Source: Radio New Zealand
A teenager with type 1 diabetes uses a CGM – a continuous glucose monitoring device. Amelie Benoist / BSIP via AFP
A specialist in treating childhood diabetes says that some children are born “almost what we call ‘programmed’” to have the disease – but new medicine could help put them in remission
Inked onto award-winning investigative journalist Guyon Espiner’s right forearm in “cursive, fancy, gangster script” is “Diabetic”. On his inner wrist: “Type One”. It’s a permanent and “proud” reminder of the medical condition he was diagnosed with seven years ago.
Espiner was able to show the tattoo to ambulance staff during a diabetic episode that landed him in hospital earlier this year.
He had woken feeling “extremely low and completely delusional because it’s like that feeling of starving oxygen to the brain – I was so low that my brain was not working properly, it didn’t know where I was, it didn’t know what I was doing”.
“I don’t like wearing medical bracelets,” says Espiner, who flashed his tattoo to medical staff to explain his symptoms and behaviour.
“I am also proud to be a diabetic. I am proud to be a Type 1, it’s part of my identity, it’s shaped my life a lot.
Diagnosed at age 47, Espiner is one of more than 300,000 New Zealanders living with diabetes. But he’s in the minority group, with Type 1, which is an autoimmune condition where the body doesn’t produce insulin. It can develop rapidly and is usually diagnosed in childhood. Up to 10 percent of people with diabetes have Type 1.
Type 2 diabetes is far more common – about 90 percent of cases – and happens when your body can’t use insulin properly. It usually occurs in adults, but more and more children are now being diagnosed.
Starship Hospital Paediatric Endocrinologist Craig Jefferies tells The Detail that Type 2 diabetes was once rare for children, but that’s no longer the case in New Zealand, and this should act as a wake up call for the country.
“Type 2 diabetes 20 years ago was very rare. At the moment, we get 70 new kids a year with diabetes, most of them are Type 1 but about 10 percent are Type 2 now … 30 years ago, it was no-one.
“It almost always comes from high-risk ethnic groups, in New Zealand that is Maori and Pasifika. They are not the biggest kids at school but they are on the heavier for weight range, and almost always have a strong history of diabetes in the family, so there is a really strong genetic component.”
Children whose mothers had diabetes during pregnancy are also at an increased risk.
“It’s like a domino effect, there is diabetes in the family, the kids are getting exposed to high blood sugars in utero, getting born almost what we call ‘programmed’, and that’s getting worse as generations come through.
“Sadly we see a number of families where the parents have got diabetes complications, and the parents aren’t very old – kids are 10, mum and dad are 30s, maybe 40s – and unfortunately, we have had a couple where they have died of renal failure or are on dialysis.
“That’s the parents, so we are really keen to treat the children really aggressively to get the diabetes well controlled, we call it, or, even better, in remission.”
He says a recent study shows that “magic” new weight loss and diabetes drugs could be a game changer for Type 2 youth, getting them into full remission and off treatments.
“They could lose significant weight and they won’t have diabetes within four to six weeks if we can get these agents … and they could get on with teenage, normal life.”
But the drugs aren’t currently funded by the government.
“It’s going to cost,” Dr Jefferies says. “I think we need to be able to fund some of these new agents, some of these new diabetic/weight loss drugs to target this group.
“I mean we have a group of relatively small youth onset Type 2, if we can target the new agents, specifically for that, we will have a massive impact on their health, economy, and reducing their risk of long term complications.”
He says early detection is critical, and symptoms include excessive thirst, frequent urination, extreme tiredness or unexplained weight loss.
Dr Jefferies adds that “there’s a lot of stigma on diabetes. Children on insulin are stigmatised, adults with Type 2 are stigmatised. All of us are at risk, whether it’s a random autoimmune event, which is Type 1, or it is part of ageing or high risk genes, you can’t say ‘only they get it’.
“We are all in the same boat and we have to treat it appropriately.”
Check out how to listen to and follow The Detail here.
You can also stay up-to-date by liking us on Facebook or following us on Twitter.
Sign up for Ngā Pitopito Kōrero, a daily newsletter curated by our editors and delivered straight to your inbox every weekday.
– Published by EveningReport.nz and AsiaPacificReport.nz, see: MIL OSI in partnership with Radio New Zealand
