Jorge Mestman, M.D., professor of clinical medicine at the University of Southern California, has seen a lot during his three decades as a doctor-but what he regularly sees among his patients these days, particularly among Latinos, he says, is alarming.
"We're seeing diabetes diagnosed much earlier in life than ever before," says Mestman, director of the Center for Diabetes and Metabolic Diseases at USC. "We're seeing it among teens and people in their 20s."
Mestman wants more people, especially Latinos, to be aware of the disease, get tested for it and to make changes in their lifestyle to delay or prevent it.
The diabetes in question is called type 2, or noninsulin-dependent diabetes mellitus. Here's how it works: When a person eats, the body ordinarily turns food into glucose, or sugar, to use as fuel. In healthy people, a hormone called insulin helps move glucose into cells. But in people with type 2 diabetes, something goes awry-the body might not make enough insulin, or the cells ignore it.
It's a lifelong disease for which there is yet no cure, and it may cause serious kidney disease, blindness, leg amputations and cardiovascular disease.
The prevalence of type 2 diabetes is twice as high in Latinos as in non-Latino whites, according to the American Diabetes Assn. About 1.2 million Mexican-Americans, or 10.6 percent of the Mexican-American population, have this type of diabetes. And more and more of them are children and young adults.
"In the old days, the children identified with diabetes would normally be type 1," says Mestman. In type 1 diabetes, the body attacks and kills cells in the pancreas, which makes insulin. Type 1 sufferers must use insulin injections and oral medications; type 2 sufferers can control diabetes with diet and exercise, though some may need injections as well.
At USC-affiliated Children's Hospital Los Angeles (CHLA), 35 of every 185 new children's diabetes diagnoses are type 2, say CHLA physicians.
Mestman says the big culprits appear to be inactivity and obesity. And it makes sense: 75 percent of patients diagnosed with type 2 diabetes are obese, and by the government's estimate, about 6 million American children are now overweight enough to put their health in danger.
"The good news is that with the proper change in lifestyle, you may prevent development or delay the onset of this type of diabetes," Mestman says. "And the whole family needs to do that, not just one family member."
Mestman recommends getting a screening for diabetes, which is a quick and simple blood test. Type 2 diabetes often shows no symptoms until a patient's blood sugar gets very high. The screenings are particularly important for those who have other family members with type 2 diabetes, are overweight, weighed more than nine pounds or less than five pounds when they were born or had babies that weighed nine pounds or more at birth, have high blood pressure or have high cholesterol.
The main treatment for early stage diabetes is altering a patient's meal plan and increasing physical activity, such as taking walks regularly, he says. If that doesn't help within a few weeks, physicians can prescribe medications that help.
Finally, Mestman says, patients need to be careful with diabetes and pregnancy. Latinas tend to have a higher risk for gestational diabetes-diabetes that appears during pregnancy and eases after childbirth. Women who have had gestational diabetes have a significant risk for getting type 2 diabetes later, so they need to be followed by a physician. And women with type 1 or 2 diabetes who want to become pregnant should check with their physician before pregnancy, as well, to prevent complications.