Growing number of children diagnosed
with Type 2 diabetes

According to the latest figures from the Centers for Disease Control (CDC), there are more than 17 million Americans with diabetes, up 50% over the past decade. Here in Texas, for the year 2000, the estimated prevalence of diagnosed diabetes (90% to 95% of which is Type 2) among adults 18 years and older was 6.2%. An additional 450,500 (3.6%) adults over age 20 in Texas were estimated to have undiagnosed diabetes. If this trend continues, approximately 1.6 million adults over the age of 18 will be diagnosed with diabetes in the year 2025. The numbers by racial/ethnic group may reach 660,000 for Hispanics; 650,000 for non-Hispanic Whites; 260,000 for African-Americans; and 80,000 for other groups. Of great concern is the number of children now being diagnosed with Type 2 diabetes. The latest figures from the CDC show that one in three (33%) children born in the U.S. will develop the disease.
Once a true medical oddity, children with adult diabetes are becoming commonplace. At hospitals and clinics across the country, boys and girls who range from "chubby" to hugely obese are being diagnosed in unprecedented numbers with Type 2 diabetes. Most are barely into their teens and some as young as six. This disease used to be called adult-onset diabetes, since it rarely occurred before middle age. However, over the past decade, it has slowly become clear that this is now a disease of the young, as well. Healthcare providers are now convinced that kidney failure, blindness, heart attacks, and amputations will be more commonplace amongst young people as they live another 10 to 20 years with their diabetes. Virtually all children with Type 2 diabetes are overweight and nearly all of them have a skin condition called acanthosis nigricans (AN).
AN is a physical skin finding first described by a German dermatologist in 1889 characterized by a light brown-black, velvety, rough, or thickened areas on the surface of the skin. This condition seems to be intensified in dark-skinned individuals. Pigmentation is usually concentrated on the following areas:
o Around the neck
o Armpits
o Over the knuckles
o Elbows (front & back)
o Knees (front & back)
o Soles of the feet
o Inner thighs (groin area)
o Skin folds in the abdomen and back
It is most prominent and more frequently seen on the back of the neck. Sometimes patients will seek medical attention because of their concern and comments from others. However, bear in mind that AN may sometimes not be readily apparent unless it is looked for carefully. For instance, it may show up as sharply contrasting shapes and shades of pigmentation; markers will differ from paler skin.
AN can begin at any age, but is most frequently seen in preadolescence. The condition may be caused by:
o High insulin levels indicative of insulin resistance
o Obesity
o Type 2 diabetes
The ethnic groups at greatest risk for developing this skin condition are Hispanics, African-Americans, and Native Americans.
A study conducted in 1999 at United Independent School District and Laredo Independent School District screened 11,745 3rd, 6th, and 9th graders and found that almost 19% of the children had AN.

United Independent School District
Acanthosis Nigricans Screening Program
1999-2000

Grade Class Number Positive Percentage
Enrollment Screened Findings
Third 2,152 2,030 180 8.86%
Sixth 1,886 2,336 220 9.41%
Ninth 2,078 2,175 228 10.48%
Totals 6,116 6,541 628 9.60%

Laredo Independent School District
Acanthosis Nigricans Screening Program
1999-2000

Grade Class Number Positive Percentage
Enrollment Screened Findings
Third 1,395 1,392 416 30%
Sixth 1,932 1,932 290 15%
Ninth 1,950 1,880 275 14.6%
Totals 5,277 5,204 981 18.9%

Recent studies indicate that in most cases AN markings, as well as high insulin levels, tend to decrease through proper nutrition, exercise, and weight reduction. If AN is present, the following steps are recommended: 1) Visit with your physician and get the appropriate exams to determine the status of your glucose and insulin levels. From there, your physician may recommend some 2) nutritional counseling and 3) exercise to help your body become more sensitive to the insulin it produces.

For more information, please contact Marta Stineff, Lado A Lado program coordinator for the Gateway Community Health Center, Inc., at (956) 523-3670