Troubling Trend: Young Adults with Diabetes
Should You Be Screened for Diabetes?
A diabetes screening is recommended for anyone who:
- Has a family history of diabetes
- Is overweight
- Is older than 45 if no other risk factors are present
- Is older than 40 if other risk factors are present
- Is of Asian-, African-, Latin-, Native-American, descent
- Has a blood pressure higher than 130/85
- Has coronary artery disease
- Has a triglyceride level greater than 150 and a high-density lipoprotein (HDL) level less than 40
- Has a history of gestational diabetes or polycystic ovarian syndrome (PCOS)
For more information, please call one of the Memorial Healthcare System Diabetes Management Centers:
Memorial Regional Hospital
(954) 985-5889
Joe DiMaggio Children's Hospital
(954) 986-2234, Press 4
Memorial Hospital West
(954) 430-6801
Memorial Hospital Miramar
(954) 538-4517
Memorial Hospital Pembroke
(954) 963-8013
November 2005 — The rapid spread of diabetes in America is only one aspect of the disease that has doctors concerned. They're also worried about an emerging trend in the people they're treating.
"There's virtually a diabetes epidemic in this country, and the average patient age is decreasing," says Stephen Novak, MD, endocrinologist on the medical staff at Memorial Regional Hospital. "Newly diagnosed patients are no longer in their 60s or 70s, but are often in their 40s — and in some populations, their 30s."
Of the two types of diabetes, type 2 is by far the more common, affecting millions of Americans. It is a metabolic disorder resulting from the body's inability to produce enough insulin or to properly use it. Type 2 has a dual defect. The first is insulin resistance, where the body doesn't respond properly to insulin. Medications are available to treat insulin resistance. The second is when the body stops enough insulin, so the patient needs insulin or medication to increase insulin production.
Type 1 diabetes is diagnosed most often in children and young adults and accounts for about 5 to 10 percent of diabetes cases. Because the body does not produce any insulin, type 1 diabetes patients must inject insulin indefinitely.
Reasons for Risk
The increase in diabetes and the decrease in age at onset are pronounced in the United States. "It's the video-and-pizza generation," Dr. Novak says. "We don't eat right and we are more sedentary than we should be."
In addition to poor diet and lack of exercise, factors that can increase diabetes risk for young adults include:
- Polycystic Ovarian Syndrome (PCOS)
Common during childbearing years, ovarian cysts are usually small and not a problem. However, PCOS is a condition that can cause irregular menstrual periods, infertility, increased body hair and other symptoms. PCOS patients have an elevated risk of developing non-insulin-dependent type 2 diabetes. - Ethnicity
Native Americans, Hispanic Americans, and Asian- and African-Americans are at increased risk. - Insulin Resistance Syndrome
Long-term insulin overproduction causes this syndrome, probably due to obesity and excess fat in the liver, pancreas and other organs. It is thought that as many as half of American adults could have insulin resistance syndrome and a significant percent of them will develop diabetes. Exercise, weight loss and proper diet often help to control it.
For women, specific diabetes risks include:
- Pregnancy
Gestational diabetes usually has mild symptoms and disappears after a woman gives birth. However, women who experience gestational diabetes are 40 to 50 percent more likely to develop diabetes later in life than women who do not. - Early Diagnosis, Aggressive Treatment
The increase in diabetes rates has another cause: more stringent criteria for diagnosing the disease. Several years ago, the American Diabetes Association and the World Health Organization redefined diabetes. Before 1997, a person with a fasting blood sugar of 140mg/dl or greater was considered diabetic. In 1997, the number was lowered to 125. Impaired fasting glucose (pre-diabetes) has been reduced from 110 to 100.
"What's reassuring about the stricter criteria is that the sooner diabetes is caught, the better," Dr. Novak says. "By the time a person's level is 140, it's often too late and the patient is at greater risk for developing complications. We want to catch it much earlier. This means we have to look for it much more aggressively, because the earlier a person is diagnosed, the more effectively complications can be prevented."
Memorial Healthcare System's inpatient and outpatient diabetes programs focus on self-care skills and improving quality of life for diabetic adults and children. Outreach services include community screenings and free support groups.
If you are concerned about diabetes and would like a referral to a physician, please call Memorial Physician Referral Service toll-free at (800) 944-DOCS. We're available 24 hours a day, 7 days a week.