Prevalence of childhood diabetes on rise in Turkey

Although diabetes is very common among adults in Turkey, the disease is also on the rise among children and adolescents. According to the World Health Organization (WHO) 2011 statistics for diabetes, 346 million people suffer from the disease worldwide, a number that is increasing every day.

Dr. Ergün Çetinkaya, associate professor at the private Endömer Pediatric Endocrinology Center in Ankara, told Sunday’s Zaman that 5 million people currently suffer from diabetes in Turkey, 17,000 of whom are children.

The WHO defines diabetes as: “A chronic disease that occurs when the pancreas does not produce enough insulin, or when the body cannot effectively use the insulin it produces. Hyperglycemia, or raised blood sugar, is a common effect of uncontrolled diabetes and over time leads to serious damage to many of the body’s systems, especially the nerves and blood vessels.”

Dr. Nurçin Saka, a professor at the Pediatric Endocrinology Unit of İstanbul University’s Faculty of Medicine, told Sunday’s Zaman that there are two common types of diabetes. Type 1 diabetes, which is more common in children, is caused by a lack of insulin, a hormone that controls the flow of glucose in and out of cells. Saka explained that type 1 diabetes occurs when the pancreas cannot produce insulin due to damage to the insulin-producing beta cells, a condition that commonly occurs in those with a genetic predisposition to the disease.

According to Saka, while the general prevalence of diabetes has increased over the last 20-30 years, there has been a marked increase in the number of children developing the disease. She added that type 2 diabetes is the most common form of the disease, particularly among adults and the elderly; 85-95 percent of adults diagnosed are suffering from type 2 diabetes. However, incidents of type 2 diabetes have also become more frequent among children due to an increase in obesity, which is generally caused by poor eating habits and low levels of physical activity and exercise.

The Society of Pediatric Endocrinology and Diabetes Chairman Peyami Cinaz told the Cihan news agency that diabetes used to be very rare among children but was occasionally seen in school-age kids or teenagers, but now it can even be seen in children under 5. Stating that diabetes has become a disease that can be seen at any age, Professor Cinaz said the reasons for the increase in diabetes cases in young children are a change in diet, increasing stress and adverse environmental conditions.

Emphasizing the importance of vitamin D in preventing type 2 diabetes, Cinaz said, “There are publications that say a vitamin D deficiency can increase the risk of developing diabetes at an early age; it is also a result of erroneous feeding habits, so a mother should not stop breastfeeding earlier than six months after her baby is born.” He added that a balanced diet and a physically active lifestyle play crucial roles in preventing the development of type 2 diabetes.

Noting that parents’ eating habits determine their children’s diet, Cinaz said parents should carefully manage their eating habits in order to prevent type 2 diabetes. However, socioeconomic status cannot be ignored, as low-income families do not have as many choices, and children in low-income families eat whatever is available in their homes.

“The consumption of fatty and sugary foods and fast food by children should be prevented, especially in schools, so such foods should not be sold in school canteens or anywhere else near schools. Instead of such foods, the consumption of healthier foods -- such as ayran, milk, fruits, vegetables and some meats that contain high levels of protein -- should be promoted in schools,” Cinaz noted.

Cinaz said if type 2 diabetes is not kept under control, it can cause other complications later on in life, such as diabetic nephropathy (a kidney disease), diabetic retinopathy (an eye disease), cardiovascular diseases and digestive disorders. Cinaz also noted, “We generally lose children with diabetes because of these complications, which can develop if children are not treated satisfactorily, not because of diabetes itself.”

Professor Oya Ercan, who specializes in the area of pediatric endocrinology and is working at Memorial Şişli Hospital in İstanbul, said there is no way to prevent type 1 diabetes. Stating that type 1 diabetes is not a temporary disease, Ercan said there is no other treatment apart from insulin injections for patients who suffer from type 1 diabetes. Since type 1 diabetes is a lifelong disease, parents of children suffering from this type of diabetes should accept this reality and help their children manage the disease until they’re old enough to handle it by themselves.

Ercan also added that if parents do not accept the reality of the disease, they can sometimes stop treatment, which can endanger the life of their child.