Carol Graham

Posted Jan 31, 2006

Jan. 29–Diabetes is a lifelong illness. Sadly, health professionals are seeing increasing numbers of young children who weigh too much.

A diagnosis of diabetes affects the whole family because it never goes away. The disease can be managed, but it always will be there. The encouraging news is that diabetes can be managed with lifestyle changes. Two important management techniques are diet and exercise. Diabetes is a serious disease that is characterized by high blood sugar levels. It occurs when there is a defect in the body’s ability to produce or use insulin. Insulin is a hormone produced in the pancreas that helps convert food into energy. The hormone imbalance occurs when the pancreas still is making insulin but not keeping up with the body’s needs. There are two types of diabetes. Type 1, often called “juvenile-onset” or “insulin-dependent,” typically occurs in children and adults who are slim. The body does not produce enough insulin. Type 2 formerly was called “noninsulin dependent” or “adult-onset” diabetes, usually the result of insulin resistance, when the body does not use insulin properly. Insulin is the hormone produced in the pancreas that allows glucose (sugar) to enter the cells, where it is used for energy. When the body doesn’t have enough insulin or can’t use it properly, the blood sugars rise higher than what is healthy. In the extreme, unmanaged diabetes can lead to blindness, pancreas and kidney failure and nerve damage in the hands and feet that can lead to amputation. Prevention program Later this year, Altru Health Systems will launch a diabetes prevention program for children. The study will focus on obesity in general in North Dakota and subsequently Type 1 and Type 2 diabetes, according to Susan Streitz, licensed registered, certified diabetes educator at Altru. Streitz said there is quite a high incidence of Type 1 diabetes in the Upper Midwest, especially North Dakota. And the clinic is starting to see it in children where they never used to, she said. “It all has to do with obesity and lifestyle,” she said. The complications are the same with both, she said “but if they don’t take the shots, they will die.” Streitz said Type 1 is what we think of that’s more common in children. It’s an immunological response caused by chicken pox or any illness such as a severe cold or flu, or mono. “Any illness can trigger it,” she said. “With the rising incidence of obesity in children and adults, we are seeing a rise in Type 2,” she said. In the past, Type 2 diabetes was considered an adult illness. The 2005 North Dakota Youth Risk Behavior Survey of adolescents 12 to 19 old confirms this trend. It shows the number of overweight students increased from 7 percent in 1999 to 11 percent in 2005. “That’s a pretty significant increase in that amount of time,” Streitz said. “It tells us that our kids are getting bigger.” Risk factors The major risk factor for Type 2 in children is being overweight. “These children often eat a high-fat, low-fiber diet that leads to weight gain,” she said. Other risk factors are little physical activity and family history. Seventy-five percent of children with Type 2 diabetes have a parent or sibling with diabetes, according to Streitz. Race is another factor. African American, Hispanic, native American, Asian American and Pacific Islander children are at greater risk than Caucasian children in America; girls are more likely to develop diabetes than boys, and the child of a mother who developed diabetes during pregnancy (gestational) is at risk. Prevention A child’s annual physical is an important step in prevention. Streitz said physicians start watching a child’s weight at 6 years of age. The annual record also includes recording the height and weight and body mass. If there is diabetes in the family, Streitz said, have your child screened regularly for pre-diabetes with a blood test to see if the blood sugars are out of the normal range but not yet classified as diabetes. Once diabetes is diagnosed, it means following a healthy meal plan provided by a registered dietitian that ensures enough calories for proper growth without excess. Weight management is built into the plan, she said. If diabetes medications are prescribed, it is important to monitor blood sugars regularly and take all medicines as prescribed. “Promote a healthy family lifestyle instead of singling out the child,” Streitz said. Plan more family outings involving physical activity such as biking, dancing, skating, hiking, walking the dog, basketball on the driveway, swimming or even building a snowman in the yard, she said. That increased physical activity means moving the arms and legs 30 minutes or more each day. Maintaining the proper weight is tied with physical activity. Streitz offers these tips: Serve fresh fruit and vegetables at meals. Make a rule about no television during mealtime and stick to it because people tend to overeat while they are distracted. Find an organized sport or any activity that is enjoyable and do it on a daily basis. Limit TV to one hour per day on school days and two hours per day on weekends. Just limiting television and video activity will help, she said. Serve food on individual plates instead of family style for better portion control; limit intake of high foods at fast-food restaurants and have healthy snacks available at home “A meal plan means controlled portions with all foods in moderation,” Streitz said. “It means you can have a ‘treat’ but you have to fit it in.” Help is available — The American Dietetic Association’s Internet site – www/eatright.org – is a good general place to start, although it is not specifically for diabetes. — The Internet site www.childrenwithdiabetes.com , for children with type 1 and type 2, has basic facts, school information and chat rooms for children and their parents. — Susan Streitz, 780-6483, will direct callers with questions about diabetes to the right person at Altru for help. For parents who want to read more about children and diabetes, she suggests two books: — “Diabesity,” by Dr. Fran Kaufman, published by Bantam books. It deals with people with Type 2 diabetes brought on by obesity, especially in children. — “Diabetes Free Kids: A Take Charge Plan for Parenting and Treating Diabetes in Children,” by Sheri Colberg and Mary Friesz, published by Avery. The book is an education guide that presents steps to take now to reduce the risk of diabetes. Date: Jan 29, 2006 Copyright © 2006, Grand Forks Herald, N.D. Distributed by Knight Ridder/Tribune Business News.