Posted by: coachingparents | November 22, 2008

Coaching Kids for Health: Managing Type 2 Diabetes in Children, Part 1


By Dr. Caron Goode, NCC

A “Lifestyle” Disease
Have you read this headline:  “6 Deaths Reported From Diabetes Drug Byetta”?

If you are the parent of a child with Type 2 Diabetic children, then read on! You must learn as much as possible about the condition. To coach your child to better health, you need a solid plan, which relies less on pharmaceuticals and more on lifestyle choices. Have you heard that Diabetes 2 is called a “lifestyle disease?” While parents of Type 2 Diabetic children spend thousands of dollars on vitamin supplements, mineral supplements and liquid vitamins, nothing replaces appropriate lifestyle choices.

Alarming Children’s Diabetes Rates

Children are diagnosed with diabetes each day and that number is increasing. Type 1 Diabetes, otherwise known as childhood diabetes, is typically diagnosed in childhood and usually represents only 5% of all diabetes cases. Type 2 Diabetes, or adult-onset diabetes, is more common and was once thought to be a disease that only afflicted adults over 30 years of age.

However, recent figures show that Type 2 Diabetes is becoming increasingly common in children and teens. The prevalence has been rising at a startling rate over the last 10 years. The National Association of School Nurses reports that approximately 1 out of every 500 children and teenagers has Type 2 Diabetes. Furthermore, an article published in the New England Journal of Medicine by Dr. William Dietz, reports that almost half of diabetes cases in children and adolescents are type 2. A 50% rate of Type 2 Diabetes was unheard of 20 years ago. Most physicians believe this increase in Type 2 Diabetes rates is due to increasing obesity, poor food choices and the progressively more sedentary lifestyle experienced by children today.
Insulin Is Key

With type 1 diabetes, the pancreas does not produce insulin. Insulin acts to keep blood glucose levels from rising too high. That’s why type 1 diabetics have to take insulin on a daily basis. However, with Type 2 Diabetes, the pancreas still produces insulin. The problem is that either the amount of insulin produced in not enough to control blood glucose levels, or the body becomes resistant to the blood sugar lowering effects of insulin.  Unfortunately, parents and children alike mistakenly believe that a prescription medication for Type 2 Diabetes will solve the problem. Prescription drugs, in theory, provide a quick fix to illnesses and diseases and are reasonably safe when taken as directed. Insulin and the oral drug Metformin are the only FDA approved prescription drugs for treatment of type 2 diabetes in children. However, these drugs are not as safe as the FDA may want you to believe.

  • Daily insulin injections are associated with a plethora of side effects, which can range from weight gain to dangerously low blood glucose levels.
  • This, in turn, may cause fatigue, dizziness and fainting.
  • The safety profile of Metformin is not much better. For example, a study led by Dr Kenneth Jones reported that in 42 children treated with Metformin, 14% dropped out of the study within 4 months, 10% required rescue medication and a startling 70% experienced at least one adverse event (most common side effects were abdominal pain, diarrhea, nausea, vomiting and headache).
  • Given the evidence, Metformin can hardly be considered a safe drug. This reveals that just because FDA approved the drug doesn’t necessarily mean that it is risk free. Clearly, parents need better alternatives to prescription medications to help treat Type 2 Diabetes in children.

Screen Children for Diabetes
The American Diabetes Association recommends that children aged 10 years or older with the following characteristics need to be screened for Type 2 Diabetes:

  • Body mass index (a number calculated from height and body weight) is in the 85th percentile or higher, or if body weight is greater than 120% of normal for their height and any 2 of the following
    Family history of Type 2 Diabetes in a first or second degree relative such as a mother, brother or first cousin.
  • Ethnic background is African-American, Hispanic, American Indian, Asian or Pacific Islander. People of these ethnic origins have higher rates of Type 2 Diabetes than people of other backgrounds.
    Signs of insulin resistance such as polycystic ovary syndrome, hypertension or high triglyceride levels.

It is difficult to detect Type 2 Diabetes, especially in children. Symptoms are usually nonexistent or mild in the early stages of the disease, which may be overlooked for long periods of time. Some telltale signs of possible Type 2 Diabetes include:

  • Constant thirst,
  • Frequent urination or bed-wetting,
  • Fatigue,
  • Blurred vision and
  • Darkened skin around the neck or underarms.

The darkened skin is called Acanthosis nigricans or AN for short and is caused by insulin resistance. In this state the body produces insulin, but it is simply not being used. Hence, a build-up in the body, which results in AN. About 75% of young people with type 2 diabetes experience the AN side effect.

In Part 2, we’ll discuss managing a healthy lifestyle.

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