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Young people getting 'mature' type of diabetes: specialist

The worldwide obesity epidemic means doctors are now regularly seeing a type of diabetes in teenagers and young adults that was once a disease of older people, a leading US heart disease specialist told a meeting yesterday in Singapore.

Richard Nesto, an associate professor of medicine at Harvard Medical School, said diabetes was rapidly increasing all over the world.

'It's like global warming. It's just all over the place,' he said. 'There is no country experiencing a decline in diabetes.'

About 83 million Asians have diabetes, and most of them have Type 2 - meaning they do not need to take insulin. Worldwide, about 246 million people have diabetes. By 2025, that number is expected to reach at least 380 million.

But now the type of diabetes being seen in teenagers and young adults is changing.

This group used to develop Type 1 diabetes, a rarer form, which occurs when the immune system destroys insulin-producing cells in the pancreas.

But now Type 2 - caused by the wearing out of insulin-producing cells that comes with age - is becoming more common among young people.

'By 2025 if you see a 20-year-old person [with diabetes], it's more likely they will have Type 2 diabetes than Type 1,' Dr Nesto said.

'It also means that more cases of heart disease, strokes and kidney failure - problems caused by diabetes - will develop in younger people. Doctors have become quite skilful at controlling some complications such as blindness and nerve damage, but nobody has found a way to control heart disease. That's because just treating the diabetes does not necessarily stop the heart disease that goes with it.'

He said he was now seeing women in their 30s having heart attacks because of diabetes, even though their female hormones supposedly helped protect them from heart disease.

'If you are seeing someone so young [with diabetes], we need to find treatments for their macrovascular complications,' he said.

Dr Nesto was speaking at a meeting to discuss studies that have shown that a new diabetes drug, rosiglitazone, which is widely available in Hong Kong and is sold under the brand name Avandia, may slightly increase the risk of heart attacks.

Rosiglitazone is meant to help people who have developed insulin resistance respond better to their own insulin. It is known to cause people to retain fluids, so doctors do not give it to people with heart failure.

Last month the US Food and Drug Administration, which licensed the drug, decided to allow rosiglitazone to stay on the market but is considering changing the safety warnings.

Dr Nesto said that if patients were worried about the findings he would not insist that they take the drug, but that if he considered it the best choice, he would still recommend it.

Rapid increase

About 83 million Asians have diabetes, mostly Type 2

It is estimated that the number of diabetics worldwide by 2025 will reach at least 380m

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