15 year-old Brittany didn’t feel sick. But two years ago, she tested positive for type 2 diabetes during a routine trip to the doctor.

Brittany says, “At first, I was asking, am I going to die? And I was like, I don’t want to die, I’m young to die.”

Doctors say almost all teens with type 2, or adult-onset diabetes are overweight. Dr. Byron Cotton, a primary care physician with Children’s Healthcare of Atlanta says, “It’s become so commonplace that 12 year-olds who are 200 pounds don’t see themselves as being abnormal or overweight.”

Of the kids who are heavy, doctors say those who get diabetes, likely have it in their genes. Dr. Cotton says, “You’ll find diabetes in all populations, but you tend to find it more in people of color: African-Americans, Hispanics, Native Americans.”

Over time, diabetes can lead to blindness, kidney failure, even amputation. Brittany says, “A lot of bad stuff can happen. You can get a lot of stuff cut off, like your legs and stuff cut off. And I don’t want that to happen because I’m young, and I want to have a teenage life, grown up life, and then when I’m old I want to still be living.”

Complications typically show up fifteen years after diabetes sets in. That means teens with the disease may deal with the effects years earlier…at 25 or 30…instead of age 60, or 70. Dr. Cotton says, “It greatly shortens your life span. So if you have a family history of diabetes, or I would even say if you are a person of color and you are overweight, I think you should be aggressive and ask your physician to check your child to see if he is either diabetic or at risk of becoming diabetic.”

Brittany knows losing even a little weight can greatly improve her health. Brittany says, “If I get down three different pants sizes, smaller pants sizes, I’d be happy.” Her mom Janelle Brown says, “Something really bad can happen to her, and I don’t want that to happen to my baby. So that’s why I have to stay focused and stay on her, even though she gets mad, I have to stay on her about the food and exercise.”

Dr. Cotton says, “Diabetes is not a death sentence. You have control over what happens to you. If you change behavior, if you exercise, eat right, you can live a happy healthy life.”

Diabetes mellitus is a group of diseases characterized by high levels of blood glucose resulting from defects in insulin secretion, insulin action or both. According to experts at the Centers for Disease Control and Prevention, there are four types of diabetes:

• Type 1 diabetes was previously called insulin-dependent diabetes mellitus (IDDM) or juvenile-onset diabetes. Type 1 diabetes may account for 5 to 10 percent of all diagnosed cases of diabetes. Risk factors are less well defined for type 1 diabetes than for type 2 diabetes, but autoimmune, genetic and environmental factors are involved in the development of this type of diabetes.
• Type 2 diabetes was previously called non-insulin dependent diabetes mellitus (NIDDM) or adult-onset diabetes. Type 2 diabetes may account for about 90 to 95 percent of all diagnosed cases of diabetes. Risk factors for type 2 diabetes include older age, obesity, family history of diabetes, prior history of gestational diabetes, impaired glucose tolerance, physical inactivity, and race/ethnicity. African-Americans, Hispanic/Latino Americans, American Indians, and some Asian Americans and Pacific Islanders are at particularly high risks for type 2 diabetes.
• Gestational diabetes develops in 2 to 5 percent of all pregnancies but disappears when a pregnancy is over. Gestational diabetes occurs more frequently in African-Americans, Hispanic/Latino Americans, American Indians and persons with a family history of diabetes. Obesity is also associated with higher risk. Women who have had gestational diabetes are at increased risk for later developing type 2 diabetes. In some studies, nearly 40 percent of women with a history of gestational diabetes developed diabetes in the future.
• "Other specific types" of diabetes result from specific genetic syndromes, surgery, drugs, malnutrition, infections and other illnesses. Such types of diabetes may account for 1 to 2 percent of all diagnosed cases of diabetes.

Diabetes may not be considered by many to be a serious disease, but statistics from the Juvenile Diabetes Research Foundation suggest otherwise. Consider the following:

• Diabetes kills one American every three minutes.
• Sixteen million Americans have the disease; of those, 5.4 million are undiagnosed.
• Diabetes afflicts 120 million people worldwide, and the World Health Organization (WHO) estimates that number will skyrocket to 300 million by 2025.
• A new case of diabetes is diagnosed every 40 seconds.
• Diabetes is the leading cause of kidney failure, adult blindness and non-traumatic amputations. It is a leading cause of nerve damage.
• People with diabetes are two to four times more likely to have a heart attack or stroke than someone without the disease.
• Life expectancy of people with diabetes averages 15 years less than people without the disease.
• Diabetes accounts for more than $105 billion of annual U.S. healthcare costs.
• One of every four Medicare dollar goes to pay for the health care of people with diabetes.

Type 2 diabetes is a serious and costly disease affecting more than 15 million adult Americans. The chronic complications of diabetes include accelerated development of cardiovascular disease, end-stage renal disease, loss of visual acuity, and limb amputations. All of these complications contribute to the excess morbidity and mortality in individuals with diabetes. Moreover, the prevalence of type 2 diabetes in adults is increasing. Superimposed on this disturbing picture in adults are the recent reports of the emerging problem of type 2 diabetes in children and adolescents.

Currently, children with type 2 diabetes are usually diagnosed over the age of 10 and are in middle to late puberty. As the childhood population becomes increasingly overweight, type 2 diabetes may be expected to occur in younger pre-pubertal children. There is evidence suggesting that type 2 diabetes is increasing in children and adolescents in the United States. One possible explanation for its emergence in children is the increase in obesity and decrease in physical activity in children.

Obesity is now reaching epidemic proportions all over the world, and specifically in the United States. It is a very common finding in children with type 2 diabetes. According to the American Diabetes Association (ADA), other risk factors include the following:

• Family history of diabetes – The frequency of a history of type 2 diabetes in a first- or second-degree relative has ranged from 74 to 100 percent.
• Sex and puberty – In the adult U.S. population, the prevalence of diagnosed type 2 diabetes is slightly higher in women than in men. Most of the studies in children, including those that are population-based, indicate a higher frequency in females. Reported cases of type 2 diabetes in children show a peak age of diagnosis during the usual pubertal age period, although there have been individuals described who were diagnosed pre-pubertally. The mean age of diagnosis was between 12 and 16.

There are a number of pharmacological treatment combinations for the treatment of diabetes, most of which include some level of insulin utilization. However, there are a number of lifestyle-oriented modifications that can also have a significant impact on the health and wellbeing of individuals dealing with diabetes. According to the ADA, the goal of lifestyle-oriented treatment is to lower your blood sugar and improve your body’s use of insulin. Components of this goal include:

• Meal planning – When an individual eats, his/her body changes food into blood sugar, making his/her blood sugar go up. A good meal plan slows this rise. A dietitian can help your child create a meal plan just for him/her, but make sure the following hold true:
  • It is low in fat.
  • It has moderate amounts of protein.
  • It contains starches, like those in beans, vegetables and grains (such as breads, cereals, noodles and rice).
• Exercise - Being active helps the cells in your child’s body take in blood sugar, so exercise plays a major role in the treatment plan. Tell your child’s doctor about the kinds of exercise he/she does now. His/her healthcare provider will help your child fit them to his/her new lifestyle. If your child doesn’t exercise, you may want to encourage him/her to become more active. It would be great if he/she could be active on most days of the week for a total of 30 minutes, which can be broken down into short sessions. If your child isn’t used to exercising, encourage him/her to start slow. Even a five-minute walk can help.
• Weight loss – Losing weight is another big part of diabetes treatment. It will help your child’s body use insulin better. The best way to lose weight is to exercise and follow a healthy meal plan. With a healthy meal plan, your child will consume fewer calories because he/she will fill up on low-fat foods, not fatty foods. Your child’s healthcare provider can help determine how much weight (if any) your child should lose. Sometimes, just 10 or 20 pounds is enough to bring diabetes under control. Your child should then decide how much to lose per week, keeping in mind that one pound per week should be the maximum. Slow weight loss is healthier and easier.
• Blood sugar checks – Once your child understands that eating healthy, losing weight and keeping fit help keep blood sugar levels normal, he/she can check his/her blood sugar levels at home to keep track of how he/she is doing.