With type 2 diabetes steadily rising among children, the Bronx has the highest rates in New York state, with roughly 16% of adults afflicted with the disease.
The reason for the increase of type 2 diabetes in young people under 20 — which doubled between 2001 and 2017 — is unclear. Childhood obesity, which affects the body’s ability to use insulin, thus causing abnormal blood glucose levels, often factors into type 2 diabetes.
But childhood obesity alone doesn’t explain the major increase in type 2 diabetes over the past decade. And a recent Diabetes Care study suggests that rate could surge nearly 700% to 220,000 in people 20 and younger over the next three decades.
A $4.1 million national grant could help the Children’s Hospital at Montefiore and Albert Einstein College of Medicine uncover some much-needed answers into the disease, its prevalence, and the social and biological risk factors that affect Bronx children.
The study — conducted by The National Institute of Diabetes and Digestive and Kidney Diseases under the umbrella of the National Institutes of Health — will enroll 3,000 children from a variety of racial and ethnic minority populations at 15 clinical sites across the country to better understand what factors have led to an increase in the disease.
In January 2024, Montefiore Einstein will enroll around 250 children between 9 and 14 years old who are clinically overweight or obese and have type 2 diabetes. The study will follow up with those enrolled over the course of two and half years.
“We anticipate that the study will help pediatricians and families in identifying who are the children that are most at risk for diabetes. As of now, we do not have good screening methods,” Dr. Carmen Isasi, an associate professor of epidemiology & population health and pediatrics at Einstein.
Type 2 diabetes inhibits the body’s ability to regulate sugar in the blood, which, over time, causes long-term damage to one’s organs. The disease can lead to health problems such as heart disease, vision loss and kidney disease.
Health officials told the Bronx Times that the borough is a key focus area for the study due to its racially and ethnically diverse makeup, and its high rate of children with obesity-related metabolic disorders and the systemic challenges plaguing the borough.
Older residents, women, Hispanic and non-Hispanic black populations and those with less education carry the highest burden of diabetes, according to state health officials. Neighborhoods like Belmont, East Tremont, Hunts Point and Melrose all have more than 20% of its residents previously diagnosed with diabetes.
Significant social detriments and socioeconomic challenges from food insecurity to environmentally compromised living situations can make the disease hard to manage for Bronx children, according to health officials.
Isasi, herself, has conducted various studies into underlying causes with a particular focus on Hispanic populations.
“The Bronx has very high rates of obesity and as a result, we also observe high rates of diabetes. We also know that social determinants of health are important factors influencing the risk of diabetes,” said Isasi. “Food insecurity, for example, is high in the Bronx compared to other counties. For individuals with diabetes, economic stressors are a big issue in terms of maintaining optimal diabetes control. High costs of medications, resources for having a healthy meal and being physically active are some of the challenges.”
Data from the study will reveal previously unrecognized factors that contribute to risk for youth-onset type 2 diabetes and inform clinicians to recognize which population of children are at greatest risk for developing the disease.
For children with diabetes, long-term management is further complicated by a lack of accommodations for affected students in school systems.
Parents and advocates have long called on NYC schools to increase equitable access to care for students with diabetes — a disease that affects more than 13,000 NYC children annually.
This week, a federal court approved a landmark settlement that will ensure children with diabetes in NYC schools receive the adequate resources needed to fully participate in school and school-related activities.
“The American Diabetes Association is hopeful this settlement with one of the largest school districts in the country will motivate other school districts to examine their diabetes policies and practices and also offer parents and advocates another tool to add to their diabetes advocacy toolkit. This precedent setting outcome has the potential to ensure that students with diabetes in other states get the help they need at school,” said Charles Henderson, CEO of the American Diabetes Association.
