Obesity Drives Diabetes in Kids

Dr. Jill Hamilton, Sick Kids, Toronto

Last Friday, I was invited to talk on obesity at the city wide Endocrinology Rounds at Toronto’s Mount Sinai Hospital.

This institution lies just across the street from Toronto’s Hospital for Sick Children (or “Sick Kids” as it is mostly referred to), which is now home to Canada’s first adolescent bariatric surgery program.

After my talk, I had the opportunity to briefly speak to Jill Hamilton, the lead pediatric endocrinologist dealing with obesity and related health issues at Sick Kids.

We talked about the new surgical program that was starting and their experience with the first few kids that had undergone surgery.

Clearly, given the remarkable increase in severe obesity in kids and the very limited success of conventional behavioural treatments, we can expect to see an increase in the need for obesity surgery in adolescents.
As Hamilton outlines in a recent paper published in Expert Review of Cardiovascular Therapy,

“The emergence of Type 2 diabetes (T2D) in children and adolescents parallels the rising rates of childhood obesity. T2D diagnosed in children and adolescents represents a distinct and challenging condition to evaluate and treat.”

The paper nicely highlights the epidemiology, pathophysiology, risk factors, clinical presentation and diagnosis, treatment and public health impact of type 2 diabetes in children and adolescents.

Given the remarkable efficacy of bariatric surgery to resolve type 2 diabetes, it is likely that the presence of poorly controlled diabetes may well become one of the more important rationales for considering bariatric surgery in adolescents with excess weight.

AMS
Burlington, Ontario