Kids With Type 2 Diabetes Face Increased Heart Risk

Just as in adults, diabetes in children is skyrocketing around the globe, and it is increasingly clear that kids with the disease are at risk for many of the same life-threatening conditions, including heart disease.

In a study funded by the CDC, one in five kids with any diabetes was found to have two or more additional risk factors for premature heart disease.

The figure was closer to nine out of 10 in children with type 2 diabetes, which is closely linked to obesity.

Earlier this week it was reported that children with type 2 diabetes also face a higher risk of life-threatening kidney disease and early death, compared with people with diabetes diagnosed in adulthood.

The two studies present some of the strongest evidence yet that young age is not protective against the body-ravaging chronic diseases commonly seen in people with diabetes, American Diabetes Association (ADA) president Robert Rizza, MD, tells WebMD.

“Clearly this is not a more benign disease in children,” he says. “We are getting a better picture of the great tragedy of diabetes in children and adolescents. They are exposed to the full spectrum of diabetes complications, but [these complications] are occurring in their 20s, 30s, and 40s, instead of later in life.”

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Even Very Young Had Heart Disease Risk

The new findings, published in the August issue of the ADA journal Diabetes Care, come from an ongoing, multiethnic study examining the long-term impact of childhood diabetes.

The latest analysis included 2,096 children and teens with diabetes from across the U.S., including Hawaii. Three-quarters of the participants were non-Hispanic whites, but children from ethnic groups known to have an elevated diabetes risk were also included, including African-Americans, Native Americans, Hispanics, and Asian/Pacific Islanders.

Most of the children were between the ages of 10 and 19, but 466 were younger. Most also had confirmed or suspected type 1 disease, with 160 having confirmed or suspected type 2 diabetes.

Researchers measured the children’s waist circumference, as a marker for obesity. They also did blood tests to determine levels of cholesterol and triglycerides (blood fat), and checked blood pressure readings. They found a high prevalence of these risk factors for heart disease, even in children younger than age 10.

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Heart Risk Among Ethnic Groups

Among the specific findings:

--92 percent of the children with type 2 diabetes had two or more of the additional risk factors for heart disease, compared with 14 percent of children with type 1 disease.

--Among all of the children with diabetes, 68 percent of the American Indian children had at least two of the risk factors, as did 37 percent of the Asians and Pacific Islanders, 35 percent of Hispanics, 32 percent of African-Americans, and 16 percent of non-Hispanic whites.

--7 percent of children with diabetes aged 3 to 9 years had 2 or more additional heart disease risk factors, as did 25 percent of kids between the ages of 10 and 19.

“We saw more cardiovascular risk factors than you would expect to see in the general population, even in the children with type 1 diabetes,” Beatriz L. Rodriguez, MD, PhD, tells WebMD.

The ADA recommends that children with diabetes be monitored carefully for these risk factors, and treated with drugs if necessary.

Rizza says the evidence is mounting that controlling risk factors for heart disease in children with diabetes is at least as important as controlling them in adults with the disease.

That means losing weight, if the children are overweight or obese, getting regular exercise, and taking medication, if needed, to keep blood pressure, cholesterol, and blood sugar at recommended levels.

“We know that we can dramatically lower risk, and maybe even remove it, by doing this,” he says.

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By Salynn Boyles, reviewed by Louise Chang, MD

SOURCES: Rodriguez, B.L. Diabetes Care, August 2006; vol 29: pp 1891-1896. Beatriz L. Rodriguez, MD, MPH, PHD, Pacific Health Research Institute, University of Hawaii at Manoa, Honolulu. Robert Rizza, MD, president, American Diabetes Association. “Effect of Youth-Onset Type 2 Diabetes on Incidence of End Stage Renal Disease and Mortality in Young and Middle Aged Pima Indians,” JAMA, July 26, 2006; vol 296: pp 421426.