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Risk of Diabetes in Daughter

Pediatrics Expert Advice from Shari Nethersole, M.D.

Q: As a type II diabetic and the daughter of a type II diabetic father who was insulin-dependent for thirty years, I am concerned about the risk of diabetes in my two daughters. I am particularly concerned about my soon-to-be nine years old daughter, who is 4'2" and weighs 108 pounds. She has a medium-to-large frame and is not athletically inclined. My concern is that I see in her eating habits and preferences, particularly her "sweet tooth," much of me at that age. Besides controlling her diet at home, what can I do to prevent the onset of diabetes in her later life? (I had gestational diabetes when I was pregnant with her at age 26 and was diagnosed diabetic at age 30). I would like to help her prevent the complications of nephropathy and neuropathy that my dad suffered as well as the constant battle I face with diet and exercise to control my diabetes. Any suggestions? Also, at what age should I begin to have her tested for diabetes?

A: Type II diabetes, or what used to be known as adult onset diabetes, is definitely influenced by genetic factors. And you are right that your children are at more risk for it, given your history and your father's history. In particular, risk factors for developing type II diabetes include being over-weight and having inadequate exercise. Given that your daughter is now nine years old, she is probably spending a significant amount of time away from you and it is much more difficult for you to oversee her diet. The best way to influence your child's nutritional habits is by modeling the proper habits. In your own household, you should make sure that there are appropriate foods and snacks for her to eat and avoid foods that have high sugar and high fat content.

It might be useful to have her join a children's group that specifically focuses on nutritional and weight issues. In addition, I would definitely recommend that she start to participate in some sort of physical activity. Even if she is not athletically inclined, there are many different non-traditional sports that will allow her to get the benefits of exercise.

In general, type II diabetes has its onset during adulthood, so she is not significantly at risk for it until the later teenage and early young adult years. I would recommend that you monitor her for possible symptoms of diabetes as she starts to go through puberty.

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Shari Nethersole is a physician at Children's Hospital, Boston, and an instructor in Pediatrics at Harvard Medical School. She graduated from Yale University and Harvard Medical School, and did her internship and residency at Children's Hospital, Boston. As a pediatrician, she tries to work with parents to identify and address their concerns.


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