New research warns of upcoming increases in cases for young people, but new technology and prevention efforts offer hope
New research from the American Diabetes Association shows that diabetes in those under the age of 20 will increase significantly in the coming decades. Research suggests that Type 1 diabetes will increase by 65% and that Type 2 diabetes will increase 700% in those under the age of 20 by the year 2060.
Dr. Ashley Thorsell, endocrinologist at Sansum Clinic, told the News-Press that the study showed “… the greatest burden in the black, Hispanic/Latino, Asian, Pacific Islander and American Indian/Alaska Native children.
“Regardless, this emphasizes the need to focus our research efforts and management of this disease on prevention,” Dr. Thorsell said. “Although it’s more difficult to prevent Type 1 diabetes, nutrition and dietary changes do play a part in the prevention and treatment of both diseases. It is absolutely vital that we ensure our youth are the healthiest they can be.”
Santa Barbara resident Kara Hornbuckle and her two children all have Type 1 diabetes. Ms. Hornbuckle also works for the Sansum Diabetes Research Institute as director of development.
Ms. Hornbuckle spoke with the News-Press recently not only about her own journey with Type 1 diabetes but that of her children as well.
“I have lived with Type 1 for 35 years since I was 6 years old,” Ms. Hornbuckle said. “At the time there were a lot of unknowns for our family. I was the first in the family to develop it and we had so much to learn.
“I had to take insulin injections four to seven times a day and check blood glucose levels about six to 10 times a day. My diet changed significantly; everything was scheduled. There wasn’t a lot of flexibility.”
The News-Press asked Ms. Hornbuckle about the early warning signs of Type 1 diabetes and when she started noticing them in her children.
“Early warning signs include excessive urination, and having to drink a lot more water. You are always thirsty; it is very noticeable. It’s like having six to seven glasses at a time. For both of our kids, we saw that. I remember Lucas at 2 was drinking more and his diapers were filling up frequently.
“We were living in denial because we didn’t want him to live with this disease,” she continued. “So one day, I checked his blood sugar level, and it was so high the machine couldn’t read it. As soon as that happened, I was shocked, but I knew I had to get him taken care of immediately. So I called the Sansum Diabetes Research Institute.
“Dr. Zisser spoke with me, and he told me to go to the ER right away. I took Lucas to the ER, and he started vomiting in the waiting room because blood sugar was so high, and blood work confirmed he had Type 1.”
Dr. Thorsell said warning signs of Type 1 diabetes include “rapid weight loss, increased thirst, increased urination, fatigue and fruity breath. In Type 2 diabetes, these symptoms are likely to be absent, and the disease progression is much slower.”
Ms. Hornbuckle also spoke about the diagnosis of her daughter.
“In December of 2021, it was deja vu when my daughter Kamryn started showing signs. It wasn’t as noticeable, but it was enough to alert my husband to check blood sugar level and we got the same reading as with my son. I was able to work with Dr. Fran Kaufman, a pediatric endocrinologist,” she said.
“Shortly after Lucas came home from hospital, he would hide from us under the table because he didn’t want insulin injections,” Ms. Hornbuckle said. “That was hard for him, and we had to negotiate with him when he needed to eat and when his blood sugar was high. Kamryn had a greater capacity to understand what was going on because she was older, and it was challenging for her to take insulin injections. Sometimes we had to negotiate with her for 30 minutes. I think in the beginning it was traumatizing for her.”
The News-Press asked Ms. Hornbuckle about the development of education in managing the disease.
“I believe education has evolved as technology available has evolved. But now there have been such incredible improvements: from better insulins, to sensors constantly managing blood glucose levels, to insulin pumps,” she said.
Dr. Thorsell said society can better educate people about diabetes by “offering patients innovative technology such as continuous glucose monitors earlier on in their diagnosis (ideally at the prediabetes level), which is crucial to provide patients with real-time glucose data, which is likely to enable immediate implementation of dietary changes and regular exercise, and encourage compliance.
Additionally, continued Dr. Thorsell: “If we can implement diet and exercise modifications early on in the disease process, then we may be able to preserve the burnout of these insulin-producing beta cells in the pancreas, and subsequently patients are less likely to require insulin or other antidiabetic drugs for their treatment.”
According to Ms. Hornbuckle, one of the greatest technological innovations is the Omnipod 5 system, which the News-Press reported on back in March. Ms. Hornbuckle and her two children all use the Omnipod 5 system, which is a patch worn externally and is changed every two to three days.
“I think Lucas had access to the technology before Kamryn because she wasn’t diagnosed. My husband or I would go into his room at night and place our hand on his heart to make sure he was alive. But we realize the Omnipod 5 system is safe and reliable, so that we can sleep peacefully,” said Ms. Hornbuckle.
The News-Press asked Dr. Thorsell what is causing the increase in diabetes.
“This alarming rate could be sparked by multiple factors — ranging from rising rate of gestational diabetes in women of childbearing age (as their babies are more likely to develop diabetes), the rising prevalence of obesity in children in the U.S., the rapid rate of diabetes disease progression in young people compared to adults, lack of emphasis on the importance of dietary and lifestyle changes, lack of available healthcare and proper screening tests in the underserved population.”
Dr. Thorsell said diabetes can be prevented by decreasing “the disparity of health care costs by providing affordable health care and cost of medicines to all people, offer and provide nutrition education and emphasize importance of exercise in prevention of the disease much earlier on, and educating the family as a whole so that the downward spiral of unhealthy eating habits doesn’t progress through generations to come.”
Said Ms. Hornbuckle, “Whenever I hear about a new diagnosis, it is heartbreaking, painful and my heart goes out. But there is so much reason for hope, and the future with this disease will only get better.”