The girl, from a Hispanic family, was diagnosed in Houston, Texas, by Dr Michael Yafi, a paediatric endocrinologist with the University of Texas. In a written presentation to the European Association for the Study of Diabetes conference in Stockholm, Yafi said she had been brought to his clinic because she was obese.
The girl weighed 35kg (5st 7lbs), putting her in the heaviest 5% of children her age. She was also in the top 5% for height and body mass index (BMI), a measure of obesity.
The child was suffering from excessive thirst and frequent urination, but her medical history was otherwise unremarkable. She was born at term weighing 3.2kg(7lbs). Although both her parents were obese, there was no family history of diabetes.
A review of the family’s diet found they had “poor nutritional habits”, the conference heard. Their food was high in calories and fat. Tests suggested diabetes, but the results ruled out type 1, which usually has its onset in childhood.
“Based on symptoms, physical findings of obesity and laboratory results, the diagnosis of type 2 diabetes was made,” Yafi said.
The child was put on metformin, an oral drug given to people with type 2 diabetes. Her family was asked to change the types of food they most often ate and to eat smaller portions, and to encourage the girl to be more active.
The treatment worked. The girl lost weight and the drugs were gradually reduced over six months, at the end of which she was 75% of the weight she had been when she first arrived at the clinic. Her blood glucose levels had returned to normal and she no longer had type 2 diabetes.
“Reversal of type 2 diabetes in children is possible by early screening of obese children, early diagnosis, appropriate therapy and lifestyle modification,” Yafi said.
“The incidence of T2DM [type 2 diabetes] has increased dramatically worldwide in children due to the epidemic of child obesity. Clinicians should be aware of the possibility of type 2 diabetes even in very young obese children, although, of course, type 1 diabetes can also still occur in obese children and is in fact much more common in young children than type 2 diabetes.”
Diabetes UK estimates that around 600 children in the UK have type 2 diabetes, a very small number of whom will be younger than 10.
The numbers are believed to be rising. Type 2 diabetes was unknown in children in the UK before 2002. A study by Julian Shield and colleagues from Bristol Royal Hospital for Children found 168 cases in 2005 of what they called “non type 1 diabetes” in children and adolescents under the age of 17, of whom 95% were overweight and 83% obese. The team is now repeating the study to find out by how much the numbers have risen.