Type 2 diabetes has been described as a growing epidemic, a pandemic, and the largest healthcare crisis facing the world, especially the subset of Type 2 diabetes found in children and young adults. The growth is all the more startling when you consider that just a few decades ago, Type 2 diabetes was considered a disease for the elderly – something that you only got as you were descending the slope from middle age. In fact, it was so rare for children and young adults to get Type 2 diabetes, that Type 1 diabetes picked up the name “juvenile diabetes”.
In the last 20 years, however, we’ve seen a disturbing trend of soaring Type 2 diabetes in young adults. Even worse, a higher and higher percentage of these new Type 2 diabetes cases are requiring insulin injections – something that was not seen in any but the most unmanageable Type 2 diabetes cases in the past. So what has changed, and what can we expect to see in the future? And why is insulin starting to play such a major role in Type 2 diabetes treatment?
A Growing Concern
The latest numbers report that the UK health system diagnoses 300 new cases of Type 2 diabetes in children under 16 annually. In the US, the most often-seen number is 4000 new cases of Type 2 diabetes in those under 20. While those numbers might not seem huge compared to the population in those countries, 62.74 million and 313.9 million respectively, they represent a huge growth over the number of new cases diagnosed even a decade ago, and researchers warn that the trend for new cases per year is going up.
While the exact causes of this increase aren’t fully known, most researchers blame an increasingly sedentary lifestyle combined with a greater reliance on processed and fast food. Since obesity is such a major risk factor for Type 2 diabetes, the increase in obesity rates is also helping to drive up cases for Type 2 diabetes across the world. In fact, there is a strong correlation between a nation’s obesity rate and the rate of growth in new Type 2 diabetes diagnoses.
Type 2 Insulin Dependent
For many years, insulin was considered a last-case treatment for Type 2 diabetes. If blood glucose levels were not controllable with oral medications like metformin, dietary changes, and exercise, patients with Type 2 diabetes would occasionally be given either rapid-acting insulin to use on an as-needed basis, or (even more rarely) would be put on an intermediate- or long-acting insulin regimen.
With the increase of Type 2 diabetes onset at a younger age, however, researchers warn that insulin treatments for Type 2 patients are going to increase dramatically over the coming years. Part of the reason for this is that Type 2 diabetes is a progressive disease – the longer you have it, the more difficult it becomes to control blood glucose levels with oral medications, diet, and exercise. A younger onset age means an increasingly large portion of the population with Type 2 diabetes will have had it for a significantly longer time.
A secondary factor, and one that has stymied diabetes professionals, is that treatment needs for Type 2 can be drastically different in younger patients than in traditional older Type 2 patients. In fact, recent studies have shown that for many children and young adults with Type 2 diabetes, exercise, diet, and an oral medication alone very frequently don’t produce the kind of diabetes control that they do in adults. This is leading to a radical rethinking of how type 2 diabetes is treated, with a new emphasis on using insulin more often and starting at an earlier point in the treatment plan.
It’s hard to say what advances in diabetes treatment will mean and how effective they will be at combating the growing wave of Type 2 diabetes. With more and more physicians recommending insulin therapy at an earlier point in treatment, it’s possible that in the near future we’ll begin to see a coming together of treatment plans for both Type 1 and Type 2.
One promising development, the bionic pancreas – a fully automatic insulin pump that reads blood glucose and provides insulin dosing in real time – may become a one-size-fits all treatment. New research into medication for treating Type 2 may be able to stop or even reverse some of the damage caused by Type 2 diabetes. Or perhaps we’ll even see a cure for one or both types in the next decade or so.
Until then, though, we would strongly suggest that people with Type 2 diabetes begin to brush up on insulin and how it’s used, because it is increasingly likely that they may need to factor it into their treatment plans in the near future.