Diabetes

My son is 11 years old and overweight for his age by about 25 pounds. He’s ALWAYS been bigger than everyone in his class and over the 100th percentile. He’s active and plays sports. Type 2 diabetes runs in my family. My dad has it, his sister has it, their mom had it, etc. I am lucky enough that I don’t and neither does my husband. I get worried my son will develop it. Are there measures I can take to possibly prevent it? He LOVES sugar and that’s a daily battle . He told me he can’t just “get” diabetes if he doesn’t have it now, but I have no clue if it’s something you’re just born with or it develops because of what you eat! Is there a cure coming for diabetes in the future? I hope so!

Johanna H. Lake Forest, CA

JohannaH October 17, 2019

Questions Answered by Leading Local Doctors

Alan Marcus, MD, FACP
Laguna Hills, Endocrinologist
Johanna H.

Type 2 diabetes is an inherited disease: having a family member with type 2 diabetes tremendously increase the risk of individual developing type 2 diabetes by 30 to 70% but obviously does not guarantee having it.

The person at risk because of family genetics also has both the increased risk of becoming overweight/obese and with a greater susceptibility to the negative consequences of increasing body fat, probably as a consequence of an increased propensity to accumulate ectopic (nonsubcutaneous) fat (fat located and stored in the abdomen or liver). Fat deposits in this area increase inflammation throughout the body.

There are interventions that a person with this risk can take to limit or prevent both the obesity and diabetes risk and it involves thwarting the bodies over production of insulin. High insulin occurs because of “insulin resistance” and while it keeps blood sugars normal it causes carbohydrates to be stored as fat especially in the belly. This goes back to our earliest existence when it was a good thing to store food during times it was available to survive through times when it was not.

Being active as your son is important but so is limiting the total amount of carbohydrates to no more than 30 grams total carbohydrate per meal and 110 grams per day. The Ohio State University showed in a study published in Nature that this is the most important dietary intervention to encourage the burning of fat and the delivery of oxygen to muscle and limit the inflammation. If this is not sufficient medications that lower the effect of the excess insulin are available and used in addition to treat the associated lack of sense of fullness that accompanies this disorder.



Alan O. Marcus, MD, FACP, FACE