Diabetes is a common metabolic disease in America. Almost 10% (over 33 million) of the American population has diabetes. Over 90% have type 2 diabetes and the rest (10% or 1.30 million) have type 1 diabetes. There are also about 84 million prediabetics in America.
Childhood diabetes (children <19 yearsold) make up a small fraction of over all diabetes. Currently, about 300,000 (0.30%) children have diabetes (type 1 and type 2) in the USA. About 220,00 or 85% of childhood diabetes is type 1 diabetes and 15-20% (55,000) have type 2 diabetes. There are about 20,000 new onset type 1 diabetes and about 5,000-6,000 new onset type 2 diabetes children every year in the USA.
Childhood type 1 diabetes can occur at any age, though it is more prevalent in the adolescent age group. Type 1 diabetes is more common in the caucasian population than any ethnic group. The diabetes susceptibility genes are more clastered on this ethnic population. Type 1 diabetes is an autoimmune destruction of the insulin producing beta cells of the pancreas. Currently insulin is the only available treatment for type 1 diabetes.
Type 2 diabetes is more common in the minority population. Type 2 diabetes can occur in young children as young as 5 years old.
Before the 1990s type 2 diabetes in children was unheard. Childhood type 2 diabetes was about 3% of the diabetes in children though in adults it was over 90%. In the last 30 years type 2 diabetes in children has been catching up to about 15%, mainly due to the epidemic and/ or pandemic of obesity and metabolic sydrome.
In native American children most of the childhood diabetes is type 2 diabetes.
Childhood diabetes in the African American population still 60% is type 2 diabetes and the rest is type 1 diabetes. In the Hispanic population type 2 is catching up to the level of type 1 diabetes.
In the Caucasian population (children) type 1 diabetes is the highest, though type 2 diabetes is increasing, but also type 1 is increasing more than type 2.
In the Caucasian population type 1 is increasing at a rate of 1.2 % while type 2 is increasing at a rate of less than 1 % (0.6%) annually ( both of them are increasing). In minorities, the African American, Hispanics, Native Americans and Asian Americans type 2 diabetes is increasing at a higher rate (6.3%, 3.1%, 9%, 8.5%, respectively) than type 1 diabetes in children though both of these diabetes are on the rise.
It is predicted that both types of diabetes will continue to increase in the future. Childhood type 2 diabetes will continue to increase until obesity rate stabilizes in the future. In some centers type 2 diabetes is the most encountered diabetes in children.
Type 2 diabetes is mainly driven by over weight and obesity, though strong family history and genetic susceptibity, gender and ethnicity also play a major role. With the epidemics of childhood overweight and obesity, type 2 diabetes in children is being encountered in children as young as 5years old. Because diabetes is starting much earlier and will have longer duration it will expose them to complications of diabetes at an early age and may cause shortens their life expectancy by as much as 20 years.
In average type 2 diabetes takes about 5-10 years to evolve (to have full blown symptoms of diabetes) in most cases. Over 50% of children with type 2 diabetes will have no symptom during diagnosis. Therefore many children with diabetes are not diagnosed at the right time. Initially the person will develop a state of prediabetes before developing type 2 diabetes. Even the prediabetes state will have metabolic insult similar to diabetes. Therefore type 2 diabetes in children has a greater risk for future complications.
The first line of treatment in children with type 2 diabetes is healthy diet, regular structured daily exercise and modest weight loss (maintaining close to ideal weight). medications may be added as indicated, mainly metformin.
Going back to your niece: Yes, diabetes can develope at a youg age. Type 1 diabetes can occur at any age age though it is more common during adolescent age. Type 2 diabetes can develop at a young age, as young as 5 years old. And in some circumstances even at younger age. Obesity (insulin resistance) is the primary driving force in childhood type 2 diabetes.Overweight children from minority ethnic groups who have genetic susceptibility and a strong family history are at a higher risk for type 2 diabetes. If there is a family history and a genetic susceptibility a little weight gain may be sufficient enough for type 2 diabetes. Sometime you can have type 2 diabetes with reasonable weight. So there are many factors in to making type 2 diabetes. However weigh gain plays a bigger role in the development of type 2 diabetes..
You need to make sure your niece loses weight through healthy balance diet and regular/structured daily physical activity. she needs to maintain a healthy, safe weight to avoid developing diabetes. She should see a good nutritionist for dietary counseling. You can also follow the my plate method of the USAD recommendation for healthy nutrition. She needs to participate in daily moderate to vigorous physical activity for at least an hour a day for at least 6 days a week. She needs to discuss these issues with her doctor in detail with an open mind.