Research: Type 2 Diabetes on the Rise for Hawaii’s Youth; obesity a factor

Several studies conducted by Hawaiian researchers predict that rates of type 2 diabetes, as well as other chronic diseases, will increase dramatically among youth across the state in the coming years.

A study by the University of Hawaii at Manoa found that more than a quarter of teenagers in the hospital and 12% of teenagers attending an emergency room had at least one chronic condition, such as diabetes, chronic kidney disease, or high blood pressure.

“It used to be only adolescents who typically developed type 1 diabetes, but now we have an increasing number of adolescents who develop type 2 diabetes,” said Dr. Tetine Sentell, author of the study. “The whole country follows this increase.”

A recent study by the American Diabetes Association found that by 2060, type 2 diabetes could increase by nearly 700% in people under the age of 20 nationwide.

In the last ten years alone, type 2 diabetes has increased by 50% among adolescents in Asia and the Pacific Islands.

“There is an element of equity in chronic disease rates,” Sentell said, adding that a broader perspective is needed to address the issue, taking into account housing, climate and healthcare to ensure adequate coverage and resources.

“The world we live in does not foster healthy communities where people can thrive in terms of food, environment and exercise opportunities,” she said.

As cases of type 2 diabetes occur earlier, disease-related complications also occur.

“We’re starting to see that those who get diabetes as teenagers go on dialysis in their 30s and 40s, much earlier than previous generations, where if they went on dialysis they would be in their 60s and 70s,” said dr Alan Parsa of the Pacific Diabetes & Endocrine Center in Honolulu. “I had a patient who had two strokes in a row, and he’s 41 years old — mostly because he’s had a hard time controlling his sugar for a few decades.”

Parsa added that he has seen patients go blind in their mid to late 30s and be amputated in their late 20s as a result of diabetes.

He recently completed a study of 10th grade students from Waipahu, Oahu, which found that many students he tested had diabetes or prediabetes without knowing it.

“I looked at 100 people and 8% of them had diabetes and had no idea they even had it,” he said. “In that 8%, they had very poorly controlled diabetes and were at very high risk.”

Other surprises included the number of students with fatty liver disease, a condition caused by poor diet and excessive sugar consumption that can lead to diabetes and other chronic diseases.

“We know that by 2026, fatty liver will become a leading cause of liver transplants,” Parsa said. “At this point we cannot cure diabetes, but we can reverse it and achieve controlled nutrition, eat healthily, be healthy and lose excess weight.”

Another factor of concern is the rising obesity rate among native Hawaiian youth.

“We’re seeing native Hawaiians onset with diabetes about 15 years earlier than the rest of the population,” said Dr. Marjorie Mau, director of the Center for the Study of Native-Pacific Health Disparities at the John A. Burns School of Medicine on Oahu. “That’s terrible because when you’re in your 20s and 30s, those are your peak earning years, then you start your family, you’re in a job that hopefully builds your career. And now all of a sudden you have all this expense taking care of your blood sugar and trying to eat healthy.”

A joint study by UH-Manoa and the state Department of Health found that among the 5 to 29 who went to the hospital between 2015 and 2019, one in three was obese.

Additional research from the Office of Public Health Studies found that Pacific Islanders, Native Hawaiians, and Filipinos were more likely to be obese.

“On a scientific level, we see obesity as a form of stress, as well as things like discrimination, social determinants, poverty, homelessness,” Mau said. “There is a wealth of data showing that native Hawaiian communities and families, as well as other racial ethnic groups here in Hawaii, are constantly stressed by multiple factors outside of medical factors.”

Mau is also the author of a 2010 study in which 127 Native Hawaiians and Pacific Islanders participated in diabetes prevention programs with a community-based approach. The study found that weight loss in high-risk minorities can be achieved over a short period of time using community-based methods, with Mau adding just 7% extra weight loss reducing the risk of developing type 2 diabetes by 60%. can reduce.

“The name of the game right now is prevention, especially with type 2 diabetes,” she said. “When I started my career a few decades ago, we had this simplistic idea that if you just ate healthily and exercised regularly, your risk of diabetes would go away. It turns out there’s a lot more to this story than that.”

Each year, Mau has focused on a younger age group to help with prevention and treatment.

“My education is for adults, but it looks like we’re treating the end of this large number of people who have diabetes and complications,” she said. “I’m getting younger and I’m on in utero and infants now.”

Mau added that genome sequencing is now playing a role, along with gestational diabetes, or diabetes that develops during pregnancy.

Gestational diabetes is highest in Filipinos, Native Hawaiians, and Pacific Islanders, in that order.

“The prevalence of gestational diabetes in pregnant mothers has tripled,” she said. “And if you’re Filipino and you have gestational diabetes five or 10 years later, you have a one in two chance of getting type 2 diabetes. That’s spooky.”

Email Grant Phillips at [email protected]