risk of diabetes early on and prevent it from developing. (Slides #2-5) So to outline my talk on Diabetes and obesity, the global population with diabetes. …
Type 2 Diabetes:
While the media has focused more on the national epidemic of childhood and adolescent obesity, a related trend needs just as much attention — starting now
A Manageable Epidemic
By Keith Ferrell
T
ype 2 diabetes was once considered a disease that only adults had to worry about Indeed, the condition was once called adult onset diabetes But thats all changing Type 2 diabetes is mirroring the obesity epidemic, notes Dr Francine Kaufman, head of endocrinology and metabolism at Childrens Hospital Los Angeles and past president of the American Diabetes Association Researchers are just starting to look into the quickly growing trend of children diagnosed with type 2 diabetes The American Diabetes Association estimates that 2 million children — 1 out of every 6 — have pre-diabetes, which is a collection of risk factors that often leads to type 2 diabetes
14
Healthy Children Summer 2007
Diabetes mellitus type 2 the full name of the disease is a disorder in which the body cant use insulin to control and process glucose sugars in the blood the way it should To correct this condition, the body may produce more insulin at first But in many cases, the body makes less
and less insulin over the years, resulting in diabetes Because the disease develops gradually, its crucial that parents be alert to the risk factors and typical symptoms of type 2 diabetes
Knowing the Risks
There is still no certain link between certain genes and the risk of developing type 2 diabetes But a type 2 diagnosis for one family member often means a greater risk for other members, as well Type 2 diabetes and obesity share some common risk factors These unhealthy lifestyle habits include lack of exercise and poor nutrition, such as foods high in calories, saturated fat, and sodium A more dramatic and obvious symptom is a skin condition called acanthosis nigricans AN, which appears as darkened skin around the neck or in the armpit Almost three-quarters of all children who develop type 2 diabetes get AN
more water, and will restrict carbohydrates, sodium, and fat Regular soda should not even be in the house, because many children will choose it over diet soda if no one is watching Make physical activity a daily part of life The more energy your child burns, the better his body uses insulin There are added benefits of physical activity for the entire family, too, including
healthy weight management, better physical fitness, enhanced self-esteem, and improved overall health An hour or so of lively physical activity every day is a good goal Reduce screen time Watching TV, surfing the Internet, and playing video games dont count as exercise The time your child spends in front of a monitor should be kept to a limit Some researchers recommend no more than 1 hour of screen time a day The risk of obesity increases when your child watches more than 2 hours of TV per day All of these lifestyle changes are good steps to take, even if your child has no symptoms of type 2 diabetes By making healthy eating and physical a 
ctivity routine in your home, while limiting screen time, you can help prevent the onset of the type 2 diabetes, as well as manage its progress in those whove been diagnosed with it
Managing the Condition
While there is currently no cure for type 2 diabetes, the disease can be managed well Your child can most likely lead a normal life by following her doctors orders and by working with school staff and health care providers A crucial part of managing type 2 diabetes is making sure that your child understands its causes and effects It is important
that she perceives what he has as the result of many factors, and not as something she has done wrong One helpful fact to use when explaining the disease to children is how common diabetes is in the US More than 20 million Americans have diabetes, and most of them have type 2 If she knows shes not alone, your child may be better prepared to do what it takes to monitor and manage the disease School officials can be very important allies in helping your child manage her condition Notify your childs school officials as soon as your child is diagnosed Be sure to provide them with monitoring and medicine schedules if your doctor recommends that your child check his blood sugar You can also set up a 504 plan to ask school personnel to monitor food intake to make sure your child is eating a healthy lunch and that he is active in PE and during recess A 504 plan is a legal document you can file with your childs school that describes what the childs medical limitations are and what accommodations the school will make to help the child manage in a regular educational setting Along with a healthy diet and exercise, your doctor may prescribe medicine to help your child manage his blood glucose
levels As with blood-glucose testing, you should show your child exactly how to use the medicine and help him understand the importance of following the instructions
Type 2 Diabetes: Warning Signs
Warning signs to be alert for include: Excessive thirst Frequent urination including bedwetting Blurred vision Tiredness or fatigue Frequent infections Slow-to-heal cuts and sores Acanthosis nigricans AN, a darkening of the skin around the neck or under the arms
Not every child with these risk factors will develop type 2 diabetes But parents should be alert to the most common warning signs See the sidebar above, Type 2 Diabetes: Warning Signs, for more information If you notice any of these symptoms in your child, you should see your childs doctor
Choosing Healthy Living
The best way to manage type 2 diabetes is to make healthy lifestyle changes These work best if they involve the entire family, and they benefit all involved — not just those with type 2 diabetes These steps include: Eat healthy Work with a dietitian or nutritionist to create a meal plan that includes more healthy foods while limiting or cutting out less healthy choices A healthy diet will usually cut out or limit soft
drinks and most juices in favor of drinking
Healthy Children Summer 2007
15
