Diabetes becomes a disease of the young

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5-26-04 State Street, Chicago - *** KEY WORDS FOR PICTURE SEARCH: obesity, fat, overweight, diet *** A woman stands at the intersection of State and Randolph Street in Chicago Wednesday. Photo by John J. Kim/Sun-Times

Updated: September 28, 2011 12:19AM

Some people say aiming to look sleek in your swimsuit or wedding duds is the biggest motivator for losing weight. But Mike Durbin’s incentive for dropping pounds beats all.

Three years ago, at age 24, Durbin’s doctor told him he had type 2 diabetes and congestive heart failure. More than 300 pounds at the time, Durbin knew that if he didn’t take action, he faced the possibility of an early death.

“I was probably pushing about 340 when I was first diagnosed. As far as the physical changes go, within about three months or so of being diagnosed I dropped about 40 pounds,” says Durbin, who takes a dozen medications now. Always a meat-and-potatoes kind of guy, he says he had to learn to eat in moderation and now opts for sugar-free foods.

Experts are becoming increasingly concerned about the growing number of people in their 20s and 30s coping with type 2 diabetes, which used to be rarely seen in those under 40.

As diabetes becomes more prevalent in young people, the long-term complications of the condition — cardiovascular problems like high blood pressure and high cholesterol, nerve damage, blindness and kidney failure — are more likely to occur at younger ages, too, says David Kendall, chief scientific and medical officer for the American Diabetes Association (ADA).

“Children and young adults, and young middle-aged people, are the groups in which the rates are apparently growing the fastest,” Kendall says.

The obesity epidemic — the fallout of people eating more junk food and getting less exercise — is an obvious factor in the rise in diabetes cases among the young, says Martin Abrahamson, chief medical officer at Joslin Diabetes Center in Boston.

Complications of the disease are more likely to occur in middle age if not sooner, especially in young adults who don’t take care of themselves or have access to medical care, says Ann Albright, director of the CDC’s Division of Diabetes Translation.

“The longer you live with the disease, the more likely you are to develop the complications. If you develop diabetes at a young age, the chances are greater of complications at a younger age,” Albright says.

Eric Choi, chief of vascular surgery and director of the Limb Salvage Center at Temple University School of Medicine in Philadelphia, fears that if young diabetics don’t get the care they need, by middle age they’ll be marginalized — unable to get jobs or participate fully in life like their peers.

Choi heads a team at Temple working on diabetes-prevention campaigns in the community. He and his team also are using medical techniques, including angiogenesis — growing new blood vessels — in at-risk diabetes patients when they spot vulnerable wounds to help stop further limb damage.

When a young diabetes patient comes through the emergency department doors, he is placed on a diabetes care fast track, which offers nutrition coaching, a vision check-up, and a cardiovascular workup, among other care, all in one shot because, Choi says, if a patient walks out the door between appointments, he is less likely to return.

A lot of changes occur in those years that can affect health, she says, especially in someone with a chronic illness: They move out of family homes and away from parents who help monitor health , they enter college and workplaces where food choices are sometimes poorer and where people may not be supportive, they change insurance plans or go without health coverage, and some marry and have children.

Albright says the Patient Protection and Affordable Care Act, which became law in March 2010, has expanded coverage for some in this vulnerable age group. According to the ADA, previously, insurance companies could deny coverage to people with diabetes or charge more for insurance. Under the new law, however, young adults with diabetes can now stay on their parents’ plans until age 26. By 2014, young patients with diabetes will be able to buy coverage from any insurer and will be protected from being denied because of their diabetes.

Gannett News Service