We always tend to associate type 1 diabetes with childhood and type 2 diabetes with late adulthood but the reality is both can occur at any age. Furthermore, we are now seeing an increased number of teenagers being diagnosed with both types of diabetes. It may co-incide with the peak of physiological pubertal insulin resistance towards the end of puberty. Often these teenagers are asymptomatic or may present with vague symptoms of weight loss / weight gain, excessive thirst, frequent urination or ketosis.
The reason for diabetes developing in adolescence may be related to various genetic factors, behavioural factors (unhealthy eating habits, lack of physical exercise) or even follow a traumatic event or severe illness. Diagnosing diabetes at this stage may be quite complex as the expected normal values clinicians are accustomed to, do not always apply. It may even require ongoing testing of blood glucose levels over a period of time to detect subtle changes in glucose levels.
The international obesity epidemic has not escaped teenagers and type 2 diabetes is fast becoming a serious threat to this age group. Those at high risk of developing diabetes (family history, obese, sedentary lifestyle) should be screened from age 10 or the start of puberty and repeated every 3 years throughout adolescence. Other criteria that may encourage diabetes screening are signs of insulin resistance including polycystic ovarian syndrome, menorrhagia, hirsuitism, abnormal cholesterol profile or a maternal history of diabetes / gestational diabetes.
Very little published evidence is available to give accurate information about the risk of diabetes in adolescents and the potential to develop complications such as eye or kidney disease, heart complications etc. It’s probably best to follow the usual common sense advice of controlling blood glucose levels as strictly as possible and pro-actively screening for potential complications on a regular basis.
Huge strides still need to be made in preventing diabetes in adolescents but the good news is we do have good medication to offer and many tools to make blood glucose control much simpler and more effective. If you know someone at risk, encourage them to get tested and repeat the screening on a regular basis; seek good medical care and make the lifestyle adaptations that will reduce the risk of diabetes complications.