Diabetes — a rising and alarming trend in young people

Research is showing an alarming trend in the prevalence of type 1 diabetes.

According to the American Diabetes Association (ADA), in 2019 in the U.S. alone nearly 1.9 million people were living with type 1 diabetes, with an estimated 64,000 new diagnoses per year. What’s more troubling is the increasing rate among children and young adults. The ADA’s most recent data shows an estimated 18,000 youth are diagnosed with type 1 diabetes annually as of 2014-2015.

Dr. Kannan Kasturi is a pediatric diabetes specialist and endocrinologist at the Essentia Health-Duluth Clinic. He completed his residency in pediatrics at SUNY Downstate in Brooklyn, New York, and completed his fellowship in diabetes and endocrinology at the National Institute of Health in Bethesda, Maryland.

Dr. Kasturi has been practicing for the last four years. Because this is a very specialized area, there are limited providers around the country. Dr. Kasturi is the only one in the Northland, from just north of Minneapolis to International Falls and as far west as Fargo.

Dr. Kasturi said we could see a continued acceleration of cases because the overall nationwide incidence and prevalence of both type 1 and type 2 diabetes are increasing.

 “Worldwide, northern European countries, especially Scandinavian countries, report the highest prevalence of type 1 diabetes,” said Dr. Kasturi. “The Northland is unique in the aspect that we have quite a bit of Scandinavian ethnicity in our population, which places us at especially higher risk.”

Type 1 diabetes causes your blood sugar levels to fluctuate rapidly in response to food, physical activity, illness and stress, requiring people to routinely measure their levels.

A recent report published in the National Library of Medicine found type 1 diabetes is one of the most prevalent chronic illnesses diagnosed in childhood and occurs in one out of between 400-600 American children. An estimated 15-20% of those cases are children younger than 5.

It’s a difficult disease to manage for anyone, let alone a youngster. Managing a type 1 diagnosis requires a healthy diet, near-continuous monitoring of blood sugar, administering insulin when needed and several other things to maintain glycemic control. 

“The easiest way to describe treating this condition would be ‘all-encompassing,’ ” said Dr. Kasturi. “It controls every aspect of a child’s life, including school, sports, playtime, sleepovers, as well as completely derailing a parent’s view of a ‘typical childhood’. This commonly leads to frustration, anger and eventually to anxiety and depression.”

Recent data from the Type 1 Diabetes Exchange indicate that 36% of children under the age of 6 fail to meet ADA goals for A1C percentages, which measure blood sugar levels. People with diabetes have an A1C level of 6.5% or higher.

Dr. Kasturi said “uncontrolled diabetes can cause multiple permanent complications,” such as eye problems, nerve problems (neuropathy especially of the lower limbs, including foot amputations), kidney problems and small blood vessel disease, including heart conditions.

The exact cause of type 1 diabetes is still largely unknown. Typically, the body’s immune system, which normally fights harmful bacteria and viruses, mistakenly destroys the insulin-producing cells in the pancreas. It is thought that genetics and exposure to viruses and other environmental factors could be contributing factors.

“Unlike type 2 diabetes, which is often caused by obesity, type 1 diabetes is an autoimmune disease, meaning your immune system, which normally protects your body, turns against you. In this case, the immune system attacks the cells in the pancreas that produce insulin,” said Dr. Kasturi.

Symptoms of type 1 diabetes include:

• Increased thirst.
• Frequent urination.
• Extreme hunger.
• Unintended weight loss.
• Irritability and mood changes.
• Fatigue and weakness.
• Blurred vision.

Complications from type 1 diabetes include:

• Heart and blood vessel disease.
• Nerve, kidney, eye and foot damage.
• Skin and mouth conditions.
• Pregnancy complications.

There is currently no known way to prevent type 1 diabetes, but doctors recommend a healthy diet, regular exercise, regular health check-ups and managing your blood sugar. Things to consider include limiting sugar, practicing portion control with food, drinking plenty of water and consuming foods high in fiber.

Dr. Kasturi says regular visits with a team of childhood diabetes specialists, including providers, registered dietitians and registered nurses, are most helpful. Recent technology like continuous glucose sensors and insulin pumps have also been helpful in managing this chronic and difficult condition. With support and good medical care, it can be very well managed.

Managing diabetes can be unique to the individual based on genetics, lifestyle, socioeconomic status and more. People wanting to learn more about treatment options offered through Essentia should visit our website to see the vast resources we offer to help patients.