From next year, the special approach to obesity in children will be reimbursed through basic insurance. This includes specialized lifestyle intervention and certain medications to tackle (the precursors of) type 2 diabetes.
(Serious) obesity is becoming increasingly common among children and young people. A quarter of young adults (18-25 years) in the Netherlands are overweight. It appears that 7 percent are seriously overweight (obese). figures from the Central Bureau of Statistics (CBS). “We live in a big candy store, which makes it more difficult to make healthy choices,” says Bas Schouwenberg, internist-diabetologist at the Vivendia (children’s) diabetes center in Nijmegen. In addition, young people often do not exercise enough, sleep poorly and suffer from stress.
One in seven young people (2-25 years) in the Netherlands is now overweight. Being overweight can lead to all kinds of health problems, such as fatty liver disease, high blood pressure or diabetes.
Pancreas has to work harder
The Diabetes Fund recently sounded the alarm about the increase in the number of children and young people with type 2 diabetes. This form of diabetes is also known as adult-onset diabetes, but is now becoming increasingly common in children who have sometimes not even reached teenage age. “If you are overweight at a young age, the pancreas has to work harder to produce insulin,” explains pediatrician Ines von Rosenstiel. She works at the Rijnstate Expertise Center for Childhood Obesity in Arnhem and sees the consequences of obesity every day in her consultation room. “It is not so much about how overweight someone is, but mainly about how long someone has been overweight.”
The pancreas becomes, as it were, exhausted from the hard work, which is called insulin resistant. “Insulin is still produced, but not enough,” says Schouwenberg. “You don’t notice this very clearly at first, because the shortage is slowly increasing.”
Alarm signals such as tiredness, thirst and frequent urination often only occur if someone already has diabetes. Type 1 diabetes is more common in children, but this form has nothing to do with being overweight. In this form, the pancreas no longer produces insulin at all due to an inflammatory response. Administration of insulin is then necessary.
Specialized lifestyle intervention
Diabetes has a huge impact on daily life and is often the start of all kinds of other health problems, such as damage to kidneys, blood vessels, eyes and nerves. “It is therefore important to be there on time,” emphasizes Von Rosenstiel. Children and young people receiving treatment at the Expertise Center are therefore checked for diabetes every year. Various forms of treatment are then possible.
For example, blood sugar lowering medication such as metformin can be prescribed. From January 1, 2024, the specialized lifestyle intervention for everyone with (pre)diabetes will also be reimbursed from basic insurance.
According to Schouwenberg, it is important that other healthcare providers are also alert to type 2 diabetes in young people. “Adjusting your lifestyle really helps, but it is difficult to achieve.” This includes exercising more and eating healthier, such as few fast carbohydrates (such as white bread or white pasta), as little sweets, biscuits and soft drinks as possible and more slow carbohydrates (whole grain products, vegetables and fruit). Schouwenberg: “Sometimes people with type 2 diabetes who adjust their lifestyle no longer need much less or even no medication at all.”
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