Not so sweet: Learning to treat children who have an adult illness

Last week the American Academy of Pediatrics debuted a list of guidelines for diagnosing and treating youngsters, ages 10 to 18 with type 2 diabetes.

Children are now exhibiting the insulin-deficient health condition formerly exclusive to adults and this is a significant concern, Amy Banes-Berceli, a biology professor at Oakland University said.

“It means we are in the middle of a serious health problem,” Banes-Berceli said.

Type 2 diabetes is a chronic or lifetime condition characterized by the body’s inability to metabolize glucose—sugar—which results in an excess of glucose in the blood.

Not surprisingly, the leading cause of type 2 diabetes development stems from obesity.

“Part of it is watching weight gain in the United States and we’re watching it in our children,” Celestial Brock, a nurse and diabetes educator at Crittenton Hospital Medical Center said. “I think it’s an area that we’re going to see more of.”

While it is difficult to assess or even estimate how many children currently endure diabetes—state records quantify cases by age, 18 years and older—Brock said she treats one or two new young patients diagnosed with type 2 diabetes each month.

“We are seeing more and more cases,” she said. “I just had a patient this week who is 14 years old.”

— “One in three children born in 2000 is at risk of developing diabetes during their lifetime,” the Michigan Diabetes Action Plan (2011-2014) states.

The set of guidelines is the first of its kind and recommends treatment with insulin for patients who are “ketotic or in ketoacidosis, hyperglycemic or in whom the distinction between type 1 and type 2 diabetes is not clear. In all others, metformin is recommended as first-line therapy, along with a lifestyle modification program including nutrition and physical activity,” according to the AAP press release.

The guidelines also include recommendations for monitoring pediatric patients’ glycemic control, implementing insulin regimens as well as suggestions for healthier diet and physical activity.

Adopting new measures “changes the whole aspect of how we handle (diabetes) management,” Brock said, “Developmental stages need to be considered.”

A preventable disease: Preventing an epidemic

Both Banes-Berceli and Brock agree that preventing the development of type 2 diabetes can be as easy as adding more physical activity and eating healthier.

“Times are different,” Brock said, “(Children) eat differently; gym classes are cut down. I think school systems are doing the best they can to give recess time but (kids are) not as physically active as I remember us growing up.”

Educating parents and kids about diabetes is equally important, Banes-Berceli said. “(It) is a way to help them live a healthy lifestyle and make good choices even if their parents are not around.”

Researching the complications of diabetes, Banes-Berceli believes prevention needs to extend beyond education on the disease and focus on the how-to for implementing healthier strategies.

“Teaching families to prepare healthy meals at home would also help curtail this trend,” she said. “It really needs to be a shift in the attitude of society to place value on diet and exercise.

Another indicator of diabetes development lies in family health history and plays a key role in preventing the disease in children.

If you have family members who are managing diabetes, “Their children need to start having physicals and being screened,” Brock said. “And talk with their physicians more closely as to the concerns.”

Pre-diabetes screening is also gaining momentum to help reduce chances for those at risk—whether there is a family history of diabetes or obesity is a concern, or sometimes both, Brock said.

While there is currently no pre-diabetes screening for children, “Maybe we should be looking ahead especially if there’s the weight and a family history of diabetes,” she said.

Prevention is a vital endeavor, because over time, diabetes can have several deleterious effects on our health such as kidney damage, nerve damage, hindered sight and more.

“Knowing what I do about this disease and its complications, it breaks my heart,” Banes-Berceli said. “To know that these children will face a lifetime of struggle with health complications like high blood pressure, kidney disease, heart disease, accelerated atherosclerosis, stroke—It makes me really sad.”

Local groups are proactive against childhood diabetes

Angela Minicuci of the Michigan Department of Community Health shares some of the current state programs addressing the health of future generations.

Some of these preventive programs include:

  • The Michigan Health and Wellness 4 x 4 Plan—(Launched in June 2012) outlines a variety of key strategies to reduce and prevent obesity in our state. To learn more about the Michigan Health and Wellness 4 x 4 Plan, visit the site here.
  • MI Healthier Tomorrow—A statewide campaign to highlight living a healthier lifestyle; also one of the 4 x 4 Plan strategies. Want more background on the MI Healthier Tomorrow initiative? Find out here.
  • Pure Michigan FIT—Teaming with the Michigan Department of Agriculture and Rural Development to work on the Pure Michigan FIT campaign, which is a healthy eating and physical activity initiative aimed at childhood obesity. You can find more information about Pure Michigan FIT here.

Learn more

Crittenton’s Outpatient Diabetes & Nutrition Counseling Center offers comprehensive individualized counseling on topics related to Type 2 diabetes, healthy eating, and lifestyle behavior modifications.  For more information, please call 248.652.5660.

Also be sure to visit the American Academy of Pediatrics site or check out the Michigan Department of Community Health, the National Diabetes Education Program and the American Diabetes Association.

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About Jen Bucciarelli

Veggie lover and aspiring word chef, reporter Jen Bucciarelli covers all things health and medicine for Rochester Media and The Community Edge. She is always on the hunt for local experts who can help improve the lives of our readers. Send her a note at JenBucciarelli@gmail.com.

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