Diabetes before age 20 leads to a high risk of kidney disease

CHICAGO, July 26: Type 2 diabetes before age 20 leads to a high risk of kidney disease and death by middle age, a significant finding because worldwide obesity is exposing more children to the disease, researchers said.

In the United States so-called adult onset or type 2 diabetes will be more prevalent than juvenile or type 1 diabetes in children within 10 years, the study from the National Institutes of Health said yesterday.

The findings reported in this week's Journal of the American Medical Association were based on a study of more than 1,800 U S Pima Indians between 1965 and 2002. Some of those in the study developed diabetes before age 20 while others came down with it between the ages of 20 and 55.

The study found that those who developed the disease earlier had end-stage kidney disease in their middle years at a rate that was up to eight times higher than the older group. In addition their death rate was 2 times higher than the older group.

The younger group is harder hit, the report said, because the disease has more time to be destructive. And while youth appears to provide some protection against the vision loss that is a complication of diabetes, it does not stop kidney damage, which can also lead to heart disease.

The findings ''may heave a significant economic and public health impact because individuals with youth-onset diabetes mellitus who develop diabetic kidney disease have a high morbidity during their peak productive years and may require increased and sustained health services,'' the study concluded.

The current increase in obesity in children and adolescents in many parts of the world had led to a higher prevalence of type 2 diabetes in those groups, the study said.

Type 1 diabetes is an autoimmune disease in which the immune system attacks the cells that produce insulin. It is treated by insulin replacement, and can affect both children and adults, though it is commonly called ''juvenile.'' Type 2 diabetes occurs when the body can't make enough insulin or properly use what it has, and it can be treated with diet, exercise, weight loss and insulin replacement. Though called ''adult onset'' it increasingly affects older children and adolescents and can account for 90 per cent of all diabetes cases in some countries.

REUTERS