Children with non-alcoholic fatty liver disease (NAFLD), which affects 5 to 8 million children in the United States, may be at risk of developing type 2 diabetes as adults.

NALFD affects liver function by storing large fat droplets in the cells of the liver. The relationship between NAFLD and type 2 diabetes in adults has long been studied but much less is known about how the disease affects children.

“There is a growing public health crisis as children with diabetes mature into adults with diabetes. We need to better understand how NAFLD contributes to type 2 diabetes risk in children so that we can actively work to prevent it,” Jeffrey Schwimmer, MD, professor of pediatrics at University of California San Diego School of Medicine and director of the Fatty Liver Clinic at Rady Children’s Hospital–San Diego, said in a news release.

Children with NAFLD experience insulin resistance, one of the most common traits attributed to type 2 diabetes, putting them at higher risk of developing the disease. In fact, the rates of type 2 diabetes in children have doubled over the past 20 years.

A new study, published in Clinical Gastroenterology and Hepatology, led by senior author Schwimmer, observed 892 children with NAFLD to determine a more concrete connection between NAFLD and diabetes risk. Schwimmer and colleagues found type 2 diabetes present in 6.6% of the children initially, with the incidence rate increasing 3% annually over the next four years.

One in every six children had developed type 2 diabetes by the study’s end.

“This is alarming because type 2 diabetes in youth is a much more aggressive disease than in adults, with more immediate and serious complications and outcomes,” said Schwimmer. “These findings have clinical implications for gastroenterologists caring for children with NAFLD. They should be aware of the risk and provide monitoring, anticipatory guidance and lifestyle interventions that help their patients avoid developing type 2 diabetes.”

To learn more about NAFLD, click here “American Heart Association Offers Advice on Managing NAFLD.”