Study of Diabetic Canadian Group Paints a Dire Picture

In the first study to look at the long-term health consequences of a form of diabetes increasingly seen in children, a Canadian researcher found that the disease is taking a heavy toll when they reach adulthood.

Doctors have long warned that the growing number of overweight children developing type 2 diabetes--which just 20 years ago was almost entirely seen in adults--potentially face complications including heart disease, blindness, kidney failure and amputations in coming years.

But the snapshot of how this small group of Canadian patients was doing in adulthood was, in some ways, worse than what doctors might have expected.

Dr. Heather Dean, a pediatrician at the University of Manitoba in Winnipeg, presented her findings recently at the American Diabetes Assn. meeting in San Francisco. She kept track of 51 patients with type 2 diabetes from her clinic who were diagnosed before age 17. Of the 51, now between ages 18 and 33, two have died from diabetes and its complications. Both were women, ages 25 and 31, who were on dialysis for kidney failure and suffered acute heart problems. One of them also was blind and had a stillborn child.

Another three patients remain on dialysis for kidney failure, including a woman who became blind at 26 and another who underwent amputation of a toe.

Of the 56 pregnancies among the 44 women in the group, only 35 resulted in live births. Dean said 18 women had miscarriages or other failed pregnancies; two delivered stillborn children over 20 weeks.

In the last 20 years, Dean said, mothers with type 1 diabetes have been able to greatly reduce their rates of stillbirths through better management of their disease. What was significant about the failed pregnancies among her former patients was that, like blindness, heart disease and kidney failure, many of their complications should have been preventable with good control of sugar levels.

The patients all were from Canada’s native First Nations people, who are very prone to diabetes, so it’s too soon to know whether type 2 diabetes would be as aggressive in other children in Canada and the U.S. But she’s seen similar rates of type 2 diabetes among Latino children in San Antonio.

Dean said her patients’ complications didn’t stem from a lack of access to health care, because Canada’s health care system provides all medications, health care supplies and doctor visits. But like many people with childhood illnesses, some of them did not receive regular medical care once they reached adulthood.