Fatty Liver To Hypertension: What Happens When Blood Sugar Is Too High In Children?

Dr. Anju Virmani (MBBS, MD, DNB - AIIMS, Delhi), Senior Consultant Endocrinologist, Rainbow Children's Hospital, tells us how obesity can affect obesity.

Fatty Liver To Hypertension: What Happens When Blood Sugar Is Too High In Children?

The Government of India's first Comprehensive National Nutrition Survey (2016-18) of 1.12 lakh 0-19 year-olds, found 5% (even the under-5s!) were obese/overweight, 5% had hypertension, and nearly 10% had pre-diabetes. This was shocking because we know well that obesity leads to several diseases, including type 2 diabetes (T2D), hypertension, fatty liver, sleep apnea, bone, and joint problems, and pubertal and menstrual problems. This happens in children and adults, but the impact is more devastating in children.

TheHealthSite.com reached out to Dr. Anju Virmani (MBBS, MD, DNB - AIIMS, Delhi), Senior Consultant Endocrinologist, Rainbow Children's Hospital, to understand what triggers diabetes in children, and how it can be a threat to India as obesity is hitting all-time high among kids in the country.

What Happens When Blood Sugar Gets Too High

High blood sugar or high blood glucose can cause diabetes. The irreversible health condition can give rise to several health issues. Here is a list of health conditions that can get triggered due to diabetes, and also with time can get worse if not treated on time:

Hyperglycemia can damage the vessels that supply blood to vital organs. This can increase the risk of developing serious heart conditions such as stroke, or heart attack. Diabetes can also affect the kidneys, trigger vision issues, and give rise to nerve problems.

Can Obesity Lead To Diabetes? Yes!

In the year 2019, when the pandemic hit the nations, strict lockdowns were implemented to contain the virus spread. Children and adolescents were disproportionately affected. For over 2 years, youngsters have been locked up at home: no school, no social interactions, no outdoor play, and no routines. Screen time got legitimized - for school, for entertainment, for social contact. There was easy access to junk food as parents managed work from home, and calling in became "child's play"! Stress and fear levels were high, so plenty of comfort foods were consumed. Adults did go out for errands and jobs, but children were mostly completely locked in. Many ended up gaining 2-25kg, or even more. Imagine a 60kg 8-year-old but you may not need to imagine, it could be a friend's or neighbor's child, or even your own! Inevitably, the consequences of obesity also sky-rocketed, in India and globally.

The Centres for Diseases Control And Prevention (CDC) reported that around 77.2% more new cases of young diabetes were registered in 2020-21. Marks et al (Washington) reported (2021) new pediatric T2D increasing by 182%, with children coming in much sicker, especially from poorer communities. Modarelli (Durham, NC, USA), similarly reported (April 2022) new pediatric T2D increasing by 231%, accounting for over half the new diabetes cases, and presenting more often severely ill. Johns Hopkins Children's Center found an identical spike in T2D.

India has little published data, but similar experiences. Childhood obesity has risen sharply. Dr. Riaz (Thiruvananthapuram) stated that in under-15s, they had 9 new T2D cases in 2021 while earlier they saw 2-3 new T2Ds annually. This 300% increase was not due to Covid infection, but obesity and sedentary lifestyles.

So, using a somewhat cruel pun, is this a big problem in India? The answer is definitely "Yes and worsening if we are not careful". Ironically, the problem is both very easy and very difficult to solve. Why easy? Because all it takes is a major shift in mindset, nothing costly. We, adults, need to drastically decrease junk food consumption - at home, at work, at parties, as rewards push away the attractive, hyper-palatable processed foods opt for more home-cooked food ... ensure all adults (especially fathers, and grandfathers) and children are involved in buying and cooking food forever! see that the food is nutritious - and looks and tastes good. So, no puris, how about multicolored rotis (methi, beetroot, haldi)? No ice cream, how about low-fat curd garnished with colorful fruits? And yes, even the five-year-old can safely knead the floor, roll out rotis, and make pretty fruit-dahi! Simultaneously, we need to start moving: walk to the market, and exercise daily. Once we are role models, send the children to play outdoors daily for, a minimum of 60 minutes. No place or no company? How about a dance class or football coaching? Whatever it is, should be fun! Finally, stop the tuition (maybe agree to tuition in classes 11-12 because of peer pressure). Play for 90 minutes and self-study for 90 minutes is better for health and academics.

"Changing mindsets is very difficult. We are drowned in advertisements - about food, studies, activities, parties We believe them, though we know advertisers are interested in their profits, not our well-being. We buy kids expensive "health foods" which spoil their health, and sign up for costly educational packages that numb their brains and bodies. Moreover, habits and peer pressure are hard taskmasters. If all my friends send their kids to tuition, I end up doing the same," said Dr. Virmani.

In the end, we have to decide. Do we learn from the devastating pandemic and improve our, and our children's, well-being? Or slide into more sloth, more disease? Our children depend on us to change, even one step at a time, for true happiness and health!