Magnitude and Indicators

Emergence of Type II Diabetes Among Children Ages 10 to 19 in the United States Over the Last 15 Years

            Type 2 diabetes was primarily known as adult-onset diabetes diagnosed to overweight patients in their late 40s and older.  However, over the last two decades or so, pediatricians have seen an alarming increase of this disease being diagnosed in children.  Diabetes is one of the most common chronic diseases in children and adolescents.

            Type 2 diabetes has been described as a new epidemic affecting the American pediatric population.  In 1992, it was rare to see a case of type two diabetes in children.  Pediatric centers reported 2-4% of patients were diagnosed with type two diabetes.  In a two-year time span, this percentage jumped to 16%.  In the past decade, this number has increased to an astonishing 33% and is continuing to increase at a rapid rate.  We see from this data how much this epidemic is growing.  In a matter of two decades this disease went from extremely rare or nonexistent to becoming a national epidemic.  If this disease isn’t controlled, prevented, and treated, a third of all children born in the year 2000 will be diagnosed with type 2 diabetes.    

            In response to this growing epidemic, the CDC partnered with the National Institutes of Health in 2000 to fund the SEARCH for diabetes in youth.  In 2001, SEARCH observed 3.5 million children under 20 years of age under active surveillance to estimate how many children had diabetes.  They observed that 154,000 kids had diabetes and type 2 diabetes was a rare occurrence.  SEARCH continued their surveillance from 2002 to 2003 but of 5.5 million children less than 20 years of age.  They estimated that the overall incidence of diabetes is estimated to be 24.3 per 100,000 per year.  Fifteen thousand youths are diagnosed with type 1 diabetes in a year.  Three thousand, seven hundred are diagnosed with type 2 diabetes a year.  The rate of new cases for individual’s under the age of 20 is 5.3 per 100,000 per year for type 2 diabetes. 

            The number of children aged 10-19 in the United States with type 2 diabetes would be a direct indicator.  There are currently 154,000 children in the United States diagnosed with this disease.  The percentage of children with diabetes that have type 2 diabetes, 30-40%, is also significant.  Blood pressure and blood sugar levels of children can also be an indicator of type 2 diabetes.  Also the percentage of children who have the potential to become diagnosed with type two diabetes would be a direct indicator. 

            Indirect indicators for type 2 diabetes would be rising obesity rates in children.  Eighty percent of all children who develop type 2 diabetes are either overweight or obese.  This statistic would be reliable because it is calculating a child’s BMI and not subject to any bias.  Another indirect indicator would be inactivity in children.  When children aren’t active, they tend to gain more weight, which can also be a cause of diabetes.  Children spend more time inside watching TV and playing on electronic devices rather than going outside and getting active.  You could look into the statistics of how many children aged 10-19 are active regularly.  Genetics could also be a indirect indicator.  The statistics of kids who have parents that are overweight or have diabetes is significant.

            For the direct indicators such a the number and percentage of kids with diabetes can be very accurate and inexpensive.  The data for this can be collected through surveillance by reports from pediatricians.  However, it might be subject to a little bias because not all children go to the doctors office.  For children inactivity, the results will not be completely reliable.  These results are based solely off of the information that children report.  There is no telling whether or not these children were truthful in the survey.  Also genetics can be reliable but also have the potential of being unreliable.  If the researchers access the parents’ medical records they would be reliable data.  However, this can be considered an invasion of privacy.  Avoiding the invasion of privacy, researchers would have to rely on the parents reporting their data.  Which these results can also be skewed based off the honesty of the parents and the parents who are willing to fill out the survey. 

Work Cited:

http://diabetes.niddk.nih.gov/dm/pubs/statistics/#ddY20

http://www.cdc.gov/diabetes/projects/diab_children.htm

http://www.cdc.gov/diabetes/projects/cda2.htm

http://care.diabetesjournals.org/content/23/3/381.full.pdf

Emergence of Type II Diabetes Among Children Ages 10 to 19 in the United States Over The Last 15 Years

Emergence of Type II Diabetes Among Children Ages 10 to 19 in the United States Over The Last 15 Years

            Just a few years ago, it was rare to diagnose a child with type II diabetes.  But over the last few years it has become more and more common.  Diabetes is one of the most common chronic diseases in children and adolescents.  About 151,000 people below the age of 20 years old have diabetes.  Type I, or commonly referred to as juvenile diabetes, is typically the type of diabetes seen in children.  This type occurs because the patient’s own immune system mistakenly destroys the cells in the pancreas that makes insulin, a hormone needed to control blood sugar levels.  Type II diabetes is thought to be brought on by obesity and inactivity in people who have a genetic predisposition to develop the disease when they gain weight.  Their pancreas still produces insulin, just not enough and the body does not use it properly.  Type II diabetes was typically seen in overweight to obese people aged 40 years or older.  However, starting in the 2000s, it started becoming a childhood problem.

            Diabetes among children is a new and emerging disease.  So new that doctors are still conducting research on the disease.  Scientists are coming up with new ways to try and treat diabetes in children.  Diabetes is a serious disease.  With it comes many other health problems.  Children now how have to live their lives with these health problems lingering over their lives.  Type II diabetes is hard to detect in children because it can go undiagnosed for a long time. 

            I found this topic interesting because there is so much talk today in the public health world about obesity.  This topic is a direct affect of it.  It shows people that obesity is actually causing harmful problems.  A disease that was uncommon for children is now emerging is such high rates.  It’s project emergence for the future is also scary.  It is such a rapidly growing disease.  This topic interested me because it is a preventable disease.  It is also a disease that can go away through certain measures.  I am interested in how the CDC plans to take action against this disease and what programs they will implement to help prevent and treat it.

            This disease is socially relevant because of the high rates of obesity this country is experiencing now.  This disease is a direct result of the rates of overweight people.  People talk about obesity and how harmful it can be to your health.  Finally, the emergence of diabetes in children at such high rates directly shows how harmful obesity can be to children’s health.

"Contagion"

            This week, I watched the movie Contagion, which follows the path of a deadly airborne virus as it makes its way around the world.  The movie depicts how highly contagious viruses are spread and how easily they are contracted through simple everyday motions one would not even think about second-guessing.  As the disease spreads rapidly and its toll on the population greatens, public health organizations desperately work to contain the disease while working with scientists work to create and then distribute a vaccine to stop this epidemic.  Watching this movie for the first time, I was struck with paranoia.  Every time I heard someone cough, I would tense up.  I applied hand sanitizer on my hands more than I ever had in my whole lifetime.  I particularly enjoyed the last scene of the movie, in which the origin of the disease is shown and how it transfers to its first victim.  It shows how easy a disease can be started and how careful we should be with our hygiene practices.  With public health knowledge, I was able to see how public health officials reacted in such a desperate situation. They worked with epidemiologists and scientists to create a vaccine to cure the disease.  They also went through extensive measures to prevent the disease from spreading further.

            An outbreak is an occurrence of a disease in more cases than expected within a specific place or group of people over a given period of time—a sudden increase in the incidence of a disease.  The movie’s plot is driven by the outbreak of the deadly disease.  We can see the outbreak as the virus transfers from animals and then human-to-human.  When pandemonium hits the public health organizations, the rising number of cases seems much higher than expected or hoped for.  Outbreak investigations are done by epidemiologists and public health officials to help identify the source of an ongoing outbreak and prevent additional cases from occurring.  In the movie, we see public health officials working to try to find a place of origin of the disease, how it was transmitted, and how to create a vaccine to cure it.  Isolation and quarantine are public health practices used to stop or limit the spread of disease.  Isolation is used to separate those who have been infected with the disease from a society where people are healthy.  In the movie, the people who had the disease were taken into medical institutions in order to prevent greater spread of the disease.  Quarantine is when people who have been exposed to the disease are separated from society.  Doctors then observe them to see if they become ill with the disease as well.  After his wife and son died from the disease, Mr. Emhoff was placed in quarantine due to his exposure to the disease from his close family.

            A major sector of public health is preparedness.  In the movie, the public health agencies were unprepared in their immediate response to the outbreak.  The hospitals were not prepared for such a large-scaled disease.  They filled beds up so quickly and patients were kept too close.  This further allowed the disease to be transmitted easily.  There was also a lack of hospital staffing.  Doctors and nurses treated the ill and put themselves in risk of contracting the disease as well.  Once they did develop the disease, there were less health officials to help the sick patients.  The CDC should have made sure those people were better protected against the disease or given the vaccine first so they could still help others.  Lastly, the public health organizations withheld the severity of the disease outbreak too long.  They should have immediately notified the public and told them what they should do to protect themselves.  This could have limited the spread and the overall severity of the disease.