Posts Tagged ‘ type 2 diabetes ’

Type 2 Diabetes In Obese Youth Is Hard To Treat (Or Another Reason Why Prevention Is So Important)

Tuesday, May 1st, 2012

We all know that obesity rates in youth are way too high and increasing. We all know that obesity in youth is associated with the onset of type 2 diabetes. And now new research – you can click here to read the report – is showing that the initial course of treatment for type 2 diabetes in obese youth only helps about half of the kids – suggesting many will go on to need insulin therapy before they reach adulthood

What’s especially sobering is that this study was very well conducted. It used the most highly supported medication regimen for the early stages of type 2 diabetes along with psychological intervention designed to change lifestyles. The research protocol attempted to secure adherence to the interventions. The youth were carefully studied and monitored over time. Yet despite all this, in only half of the cases did the medication regimen achieve “glycemic control” – and that the psychological component did not produce additional benefit. Again – it bears repeating – the net result is that half of these kids will likely need insulin therapy in just a few years.

While it’s clear that researchers will continue to try to come up with more effective treatments for the early stages of type 2 diabetes in obese youth, this study provides yet another reason for parents to take prevention seriously in childhood. There are no magic bullets here – we all need to struggle with a number of environmental trends and pressures that promote the development of obesity in youth. So here are the logical places to start:

None of this is easy. It’s really not. Especially given the day to day challenges we all face as parents. But trying to be vigilant about your child’s nutrition, exercise, and sleep is the best pathway to trying to prevent obesity and the onset of type 2 diabetes.

Definition of insulin via Shutterstock.com

 

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Does Severe Childhood Obesity Warrant Separation From Parents?

Friday, July 15th, 2011

If a child is severely obese, and facing immediate health risks (such as onset of Type 2 diabetes), should this be considered a form of child abuse or neglect? Should the child be placed in foster care to promote substantial weight loss?

As many of you know, an essay published earlier this week in the Journal of the American Medical Association (JAMA) suggested that, in some rare cases, the answer is yes. (Do keep in mind that the paper was an opinion expressed by researchers and not a formal statement by any professional organization or JAMA).

I say no. But before I share why I came to this conclusion (it took me 3 days to figure out exactly what I think about this complex issue), let’s consider the many important points raised in this paper.

First, I appreciate how the authors articulated the responsibility that parents have these days to understand the very real risks for obesity for youth in a culture that the Centers for Disease Control and Prevention has labeled “obesogenic.” These include: too much unhealthy food, not enough sleep, and not enough exercise. It’s a challenge for all of us parents to keep up with the many factors (obvious and subtle) that continue to push kids into unhealthy lifestyles.

Second, I firmly agree with the authors that educating parents about lifestyle choices is imperative, especially if kids are edging towards very real health issues that are related to weight. As they point out, it is possible to intervene and try to prevent problems before they happen in youth — immediate weight reduction could prevent onset of Type 2 diabetes in severely obese youth.

Third, I also respect how the authors suggested that only a very few clinical cases (the most severe and extreme) would warrant consideration of separation from parents. And I get the frustration that health care providers experience when they see a child heading towards potentially irreversible diseases, yet observe no changes happening with respect to parenting.

All that said, I still think that are emphasis should be placed on developing interventions to help families lead more healthy lives (especially since our culture is full of risk factors that impact parents as well as their children), and to find methods to help parents help kids achieve immediate lifestyle changes when necessary. Although the clinical perspective may lead some to want to impose temporary interventions to protect children, the broader public health mission is to put more resources into ways to educate both parents and their children as a unit to support each other’s transition to healthier lifestyles. Let’s try to keep families together and help them develop into healthier families.

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Sleep Loss And Fat Gain: The Link Between Two Childhood Epidemics

Thursday, June 30th, 2011

In my last post, I referenced new evidence confirming that children today suffer from a severe sleep loss compared to previous generations. One reason for concern is that new studies are showing how lack of adequate sleep in childhood leads to increases in body fat — which is a first step toward risk for type 2 diabetes (another related epidemic) as well as heart disease.

What’s especially troubling is that this process starts early in life. Two new studies have used longitudinal designs to show that short sleep (less than the minimum recommended amount of sleep for a given age) in toddlers leads to increases in body fat at age 7. In one report, consistently short sleepers at age 2 were shown to have a higher fat mass index (FMI) at age 7. Another paper showed similar findings linking short sleep at age 2 to increased Body Mass Index (BMI) at age 7 — the authors concluded that extending sleep by an additional hour per night would lead to a significant decrease in BMI reflecting a reduction in fat deposits. Importantly, both of these studies accounted for a number of confounding factors that could have skewed the results, suggesting direct links between sleep loss and fat gain.

Why is this information so important for parents? A third study has taken the research a step further by demonstrating that short sleep is linked with direct changes in body functioning, such as altered insulin levels, that signal early risk for type 2 diabetes. This report also suggested that inconsistent amounts of sleep from night to night was also bad for kids’ metabolism on top of the effects of short sleep. And there was one more important take-home message for parents:  a little catch-up sleep on the weekend was a good thing for kids and helped protect their bodies from the effects of short sleep.

As a parent, I know first-hand that regulating a child’s sleep is not easy (and sometimes becomes very hard). But putting as much effort into this as possible — especially in terms of making sure minimum sleep requirements are met consistently — can have an important positive effect on your child’s health and well-being.

In my next post, I will take on the issue of sleep methods, and provide a surprising perspective on how to determine the best sleep method for your child.

boysleepingImage by photostock via freedigitalphotos.net

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