Diabetes: are you at risk? Today's teens find themselves battling the latest epidemic.

Julia, a 16-year old from Phoenix, Arizona, sings in her school's chorus and spends free time on the computer. For dinner, her family gathers to eat fast food or pizza. Then Julia watches TV until bedtime. Her couch-potato lifestyle might be typical of today's teens, but it could also shorten her life. Last fall, Julia collapsed at school and was rushed to the hospital. Her diagnosis: diabetes.

Julia's body can't burn sugar molecules for the fuel it needs to function properly. She collapsed because sugar had built up in her bloodstream instead of feeding her cells. Like a car running on empty, Julia's cells were starved for energy.

There are two main forms of diabetes, type 1 and type 2. Julia has type 2, which accounts for between 90 and 95 percent of all cases. In type 2 diabetes, the body either doesn't make enough insulin (a chemical, or hormone, needed to burn sugar molecules) or its cells ignore the hormone. Many researchers believe obesity may trigger the onset of type 2. In type 1 diabetes, the body stops making insulin. This type can run in families and mainly strikes children and young adults, though it can occur at any age. (For more on type 1 diabetes, see "Why Me," right.)

A recent study by the Centers for Disease Control and Prevention (CDC) predicts that one in three Americans born in the year 2000 will develop diabetes. While there's no cure for the disease, there are ways to keep it in check. For more on this epidemic, read on.

Q WHAT IS DIABETES?

A: "Diabetes is a chronic disorder in which the body is unable to metabolize (break down) sugars and starches to produce energy for the body," explains Dr. Lori Laffel of the Joslin Diabetes Center in Boston. "As a result, the level of sugar (called glucose) in the bloodstream increases, often to dangerous levels."

Normally the pancreas, a fist-size organ behind the stomach, acts like an insulin-producing factory. Anytime you bite a Big Mac or sip a Slurpee, for instance, the pancreas pumps up insulin production in response to a rise in glucose levels in the blood. The insulin locks onto the body's cells, enabling glucose to slip in and get converted into energy. (See diagram, below.) But in someone with diabetes, the body may lack insulin or have developed resistance to it.

Q: WHAT CAUSES TYPE 2 DIABETES?

A: Believe it or not, researchers aren't sure. Genes (units of hereditary instruction) are partly to blame--you must inherit a predisposition for diabetes. But something else must then set off the disease. Obesity is perhaps the most common trigger. To test this theory, scientists studied identical twins who, by definition, have identical genes. Research revealed that when one twin had type 2 diabetes, the other's risk of getting it was at most 75 percent. How could that be? The other twin may have made healthier lifestyle choices. By doing sit-ups instead of sitting down, for instance. Or by reaching for fruit rather than fries.

Q: WHO IS AT RISK FOR TYPE 2?

A: Doctors agree: Obesity is a trigger. But anyone with a genetic predisposition is at risk.

Drinking from the fountain of youth won't help you either. Type 2 diabetes was once considered an adult-onset disease, but no longer. "I've diagnosed children as young as age 12 with type 2 diabetes," says Dr. Khalid Hasan, a pediatric endocrinologist (hormone doctor). "There has been an 800 percent rise of type 2 diabetes in children in the last 10 years." Additionally, Native-Americans, African-Americans, and Hispanic and Latino-Americans have the highest rates of type 2 diabetes. Two famous diabetics? Actress Halle Berry and scientist Thomas Edison.

Q: WHAT ARE THE SYMPTOMS?

A: It's easy to know when you have the flu, or even strep throat. The achy muscles and sore throat are a dead giveaway. But a person suffering from diabetes may not even know it. "The symptoms of type 2 diabetes usually aren't very pronounced--particularly in teens," says Matt Petersen, director of information resources at the American Diabetes Association. "Fatigue is the most common symptom, but who isn't tired with today's busy lifestyles?" Easier-to-spot symptoms: frequent urination, excessive thirst, unusual weight loss, and blurry vision.

Diagnosis is as simple as a few blood tests. But it wasn't always that way. In ancient times, physicians diagnosed diabetes by tasting a patient's urine. If it was sugary sweet, the patient's body wasn't absorbing glucose properly.

Q: WHAT'S SO BAD ABOUT DIABETES?

A: "High Glucose Levels" wouldn't make a good title for a scary movie, but for diabetics, the phrase can be terrifying. Why? High glucose levels make it hard to fight infection. So diabetics may suffer from foot ulcers that become so infected the leg has to be amputated. If that doesn't send you scrambling for your yearly physical, consider this: Diabetes can also lead to blindness, strokes, and heart disease later in life.

Q: HOW CAN YOU PREVENT OR TREAT TYPE 2?

A: Even standing burns more calories than watching TV. So in addition to following the final season of Friends, take a dance class, shoot hoops, or attack the climbing wall. Less TV time will also make it easier to forget about those snacks during commercials. Eat a well-balanced diet and avoid drinks high in sugar and low in nutritional value, such as lemonade, soda, and sports drinks. "There's no question that the very dramatic increase in diabetes is closely related to lack of physical activity and weight gain," insists Dr. Frank Vinicor, of the CDC.

The good news: If you or a friend has been diagnosed with diabetes, it can be kept in check by watching glucose levels and taking insulin shots or oral medicine. And according to Hasan, "Type 2 patients can use diet and exercise to get off medication."

THE TROUBLE WITH DIABETES

Sugar, or glucose, fuels our bodies. But when it builds up in the bloodstream, it can be deadly. Find out how diabetes takes its toll on the body.

1 DIGESTION

The small intestine breaks down a food's carbohydrates, or chains of sugar molecules, into glucose, a simple sugar.

2 TRANSPORT

Glucose enters the bloodstream.

3 DETECTION

When the pancreas detects the increase in blood glucose, it releases insulin, a hormone that helps cells absorb sugar.

4 DELIVERY

Blood vessels ship insulin to muscle cells.

[ILLUSTRATION OMITTED]

IT'S YOUR CHOICE

After reading the article, choose the correct answer to these questions.

1 Which of the following is not a possible complication caused by diabetes?

A. foot ulcers

B. heart disease

C. blindness

D. pneumonia

2 Which hobby has the best chance of lowering your risk of diabetes?

A. painting

B. running

C. knitting

D. baking

3 Which statement below is false?

A. Researchers still aren't sure what causes diabetes.

B. There has been an 800 percent rise of type 2 diabetes in children in the last decade.

C. Fatigue, loss of hearing, and unusual weight loss are common symptoms of diabetes.

D. Obesity commonly triggers type 2 diabetes.

4 Which words best complete this statement: Insulin is to the pancreas as--is to--.

A. sunlight, sunburn 

B. money, the mint

C. nail polish, fingernails

D. grass, a lawn mower

WHY ME?

NAME: Gary Hall, Jr.

ACHIEVEMENTS: Eight-time Olympic medalist in swimming and diabetes spokesperson

DISEASE: Type 1 diabetes

In 1999, Hall, then 24, was already a member of the American record-holding relay swim team and a decorated Olympian. Then Hall started feeling tired all the time. He had an unquenchable thirst and blurry vision. After collapsing, he was diagnosed with type 1 diabetes.

"I had all the warning signs and symptoms but I believed diabetes happened to older, overweight, sedentary people," says Hall. "I had spent my entire life eating right, exercising, minding my health, etc."

Hall worried how the disease would affect his swimming career. Diabetes can be difficult to manage under normal circumstances. As an athlete, Hall expends an enormous amount of energy and must consume more food than most people.

"When I'm training 6 to 8 hours a day, my body craves carbohydrates (such as sugars and starchy foods) so I need more insulin to counterbalance." To keep his body in this delicate balance, Hall tests his blood sugar about eight times a day, and carries his testing system and insulin everywhere he goes.

As Hall sets his sights on the gold at the 2004 Olympic Games in Athens, Greece, he has one last piece of advice for diabetics: "Don't let diabetes stop you from living a normal life or obtaining your dreams."

Did You Know?

* Approximately 6.2 percent of the D.S. population, or 17 million people, have diabetes. While all estimated 11.1 million have been diagnosed, scientists estimate that 5.9 million people are unaware they have the disease.

* Diabetes is a worldwide epidemic. There are more than 194 million people on Earth with the disease. If the epidemic doesn't slow, the number will exceed 333 million by 2025.

* People with diabetes are two to four times more likely to develop cardiovascular disease than people without diabetes. Cardiovascular disease is the number one cause of death in industrialized countries.

Cross-Curricular Connection:

Health: Have students keep a food diary for two to three days. Then have them enter their food intake on blank food-pyramid charts. View the food pyramid online at: www.nal.usda.gov:8001/py/pmap.htm. Have students analyze their own charts for unhealthful dietary trends.

Remind students about serving sizes.

Example: A sandwich made with two pieces of bread equals two servings of bread.

Critical Thinking:

This year, a group of teenage girls unsuccessfully sued McDonald's. Their complaint: McDonald's advertising was deceptive, and frequent dining there caused the girls' obesity and subsequent diabetes, as well as other health problems. Who should take responsibility? McDonald's? The parents of the girls? The girls? Debate it.

ANSWERS

1. d 2. b 3. c 4. b

For more information on diabetes, check out the following Web sites:

The American Diabetes Association: www.diabetes.org

Centers for Disease Control and Prevention's Diabetes Public Health Resource: www.cdc.gov/diabetes/

National Diabetes Education Program's Resources on Diabetes in Children and Adolescents: ndep.nih.gov/get-info/children.htm

For more information on Gary Hall, Jr., go to his official Web site at www.garyhalljr.com.