A woman lies in a hospital bed in Cairns, almost blind from the eye disease ravaging her vision and dependent on thrice-weekly kidney dialysis. Her left leg is amputated above the knee. Diagnosed with Type 2 diabetes at nine, the woman is now just 25, but her case is by no means an isolated one.
Type 2 diabetes, which accounts for 90 per cent of all diabetes cases, has traditionally been a condition of older age but is now being diagnosed in children as young as five, and is increasingly seen in adolescents and young adults.
Last month at a meeting at South Brisbane’s Lady Cilento Children’s Hospital on diabetes in the young, Dr Emily Papadimos detailed the case of a 178kg, nine-year-old Queensland boy diagnosed with Type 2.
Officially, according to the latest figures from the federal government’s voluntary registration to the National Diabetes Services Scheme (NDSS), there are 209 children aged 15 years or under with Type 2 diabetes in Australia.
However, Lady Cilento Children’s Hospital director of endocrinology Professor Jerry Wales believes “there are probably 10 times that number that aren’t recognised”.
A recent review of services across Queensland found there are at least 70 children with Type 2 diabetes under the age of 16. “There are likely [many more] that aren’t recognised or diagnosed because it’s quite silent early on and the parts of Queensland where it is most common, there’s nobody looking for it,” Wales says.
”Fifteen years ago it was almost unheard of [in children]. At the turn of the century people used to write up cases of Type 2 diabetes at this age as incredible rarities. Now there is a recognition that it is something that happens in childhood.”
With 35 years’ experience in treating the condition, Wales is blunt with the facts.
“The younger you get it, the worse the outlook,” he says.
“It’s worse than having insulin-dependent diabetes [Type 1] and worse than many childhood cancers. It’s an awful disease. Type 2 diabetes in the young is not mild diabetes. If you get it at less than 30 years of age, your standard mortality rate is six times the average. You are going to lose 20 to 30 years of life.
“It’s a terrible, terrible disorder, the commonest cause of renal failure and dialysis in Australia, the commonest cause of blindness and foot amputations. It’s contributing to at least 60 per cent of all heart disease. You can name your cause of death, sadly.”
Worldwide, diabetes is regarded as an escalating global health threat with the International Diabetes Federation (IDF) estimating one in 11 adults, or about 425 million people, are living with all forms of diabetes – 10 million more than in 2015. On current trends, almost 700 million people worldwide will be affected by 2045.
Diabetes Australia puts it this way – it is the epidemic of the 21st century and the biggest challenge confronting Australia’s health system.
THE SILENT KILLER
Before Type 2 diabetes knocked him for six, Joel Wiggins regularly ate his meals from fast food outlets. It was cheap, easy, fast. Wiggins, a contestant on the 2018 season of reality TV singing show The Voice, grew up knowing how to prepare home-cooked food but as a young man living out of home for the first time, he fell into bad habits.
In 2008, Wiggins weighed 98kg. By 2012, his weight had ballooned dramatically to 191kg. At age 24, Wiggins was diagnosed with Type 2 diabetes. Now 28, he says he was shocked, even angry, at the diagnosis and fell into denial.
Wiggins says he was aware of Type 2 diabetes because his aunt and father had already been diagnosed, but he falsely believed he was too young to worry about that. A year ago, Wiggins’ older brother Phillip, then 29, was also diagnosed with Type 2.
“Before my diagnosis, I was just eating pretty much junk – Maccas, Hungry Jack’s, all that rubbish stuff. I wasn’t really cooking anything myself,” Wiggins says.
“I knew people got diabetes and I knew there were two different types, but that was kind of it. I wasn’t really aware of what could happen. So I wasn’t expecting it and I was quite taken aback by the whole thing. Even after my diagnosis, I wasn’t eating right. And I’m still not perfect, but I have changed – I am 145kg now.
“About a year after my diagnosis, when I started to lose weight, I had a friend who lost her leg when she was 39 because of Type 2 diabetes. I knew I never wanted to get to that point. The thing I’ve learned with diabetes is that it’s a silent killer. Unlike a lot of other diseases, it doesn’t show as quickly or significantly as other conditions.”
Wiggins, of Zillmere, in Brisbane’s north, works for the Department of Education as an Aboriginal liaison in a state primary and secondary school on Brisbane’s northside.
“My goal one day is to become an ambassador for Aboriginal health and education, but I want to get my own health right before I can do that. I believe that education is one of the most powerful things that kids can have.”