Dr Sheela Magge

KUWAIT CITY, Jan 30: Pediatric obesity and type 2 diabetes is a growing concern in Kuwait with the increasing prevalence as well as the added risk and early onset of cardiovascular complications. In Kuwait, prevalence rates for the interim overweight category is in the range of 20% while obesity stands at 30%. Moreover, 42% of all new cases of pediatric diabetes is Type 2 in nature, informed Dr Sheela Magge. Sheela Magge, MD, MSCE, is a Pediatric Endocrinologist at the Children’s National Health System. She also serves as the Director of Research for the Division of Endocrinology and Diabetes through the Center for Translational Science, and is an Associate Professor of Pediatrics at the George Washington University School of Medicine and Health Sciences. Dr Magge spoke to the Arab Times on the sidelines of her visit to Kuwait with a group from Children’s National Medical Center who visited Kuwait University and Al Sabah Hospital to deliver several lectures to local physicians on common interests and issues affecting children. She stressed that the increase in incidence of diabetes in childhood brings related complications such as heart disease, high blood pressure, cholesterol problems, earlier. “There is some evidence to suggest that type 2 diabetes in children will progress faster than adults”, she remarked. The rise of pediatric type 2 diabetes can be linked to the rise of obesity which has been increasing over the last three decades due to a combination of genetic and environmental infl uences and impacted by lifestyle factors such as decreased physical activity and a more sedentary routine, decreased consumption of fruits and vegetables and more fast food.

UnawareShe shared that people were unaware of the genetic component and informed that 75% of children with type 2 diabetes have a parent with the same condition making type 2 diabetes more heritable than type 1 diabetes. While adults can avail of many treatment options, the number one treatment for type 2 diabetes in children is lifestyle along with metformin and insulin. “Metformin is the only oral medication that has been approved for pediatric diabetes”, she stated. Increased obesity increases the risk for both cardiovascular diseases as well as diabetes and related complications of high cholesterol, high blood pressure, fatty liver diseases, as well as obstructive sleep apnea.

She pointed out that this Obstructive sleep apnea should not be ignored as the narrowing of the airway results in not enough oxygen reaching the brain. “What people don’t realize is that actually treating sleep apnea helps the metabolic issues as well; it improves how insulin works in your body and decreases the risk of type 2 diabetes.” Moving to the future, she stressed that pediatric healthcare needs to leverage some of the new mobile technologies. “Kids today are very adept in using technology. If we as providers could become equally as adept, I think we could try and devise new interventions.” With regards to treatment, the impact of technology has been remarkable in the case of type 1 diabetes with an increasing number of those affl icted better managing their condition with newer pumps and sensors. “What people are waiting for now is the closed loop artifi cial pancreas.

There are Islet transplants happening so the technology is improving to help kids lead a more usual lifestyle, play sports and everything”, she said. Brunt But Dr Magge warned that we haven’t yet seen the brunt of it. “Earlier, if an adult was diagnosed around 70, complications would emerge when he or she reached the age of 80. Now, if a child is being diagnosed at just 10 years of age, the complications are occuring earlier and the deterioration is happening faster. If you look forward, it could be a huge public health issue.” Dr Magge stressed that prevention is paramount, “One of my interests is identifying children with pre-diabetes, in this category, the condition is re-versible. There is a diabetes prevention program that showed that with lifestyle modifi cation you can revert back to normal. Increasing physical exercise, improving nutrition, increasing fi bre in your diet, fruits and vegetables, decreasing screen time are all important steps to be taken by families.” “We advocate for children to have at least an hour a day of moderate to vigorous physical activity. Limiting screen time is very important, children less than 2 years should have no screen time, and those above 2 should be restricted to 2 hours.” Dr Magge underscored that starting healthy habits early is important and laid emphasis on the point that any kind of obesity treatment should be focused on the whole family. On the wider national scale, healthy food must become more economical and available to people and part of the everyday culture

By Cinatra Fernandes Arab Times Staff