Black youths: the new face of diabetes: as African-American youngsters have become heavier, half of then are predicted to be diagnosed with the disease during their lifetime

Ebony, March, 2008 by Kevin Chappel

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To friends and family, Bryan Moore, 14, was always considered to be a cute, chubby kid who loved fast food. "Pizza, burgers, fries, candy, I would eat anything that tasted good," says the Baltimore ninth-grader who, at his heaviest, weighed 220 pounds.

It wasn't until one day at dinner that his mother, Virginia, realized that her son's weight was nothing to take lightly. "I will never forget that day. When we went out to dinner, he got really tired and sleepy," she says. "He couldn't sit up."

"I kept dozing off, and my morn kept waking me up," Bryan says. "I was scared. I thought that I was going to die."

Moore rushed her son to the emergency room. His situation was so serious that doctors kept him in the hospital three days. The diagnosis shocked his mother. Bryan's excessive weight had triggered type 2, or adult-onset, diabetes. He was eating himself to death.

"I didn't know," Moore says of her son's condition. "Everyone would say to me, 'He's just so cute and chubby.' No one told me that there could be underlying dangers to my son being overweight as a kid."

Type 2 diabetes, which in 1994 represented less than 5 percent of new diabetes diagnoses among youths, now accounts for as much as 50 percent of the new cases in children, according to latest estimates from the Centers for Disease Control and Prevention (CDC). As many adolescents are now being diagnosed with type 2 diabetes as those with the less-ravaging type 1 form, which traditionally victimizes younger children.

The increasing rate of type 2 diabetes among children is believed to be a result of the dramatic rise in adolescent obesity, particularly central obesity or belly fat, which has been found to trigger the body to resist insulin.

And nowhere can that weight gain be seen more than in African-American youths. Today, close to 24 percent of African-American children are obese (a 10-year-old child, for example, who is 4-foot-6 is considered to be overweight if he or she weighs more than 97 pounds, according to the Body Mass Index). In fact, the rate of obesity for Blacks is double what it was just two decades ago and twice the rate of White adolescents.

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Excessive weight gain coupled with a genetic predisposition for diabetes among African-Americans has made Black youths (ages 10 to 19) the new face of type 2 diabetes.

According to the World Health Organization, worldwide obesity and obesity-driven diabetes has reached epidemic proportions. In fact, obesity has overtaken AIDS and malnutrition as the top health problem in the world, and diabetes has become the first non-infectious disease that, the health group says, presents "a significant heath threat" to the world.

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In some U.S. cities, childhood type 2 diabetes has increased fivefold in the last decade, with overweight African-American adolescents accounting for nearly 90 percent of the new cases. In fact, the CDC predicts that if the problem persists, half of the African-American children who were born in 2004 will develop diabetes during their lifetime.

"What we see going on in our community rises to the level of an epidemic," says Dr. Eugene E. Wright Jr., medical director for Primary Care Services for Cape Fear Valley Health System in Fayetteville, N.C.

Wright says "the perfect storm" has created an explosion of diabetes among Black youths. "You have the cultural and ethnic proclivity for developing diabetes by being African-American, you have increased obesity because of what we see in terms of the foods that our children are exposed to, then, on top of that, children arc less active relative to 20 years ago," he says. "You take those three factors together and those lead to this explosion of diabetes that we see in our children."

The diabetes epidemic in children has prompted the American Diabetes Association (ADA) and the American Academy of Pcdiatrics (AAP) to jointly recommend that youths who are obese and have a first- or second-degree relative (such as one's mother or cousin) with diabetes be tested for the illness around age 10. This would result in testing about l0 percent of all young people.

Wright, who has diagnosed children as young as 9 with diabetes, says the effect of the disease on youths will be devastating. "The complications of diabetes take 10, 15, 20 years to develop," he says of complications, including blindness, kidney failure and amputations. "When you develop diabetes at age 40, the complications will start to occur around age 60, which is not good, but at least you have lived a relative healthy life. But when you develop diabetes at age 10, it puts you into those complications much earlier."

To make matters worse, medical experts say that half of the children diagnosed with diabetes don't comply with care recommendations, sometimes because of teasing by peers or lack of family support. Also, the silent nature of type 2 diabetes, whose damage isn't immediately identifiable, can lead children and their parents to ignore health recommendations.