Chicago Health

The Diabetic Misconception

Being young and thin is not a free pass from diabetes

By David Himmel

There’s an assumption that diabetes is only for the old and overweight. It’s not true. Today, the young and thin are being diagnosed with more convoluted versions of the disease.

November is American Diabetes Month. Designed by the American Diabetes Association (ADA) to bring about awareness and put a stop to the disease, now is as good a time as any to understand how you can potentially avoid the disease that could have you in its sights.

“Diabetes is very complex,” says Dr. Ilene Yohay, an endocrinologist at St. James Hospital and with Horizon Healthcare Associates in Olympia Fields and Flossmoor, respectively. “It’s never black and white. Diabetes is grey.”

Only 5 percent of the population has Type 1 diabetes, according to the ADA. Type 1 is found mostly in children and young adults. Those with Type 1 are unable to produce insulin, which is the hormone needed to turn sugars and starches into energy.

Perhaps because of the early onset and diagnosis, Type 1 can easily be managed with insulin therapy, and those with it can live long and healthy lives. The other types are trickier.

Type 2 diabetes lets the body produce insulin, but the cells are unable to process it into the needed energy. Because having Type 2 is often a result of obesity, inactivity and age, this type increases the risks of heart disease, kidney failure, blindness and circulatory issues in the limbs that could lead to amputation.

According to the National Institute of Diabetes and Digestive and Kidney Diseases, an estimated 10 percent diagnosed with Type 2 diabetes have latent autoimmune diabetes of adults or LADA. It’s a tricky diagnosis because those with LADA often display signs of both types 1 and 2. Hence it’s other name, Type 1.5. Early stages of the disease will act more like Type 2, but as it progresses, even with proper treatment, it can show Type 1 symptoms. Many of those diagnosed with Type 1.5 are thin, even while displaying symptoms found in obese patients. This makes the misdiagnosis all the more common and explains Yohay’s grey area.

Meanwhile, doctors are finding more cases of Type 2 in children.

“Classic Type 2 is still the disease of the sedentary, overweight, middle-aged nonwhite,” Yohay says. But because diabetes is affected by genetics, and there has been an increase of obese children in recent decades, the disease associated with sedentary, heavy people is manifesting at a younger age because all the variables are there.

The Center for Disease Control and Prevention (CDC) reports that 17 percent of children and adolescents are obese. Dr. Sean Cahill, a specialist in internal medicine and pediatrics who sees both adults and children as a member of the Central DuPage Physician Group in Naperville, says he is seeing more and more youngsters with Type 2 diabetes. “In general, I make it a point with most of my patients—especially overweight patients with Type 2 diabetes—to tell them that it is a disease that patients can control because they can avoid taking medicine by losing weight, exercising and watching what they eat. The earlier you catch Type 2 diabetes, the better chance you have of breaking bad eating habits and getting kids up off the couch and outside riding their bikes and playing sports and burning calories.”

To Yohay’s point, diabetes is rarely cut and dried, and neither are its treatments. “If current therapy isn’t working, you’ll have to reevaluate what you’re dealing with,” she says.

Because of the variance of diabetes, new therapies are being developed and implemented. One of the latest treatments being used is a hormone injection known as a GLP inhibitor. This is an ideal treatment when insulin is not needed such as with types 1.5 or 2 patients.

Overall, there’s plenty that people can do to stave off a diabetic onset. Healthy diets, regular activity and exercise can help keep types 1.5 and 2 away, regardless of age, weight or genetics. The biggest mistake we make when dealing with diabetes is thinking that it can’t happen to us. And that’s exactly the kind of sedentary thinking that diabetes feeds on.

Nancy Maes contributed to this report.