NHD Paediatric Hub
Type 2 diabetes on the rise in UK children
Kate heads up our Paediatric Hub this month. Here she focuses on T2DM and the worrying increase in incidence in children.
Twitter : @kate_roberts
Kate Roberts, RD
Senior Specialist Dietitian
In recent years, a worrying trend has emerged in the UK's healthcare landscape: the sharp increase in type 2 diabetes (T2DM) amongst children. Once considered a disease of adulthood, T2DM is now encroaching upon the younger population at an alarming rate. This is something that needs to be understood and addressed.
T2DM is characterised by the inefficiency of insulin produced by the pancreas, leading to either inadequate insulin production or ineffective utilisation. Consequently, this results in a continual rise in blood glucose levels. (1) The emergence in children underscores the complex interplay of genetic predisposition and environmental influences. Traditionally associated with adults, risk factors in children include the following: (2,3)
- Being overweight or obese
- Being inactive
- Family history of T2DM
- Eating red or processed meat and sugary drinks
- Racial and ethnic minorities
- Maternal gestational diabetes
- Low birthweight or preterm birth
- Living in areas of deprivation
THE RISE OF T2DM IN UK CHILDREN
The prevalence of T2DM amongst UK children has surged in recent decades, mirroring global trends. According to the NHS, the number of children diagnosed with T2DM has more than doubled in the past five years alone.(4) This troubling escalation presents a multifaceted challenge to public health authorities, healthcare providers, and society as a whole.
Contributing Factors:
Several factors contribute to the rise of T2DM amongst UK children:
- Obesity epidemic: Obesity is a significant risk factor for T2DM and its prevalence amongst children has reached epidemic proportions. Sedentary lifestyles, excessive consumption of processed foods high in sugar and fat and limited access to nutritious meals exacerbate the problem.(5)
- Socioeconomic disparities: Children from disadvantaged socioeconomic backgrounds are disproportionately affected by T2DM. Economic constraints often restrict access to healthy food options, recreational facilities and healthcare services, perpetuating a cycle of poor health outcomes.(6)
- Family history and genetics: Whilst lifestyle factors play a pivotal role, genetic predisposition also contributes to the development of T2DM. Children with a family history of the disease face an elevated risk, highlighting the complex interplay between genetic susceptibility and environmental influences.(7)
- Marketing and advertising: Marketing of sugary beverages, fast food and processed snacks directly targets children, influencing their dietary preferences and consumption patterns. Advertisements often prioritise profit over public health, perpetuating unhealthy eating habits and contributing to the obesity epidemic.(8)
T2DM in children: a global concern
The rise of T2DM amongst children is not confined to the UK; it is a global phenomenon with significant implications for public health. In the United States, the prevalence of T2DM amongst children and adolescents has also escalated in recent decades. According to the Centers for Disease Control and Prevention (CDC), the incidence of T2DM in youth aged 10 to 19 has increased by approximately 30% in the past decade.(9) Like the UK, obesity remains a predominant risk factor, with nearly one-third of American children classified as overweight or obese. Socioeconomic disparities further exacerbate the problem, disproportionately affecting marginalised communities with limited access to healthcare and healthy food options.
Consequences and challenges:
The ramifications of T2DM extend far beyond physical health, encompassing psychological, social, and economic dimensions. Children with diabetes face increased risks of complications such as cardiovascular disease, kidney dysfunction, and nerve damage.
Worryingly the presentation of T2DM in young individuals tends to be more severe than in adults, with complications and adverse clinical outcomes manifesting at an earlier stage. Additionally, complications are more prevalent among those with youth-onset T2DM compared to their counterparts with youth-onset type 1 diabetes.(10) Managing the condition imposes a significant burden on families, healthcare systems, and society at large.
Challenges in addressing the rise of T2DM in UK children
Challenges include:
- Preventive strategies: Efforts to prevent T2DM must adopt a multifaceted approach encompassing education, policy interventions and community-based initiatives. Promoting healthy lifestyles, fostering nutritional literacy and enhancing access to affordable, nutritious food are essential components of prevention.
- Early detection and diagnosis: Early detection of T2DM is crucial for timely intervention and improved outcomes. Healthcare providers must enhance screening efforts, particularly amongst high-risk populations, and facilitate access to diagnostic services for timely identification and management of the condition.(11)
- Holistic care and support: Managing T2DM in children requires a holistic approach encompassing medical care, nutritional counselling, psychological support and behaviour change intervention. Integrated care models that engage patients, families, and communities can enhance adherence to treatment regimens and promote long-term health and well-being.
- Policy and advocacy: Policy measures, such as sugar taxes, food labelling regulations, and restrictions on marketing unhealthy products to children, can help create environments conducive to healthy behaviours. Advocacy efforts aimed at addressing social determinants of health and promoting equity are also essential for combating the root causes of T2DM.
Conclusion
The rise of T2DM in UK children represents a critical public health challenge that demands urgent attention and concerted action. Addressing the underlying determinants of the disease requires a comprehensive approach encompassing preventive strategies, early detection, holistic care, and policy interventions. By prioritising the health and well-being of future generations, we can stem the tide of this growing epidemic and create a healthier, more equitable society for all.