life-long disposition; children affected by diabetes risk facing long-term health complications.
In general, the most important step we can take to avoid diabetes is to maintain healthy life practices. Managing a balanced diet, regulating exercise in daily life and frequently getting check-ups are all essential steps to take in order to avoid diabetes.
**American Diabetes Association
Lee Kyo-jin firstname.lastname@example.org
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