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October 26, 1999

Research: Other

Question from Knoxville Tennessee, USA:

About a year and a half ago I made an inquiry concerning whether or not there had been any studies regarding differences in African American Children with type 1 diabetes. The response was there appeared to be something present or absent (I can not remember which) in Hispanics and African Americans that was not in Caucasian children. The response said that further studies were be conducted. Do you have more information on this or could you direct me to an information resource?

Answer:

There are many studies being done about an apparent epidemic of diabetes in not only African American but also Asian American, Native American and Hispanic children in the United States. It is likely that this is also going on in other places in the world but perhaps not yet recognized. Certainly it is also true in Canada in the same populations.

I am participating in a special task force headed by Professor Arlan Rosenbloom of the University of Florida in Gainesville on behalf of the American Diabetes Association. We will meet at the end of August to prepare a position paper that will likely be published a few months from then describing the situation at present and making recommendations for funding and specific studies as well as treatment. Some of these youngsters present with ketoacidosis and some with mild blood glucose elevations and not much of anything else. Often they are overweight and some are very hairy (hirsutism) as well as have excess adrenal hormone production. Some of the young girls and women have polycystic ovary syndrome. Many also have acanthosis nigricans, a thickening of the neck and other skin areas that goes along with insulin resistance. Some need insulin but many really have forms of Type�2 diabetes that respond to weight loss, increased exercise and the same types of pills that are used for adults with type 2 diabetes. Current feeling is that this is all related to obesity and lack of exercise in susceptible populations who would get type 2 diabetes later — but because of the weight increasing so much earlier than in the past, the abnormalities are showing up earlier.

Hope this helps. If you have access to a medical search book or website [such as PubMed] you can use the key words: type 2 diabetes, children, adolescents, acanthosis nigricans, hypertension, hyperlipidemia, PCOS and hyperandrogenism to find many references over the past five years.

SB