Type 1 diabetes on the rise in California, United States

Michael Flowers, 12, remembers well what it was like when he was admitted to the hospital and diagnosed with type 1 diabetes. Flowers was 8 when his mother first suspected he might have the illness because he had started drinking a lot of water and urinating frequently.

“I had to take a shot, but I thought it was too big so I faked it and went into the restroom,” said Flowers, who is from North Salinas and now a seventh-grade student. “I was crying and my mom came in.”

“It took a couple days for him to allow me to give him the shot,” said his mom, Kelly Flowers-Goulart.

As with all people diagnosed with type 1 diabetes, Flowers needs insulin each day to keep his blood sugar levels at the right level. If it dips too low, he is at risk of losing consciousness or having seizures. If it gets too high, he is at risk for other complications.

Type 1 diabetes is an autoimmune disease in which the immune system attacks the cells in the pancreas, eliminating the body’s ability to create insulin. While the onset of type 2 diabetes is associated with lifestyle factors such as a diet high in fat and carbohydrates as well as a lack of exercise, type 1 is thought to be caused by a genetic mutation.

Of those diagnosed with diabetes, 90 to 95 percent have type 2, according to the Centers for Disease Control and Prevention.

But a recent research finding is triggering more concern about type 1 diabetes as the rates appear to be increasing.

At the turn of the last century, 1 in 100,000 people were diagnosed with type 1 diabetes in the United States, according to a spokesperson from JDRF, a research and advocacy nonprofit devoted to finding a cure, treatment and prevention options for type 1 diabetes.

Now some researchers say the prevalence is closer to 1 in 300, with the prevalence going up by 3 percent a year for the last eight years.

“If it’s a genetic mutation it shouldn’t change over time,” said Kimberly Chisholm, a member of the JDRF executive board of directors as vice president of research. “With something rising as quickly as type 1, we need to look for some kind of environmental factor.”

The increase in the rates was announced in June at the American Diabetes Association meeting. In 2001, the CDC and the National Health Institute started funding a study called SEARCH for Diabetes in Youth. One of the key reasons for the study was to gather statistics on those diagnosed with diabetes under the age of 20 because the prevalence of type 2 had been increasing in young adults in the last two decades. The study has tracked 5.5 million youth under the age of 20 since 2002.

“Reports of increasing frequency of both type 1 and type 2 diabetes in youth has been among the most concerning aspects of the evolving diabetes epidemic,” according to the CDC website.

To gather data, they enlisted seven hospitals including Kaiser Permanente Southern California, in Pasadena.

Chisholm said researchers are now looking into the possible causes of the increase in type 1.

She said scientists have a few theories, but studies still need to be conducted. Some theorize that a decrease in vitamin D levels may make people more vulnerable to developing the chronic disease.

“There are fewer incidences close to the equator, and Finland has a high rate,” Chisholm said, in reference to sun exposure. “Some believe the lower amounts of vitamin D might account for it. People are using more sunscreen.”

Others have theorized that consumption of cow’s milk or less exposure to allergens could also trigger the disease.

The Bay Area chapter of JDRF is one of many chapters that is working to raise money for research as well as dispel myths about the disease. For instance, it is no longer referred to as juvenile diabetes because at least 50 percent of those diagnosed are 18 years or older. She said one of the other big myths is that people who develop type 1 didn’t exercise enough or manage their health. Parents also often do not recognize the early symptoms of type 1 diabetes, which includes extreme thirst and frequent urination, weight loss, fatigue and a fruity or sweet smell on the breath.

“It’s an enormous burden on the healthcare system,” Chisholm said. “It’s a concern, management of the disease, especially type 1. We are getting better with insulin pumps and meters. Part of that is because the population is growing so the market share is growing.”

Flowers-Goulart said she likes that JDRF keeps parents informed on what research is going on and they sponsor events for families. Michael has a team set up to raise money as part of an Oct. 20 Walk to Cure Diabetes that will be held in Salinas at the Mazda Laguna Seca Raceway.

The family has a new routine now, but it took awhile to adjust to things. Flowers-Goulart said she used to make her own recipes and just threw everything in. But after Michael’s diagnosis she had to start premeasuring ingredients to track the carbohydrates. Michael’s diet was further complicated a year later when he was diagnosed with celiac’s disease, another autoimmune disorder.

Flowers still has the backpack he received from JDRF when he was in the hospital to receive his diagnosis. The agency gives out the bags so kids have something to carry home their new medical supplies, which include lancets, test strips, a blood sugar meter, insulin injection pens and more. Flowers held up the JDRF teddy bear he received in the hospital and demonstrated how doctors and nurses showed him where he would need to prick his finger to test his blood sugar or inject insulin.

Flowers said he is looking forward to hanging out at the October walk with other kids who have the disease. His father Richard Goulart said the walk is also a chance to see what new supplies or equipment are available. The family initially learned about the insulin pump Michael uses at one of the JDRF events.

“I like the fact that the money goes to JDRF,” Goulart said. “We saw Mikey’s pump there and we are seeing new stuff that is coming out.”

There are four Walks to Cure Diabetes across the Bay Area in October, including California’s Great America, in Santa Clara, on Oct. 7, the Oakland Zoo, on Oct. 14, the Salinas race on Oct. 20, and Great Meadow at Fort Mason on Oct. 28. For more information on JDRF, type 1 diabetes or starting a team to participate in one of the walks, visit www.jdrfbayarea.org.

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