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Weight and Diabetes in Kids

by Julie Deaner

A study completed in 2004 by the Centers for Disease Control and Prevention found that more than 12.5 million (17.1%) of children ages 2-19 in the United States were overweight. From 1999 to 2004, overweight and obesity had increased almost 33% in children and teens in the U.S. Specifically, the prevalence of being overweight increased from 5% to 13.9% in children ages 2-5, from 6.5% to 18.8% in children ages 6-11, and from 5% to 17.4% in children ages 12-19.

The increasing rate of overweight and obese children in America is sending an alarming message about the state of our nation's health. Overweight children and teens are at risk for health problems not only during their youth, but also as adults. In fact, experts believe that more children and teens have been diagnosed with type 2 diabetes over the recent years as a result of the rapidly growing weight problem.

What Is Diabetes?

Diabetes is the sixth leading cause of death by disease in the United States. The disease affects how the body uses glucose, the major source of energy fueling the body. Insulin is needed to properly use glucose, but with diabetes, the body either can't produce insulin (type 1 diabetes) or it doesn't work in the body like it should (type 2 diabetes). In both types of diabetes, glucose can't get into the cells normally, which increases the blood sugar level. This can cause many lifelong health complications, and can be life-threatening.

Type 1 Diabetes
Type 1 diabetes is not related to being overweight and can not be prevented. Type 1 diabetes occurs when a person's immune system attacks the pancreas and destroys the cells that create insulin. Children and teens with type 1 diabetes depend on daily injections of insulin or an insulin pump to control their blood glucose level. This form of diabetes usually comes on suddenly. Symptoms of type 1 diabetes include the following:

• Frequent urination - Children with diabetes need to urinate more frequently, due to the kidneys responding to and flushing out the high levels of glucose in the bloodstream.
• Excessive thirst - Because of frequent urination, a child loses a large amount of body fluid, which results in thirst and which can lead to dehydration. Children with diabetes drink more fluids in an attempt to stay hydrated.
• Extreme hunger accompanied by loss of weight - Kids and teens who develop type 1 diabetes may have an increased appetite, but often lose weight because their bodies can't use glucose properly, and flush it out of the body in urine.
• Nausea and vomiting - When the symptoms of diabetes aren't properly recognized and treated, chemicals called ketones can build up in the blood and cause stomach pain, nausea, vomiting, breathing problems, fruity-smelling breath, and loss of consciousness.
• Weakness and fatigue - Children with diabetes may become fatigued more easily, because their bodies do not use the glucose properly to supply energy.

Other symptoms may include bedwetting in children who were typically dry at night, or vaginal yeast infections in prepubescent girls.

Type 2 Diabetes
Type 2 diabetes occurs when the pancreas can produce insulin, but the body can't use it properly to move the glucose into the cells (this is called insulin resistance). Overweight or obese children are more at risk for developing type 2 diabetes, because excess body fat, especially around the waist, increases insulin resistance. Developing type 2 diabetes may be delayed or prevented with a healthy and physically active lifestyle.

Children are at increased risk of developing type 2 diabetes if they have one or more family members with the disease, or if they belong to certain ethnic and racial groups - including Native Americans, African Americans, Hispanics/Latinos, Asian Americans, and Pacific Islanders. This form of diabetes usually develops slowly. Symptoms of type 2 diabetes include:

• Tingling or numbness in feet and hands
• Recurring or hard-to-heal skin, gum, urinary infections, or bladder infections
• Fatigue
• Blurred vision
• Itching
• Any type 1, insulin-dependent symptoms

Long-Term Complications of Diabetes
Thinking about the long-term complications from diabetes can be scary for parents and kids. Even though your diabetic child or teen may not display any symptoms now, complications may develop over time in adulthood. If a diabetic's blood sugar isn't monitored and cared for properly, the body can suffer negative effects in the eyes, kidneys, nerves, heart and blood vessels, gums, and feet. To help avoid these complications, people with diabetes should be diligent about following doctor's instructions for routine care, including regular eye exams, annual tests for kidney disease, regular monitoring of cholesterol and blood pressure, regular exercise, routine dental care, and proper foot care.

Preventing Type 2 Diabetes

Because overweight and obese children are more likely to develop type 2 diabetes, the main strategy for preventing this disease involves a healthy diet and exercise routine. As a parent, you can lead by example with your own healthy lifestyle. Exercising regularly and choosing nutritious foods over foods high in sugar or fat are great ways to influence your child to adopt a healthy lifestyle. A well-balanced meal plan can guide you and your child in choosing nutritious foods to incorporate in your diet.

Exercise is important in preventing diabetes because it improves the body's response to insulin, which helps control blood sugar levels. Any activity that gets children moving is beneficial; encourage outside play with friends, school sports, or extracurricular activities. If your child is overweight, exercising will decrease body fat and get heart and blood vessels in shape, which also helps prevent cardiovascular disease. Encourage and implement a healthy lifestyle in your child's routine as well as your own, and you can work your way towards better health together.

Controlling Diabetes

Here are some strategies you, as a parent, can use to manage your child's diabetes symptoms:

• Provide a healthy diet - Parents largely control what foods their children eat. Work with your child's health care team to create a well-balanced and portioned meal plan. This will guide you in selecting nutritious foods based on your child's age, activity level, schedule, and food likes and dislikes.
• Discourage extreme dieting - Extreme dieting can be dangerous even for healthy individuals, but is especially dangerous for those with diabetes, since it can create a rise or drop in blood sugar - as well as vitamin deficiencies.
• Limit intake of sugary foods and beverages - Parents need to limit the intake of sugar in their child's diet. Here are some common problems to look for when controlling your child's sugar consumption:
• Oversnacking
• Sneaking snacks
• Skipping insulin
• Implement exercise routines - Exercise can improve the body's response to insulin, which helps to control blood sugar levels, burns calories, decreases excess body fat, keeps blood pressure under control, gets heart, lungs, and blood vessels in good shape, and even improves self-esteem. To avoid problems during exercise, children with type 2 diabetes may need to:
• Have an extra snack prior to physical activities
• Carry snacks, water, and medication with them when they exercise
• Check their blood sugar levels before, during, and after exercise
• Wear a medical identification bracelet
• Make sure coaches know about their diabetes
• Give medication as prescribed - Sometimes a healthy diet and increased exercise aren't enough to help children with type 2 diabetes, and they need to take insulin. The types of insulin and the daily injection doses need to be adjusted to handle the rise in blood sugar that occurs with meals.
• Check blood sugar levels regularly - Make sure that your child checks her blood sugar levels regularly, as well as before and after meals and exercise, and that she adjusts insulin doses as necessary.
• Schedule regular checkups - Work closely with your child's doctor and health care team to achieve the best possible control over her diabetes.

Weight loss, healthy eating, and proper exercise can reduce the risk of developing diabetes and can actually reverse insulin resistance in those who already have type 2 diabetes.

Providing Parental Support

Children who have diabetes may experience many emotions, including depression, embarrassment, anxiety, isolation, guilt, and anger. Teens may want to live a more spontaneous life than their diabetes will allow. Young children may not understand why blood samples and insulin injections are necessary, and may become scared, angry, and uncooperative. Providing emotional support is key to helping your child deal with diabetes.

As a parent, it is your responsibility to provide a healthy diet and encourage physical activity in order for your child to be healthy. Try to stay positive and concentrate on talking about being "healthy," not about being "fat" or "thin." Children with type 2 diabetes who maintain a healthy weight have greater self-esteem and find diabetes management easier. Be a positive role model and you will help your child develop healthy eating and exercise habits.

With proper treatment, blood sugar levels can be controlled, dramatically reducing the risk of long-term complications. Until research can provide a cure or perfect diabetes treatment, parents will play a primary role in helping their children lead happier, healthier lives.

Sources:
www.cdc.gov
www.kidshealth.org
www.healthiergeneration.org