Kids at Risk For Diabetes

Registered Nurse, Diabetes Educator, CDE, Obesity, Children, Youth, Lifestyle

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Julie RN CDE

Childhood Diabetes Progresses Quickly

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Life Lessons:

We just don’t go through life.

We grow through life’s experiences.

Some lessons can be very difficult to accept. Being diagnosed with diabetes is one of them.

Your first reactions is shock. How can this be? Followed closely by denial. The test must be wrong? Next comes frustration or anger. How can this be happening to me? Followed by bargaining. If I lose weight it will go away.

Eventually, after failing to keep the required weight off, you become depressed. You realize this is going to be your life; it is not going away. Then you start to seek realistic solutions, usually involving taking medication. Finally your perception changes to acceptance.

So many times, people diagnosed with type 2 diabetes take a long time to move through these normal changes. Many times they develop complications from uncontrolled blood sugars before accepting their diagnoses.

Time isn’t a luxury with childhood diabetes

Unfortunately, with youth-onset type 2 in young people, you don’t have that time. Progression is much quicker. Once weight-challenged children are diagnosed with type 2, it is too late to reverse their beta cell destruction.

Type 2 in children is very different from adult on-set.

  • Unlike adults, children’s problems with blood sugar have more to do with fatty liver disease than with insulin resistance.
  • Unlike adults, children with type 2 can lose up to 37% of their beta cells in one year.
  • Unlike adults, as soon as their blood sugar cannot be controlled with medications, they need insulin.

Because of the worldwide obesity epidemic, it has been predicted that we will experience a public health catastrophe. We need to improve the overall wellness of our children during childhood. Parents cannot wait until their child is diagnosed.

Knowledge is power!  To determine your child’s risk for type 2 diabetes, download my checklist. If any of the items on this list pertain to your child or children, you should consider my 30-day kid’s program.

If you want to start protecting your family, my kid’s program is good for the whole family!

Children need activity every day!

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Children need activity every day!

Being active for children means being active every day. Adult exercise goals are 150 minutes each week. But children need activity every day for at least 30 minutes.

Cut down on screen time!

Kids need to cut down on computer time and video games.  They need encouragement to disconnect. Put a timer on them and make a record of how much time they are spending. Be the parent, stand firm. Use screen time as a reward.

Every day children need to go for a walk, or play at their playground.

3-5 times a week they need a cardio workout that will develop a healthy heart and lungs. There are many different kinds of aerobic exercise. It is important to increase their heart rate into a cardiac range. That range should be determined by your doctor.

Aerobic exercise examples:
  • step exercises
  • cross country running
  • rowing
  • stair climbing
  • wind surfing
  • racquetball
  • tennis
  • squash, you get the idea.

There are many different kinds of aerobic exercise. It is important to increase their heart rate into a cardiac range. That range should be determined by your doctor. One of the easiest way to encourage this type of activity is to get them into an organized sport. Even golf can get them motivated.

In addition, children need muscle strengthening and stretching exercises at least 3 time a week.

Muscle strengthening exercise examples:
  • weights
  • resistance bands
  • calisthenics like push-ups, jumping jacks, or lunges.

It is easy to stretch before you do the muscle strengthening routine and afterwards as a
cool down.

Start slow with 30 minutes each day. Set a goal of 60 minutes per day. Keep a record of all your exercise.

Record your progress on a calendar and celebrate your success!

Remember, a little progress everyday will become a healthier lifestyle over time.

Find an activity that they enjoy doing!

Schedule a time and commit to doing it.

Make your family’s health a priority!

This really is a lifestyle change.  It is so important to help control your weight and exercise is a great way to improve your health. Get started, you’ll feel better.

PRECAUTION NOTE: Before beginning any exercise program consult your physician.

Complications from elevated blood sugars include hypertension, cholesterol problems, eye problems, heart disease, peripheral vascular disease, foot problems, kidney disease or gastroparesis. Adults may be requested to complete a graded exercise evaluation before starting any exercise program due to these complications.

Do you need encouragement to increase your daily activities?  That’s what a life coach does! Email me if you have questions, Julie@kidsatriskfordiabetes.com. Also check out my 30 day virtual course for your whole family! Or schedule a call with me to discuss your specific needs.

Syndrome X

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Syndrome X, aka Metabolic Syndrome or Obesity Syndrome

Syndrome X is a diagnosis you might here if you are at risk for a chronic disease, which is also known as Metabolic Syndrome. This is a group of health conditions that puts an individual at risk for chronic health problems like heart disease, strokes, and diabetes, plus high blood pressure and obesity.

Metabolic syndrome includes: (you must have at least 3 risk factors for this diagnosis)

  • A large waistline or apple shape body
  • High total cholesterol (LDL, HDL  & VLDL)
  • Low HDL cholesterol (HDL improves your blood vessels)
  • High triglycerides (caused by daily overeating)
  • High blood pressure or taking medication for high blood pressure
  • Fasting blood glucose over 126 (early signs include blood glucose 100-125)
  • Other risk factors are your genetics and your age.

Insulin resistance increase your risk for an apple shaped body. Not everyone who gains weight develops an apple shape. However, insulin resistances causes fat to be deposited within your abdominal cavity.

Another common problem in metabolic syndrome is unacceptable levels of triglycerides. Many times triglycerides go up when people eat more calories during the day than they are burning. If you have above range triglycerides or are taking medications to control your triglycerides, then you are at risk for chronic disease.

If your LDL (low-density cholesterol) levels are high, that is another risk factor for a Syndrome X diagnosis. Cholesterol is often a reflection of the food you eat. Typically this is a high fat diet. It amazes me how many adolescents today are on cholesterol lowering medications. If you don’t know your cholesterol numbers, then you need to consult your medical provider and seek a blood test. Total blood cholesterol should be less than 200. If you are taking a medication to lower your cholesterol, then technically you have this medical diagnosis.

Metabolic syndrome includes blood pressure higher than preferred. I will say, trying to get accurate blood pressure reading on teens is difficult at best. First, acceptable pediatric blood pressures are difficult to pin down. You need to be educated in pediatric medicine to know what is acceptable. (Don’t go to the drug store with your children and get a reading; adult blood pressures are different from children’s numbers. Even adult sized machines can give wrong information for children.) Teens blood pressure can swing with changing thoughts (ask them about their personal problems and it will jump quickly).

My point: if a teen is taking medication for blood pressure, then they have been diagnosed with a health problem. At that time, the blood pressure may be within normal ranges, but they still have the diagnoses. This places them at higher risk for chronic disease like heart disease and kidney disease.

Metabolic Syndrome Risk Factors include:
  • insulin resistance
  • stress
  • diet (sugar-sweetened drinks)
  • genetics & age
  • low physical activity
  • disrupted sleep patterns
  • mood disorders
  • excess alcohol
  • smoking (tobacco and other substances)
  • chronic inflammation
  • other chemical imbalances in the blood.
Metabolic Syndrome Associated Health Conditions include:
  • Polycystic ovary disease
  • Erectile dysfunction
  • Hyperuricemia (uric acid in the blood)
  • Acanthosis nigricans
  • Fatty liver & Non-alcoholic fatty live disease

(More later on teens with fatty liver disease. I have been absolutely amazed at the number of preteens that I have seen diagnosed with fatty liver disease!)

 

Source:  National Heart Lung & Blood Institute  www.nhlbi.nih.gov/health/health-topics/topics/ms

https://en.Wikipedia.org/wiki/Metabolic-syndrome

 

Coping skills for children’s stress

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Coping skills for children’s stress

Few people today have developed good coping skills, which are especially important for children. It’s unfortunate that coping skills for children’s stress is not taught in most schools. I am amazed at the number of preteens that are taking antidepressants every day. Parents need to be very aware of the need to help their children learn good coping skills. Good nutrition is important with stress management. Parents really need to teach their children not to turn to carbs for comfort. Many weight problems are directly connected to eating during times of stress.

Unfortunately, coping skills are very individualized. It is possible that the coping skills which parents use may also help their children. But this is not always true.

Things you can do to help your children cope with stress

  • Adequate sleep is always important particularly in stressful situations, but many times stress will interrupt your sleep.
  • Some adults like to work-out to work off frustrations. Kids might like to participate in contact sports.
  • Talking with friends is a way we all de-stress; just be aware of where your children are getting advice.
  • Being over scheduled can cause a lot of stress. Be aware of how many activities your children are involved in.
  • Even being connected to their cell phones and keeping notifications on all night can increase stress hormones. Cell phones should be plugged in outside of their bedroom.

Find what works for you and your children. Many times taking several really deep breaths can calm someone down. Just be aware it may take up to 10 deep breaths. Some people meditate, do yoga, or go walking in the trees. Some people pray, while others find no benefits of prayer. My point, you really have to find what works for your kids and teach them to practice it often.

How stress affects diabetics

Especially if you are borderline diabetic, it is so important to find what coping mechanisms work for you. Learn to monitor your stress load and take care of your emotional health.

The emotional side of diabetes management is very important. Hormones released during stress will increase your blood sugars. Stress will raise your blood sugars unpredictably. Anyone who is diagnosed with a chronic disease will go through the steps of grieving. (The first step is denial!) Good coping skills will help individuals move forward with their lives after they have been diagnosed with a chronic disease.

Good luck and let me know what works for you! For more information contact me at Julie@kidsatriskfordiabetes.com.

The Link between Pregnancy and Diabetes    

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Did you know there’s a connection between Pregnancy and Diabetes? And did you know there’s also a connection between Gestational Diabetes and Type 2 Diabetes?

Read on to understand the connections.

Scenario:

Woman in her late twenties gets pregnant. At 26 weeks, she takes an oral glucose tolerance test (OGTT) and is diagnosed with gestational diabetes. She is challenged to keep her blood sugar within the recommended zone.

At 32 weeks gestation, she starts having trouble with high blood pressure (hypertension). Her doctor admits her into the hospital on mandatory bed rest. They give her drugs to encourage fetal lung development. She is informed she will be induced.

During the induction, it is determined the baby is not in the head down position. She is immediately scheduled for a C-section.

After delivery, the new mother’s blood sugar is higher than normal. Her baby has a poor sucking reflex which makes it difficult to nurse. For some unknown reason, the nurses want the new mother to nurse at least every hour. The medical staff inform her that stress can cause elevated blood sugars and she is not to worry.

Follow-up appointment:

Her doctor recommends she returns for a follow-up appointment at 3 weeks. She feels that is a little odd, but they explain it is the new recommendation and will be covered by her insurance.

At 3 weeks, she is feeling better and the baby is doing better nursing. They take a random blood sugar test and it is a little high. She explained that since she was out of the house, she treated herself to a deep dish pizza. She believes that her lunch was the reason her blood sugars were a little high because every time she ate pizza while she was pregnant, her blood sugars would go up for a long time. Her nurse smiled and said, “We’ll keep an eye on it.”

At her next follow-up appointment, her doctor required an A1c test. Her result was 6.8. She was diagnosed with type 2 diabetes. She now blames her pregnancy on her diagnosis and she is convinced it will go away.

What went wrong?

Chances are she was prediabetic (aka borderline diabetic) before the pregnancy. Her fasting blood sugar tests were normal, because through the night her body could bring her blood sugar into normal range.

The A1c test is an average blood sugar test over the previous 2-3 months. Unfortunately, once you are diagnosed, you will always be flagged as at-risk for high blood sugar.

Pregnancy places a stress on your body in many ways. There are a lot of hormone shifts during pregnancy. Diabetes is caused by the hormones required to grow the placenta. The larger the placenta gets, the more you become at risk for high blood sugar.

This is the reason the oral glucose tolerance test is delayed until 26-28 weeks gestation. After delivery and you expel the placenta, your body should go back to normal.

One complication from uncontrolled blood sugar is eclampsia. This is a chemical reaction that causes uncontrolled high blood pressure. It causes heart problems and sometimes death of the baby and/or the mother.

When blood pressure (BP) starts to increase, doctors are proactive and require strict bed rest to prevent the chemical progression of pre-eclampsia into eclampsia. The doctor will induce as soon as it is safe. Many times, the baby is not in the correct position, so the doctor will do a C-section.

Typically, your blood sugar will go back to normal after delivery. But we all gain weight with pregnancy. It is very possible someone can develop insulin resistance from the weight gain. Hopefully this is a temporary condition. Sometimes it can take over a year to lose the weight. If you have developed insulin resistance, you can have prolonged sugar problems.

Once diagnosed, always a diabetic

The standard for diagnosing type two diabetes has changed. Previously, you needed two fasting blood sugar results over 125. Today, you only need one.

The medical community is trying to diagnose earlier in this disease progression to encourage lifestyle changes. Women who develop Gestational Diabetes are at high risk for developing Type 2.

Over 40% will be diagnosed within 5 years. When this disease is diagnosed early, there is a better chance of reversing it. Your diagnosis may be changed to T2 in remission, but you will always be at risk of it returning as you age.

Knowledge is Power

The internet has a lot of suggestions to reverse diabetes. Unfortunately, many of the suggestions you’ll find online are false or misleading. The American Diabetes Association encourages a balanced lifestyle. Remember, only 1% of people who attempt irrational weight control are successful in the long run. Yo-yo dieting is very hard on your body and can cause other health problems.

Slow and steady wins the race!

Many people need support to make and maintain new habits. If you need help setting realistic goals and sticking to what you really want to do, I can help you.

 

About the author

Julie Stelting is a registered nurse with a bachelor’s degree in nutrition. She is the founder of Kids at Risk for Diabetes LLC. Julie designed a program for gestational diabetes, to help women understand and cope with their diagnosis. She is passionate about preventing or delaying diabetes through holistic lifestyle changes.

For more information go to www.kidsatriskfordiabetes.com, or email Julie directly at Julie@kidsatriskfordiabetes.com.

 

What’s Missing?

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What’s Missing from your Gestational Diabetes Program?

Women diagnosed with gestational diabetes (GDM) get lots of information on how to care for themselves, but many of you will still end up with preeclampsia or C-sections?

How successful is the diabetes training for pregnancy that’s been offered to you?

Could it be improved?

Read on to see My Solution…

The Current Program

Gestational diabetes programs vary greatly. Many areas do not offer support for the confusing disease.

Do you know what to do when your blood sugar is too high?

Do you have someone to contact for emotional support?

Do you know what it means when your blood pressure starts running too high?

Are you afraid of ending up on insulin?

What’s missing?

There are lots of educational resources available. Unfortunately, many of the programs are provided when it is convenient to the provider, for example, classes you need to attend at the hospital. And many programs are missing the emotional support so many women need.

When are Gestational Diabetes women ready to learn?

Whenever someone is diagnosed with a chronic disease like diabetes, their first reaction is shock.

After the shock of the diagnoses, they will progress through the 5 stages of grieving starting with denial.

  • Denial – trying to avoid the inevitable, “Do the test again”
  • Anger or frustration – the coming out of pinned up emotions
  • Bargaining with their provider or with God
  • Depression – the realization of the inevitable
  • Acceptance and finding a way forward in their life

I have heard so many women, who have been diagnosed with gestational diabetes say, “How can this test be right? I must have eaten too much the day before the test.”

Unfortunately, gestational diabetes is 100% driven by the hormones produced during pregnancy.

It is critical that you understand that your condition will get worse before delivery.

Timing is everything!

When you are in denial, it is difficult to remember details.

When I taught our gestational diabetes classes, my patients were within two weeks of being diagnosed. Many of them were frustrated and feeling betrayed by their body. Their providers wanted them to start testing their blood sugar immediately multiple times a day.

For half of one day, I provided diabetes management techniques through a program at the hospital. Only a few of the women took notes. Many were in shock’s first phase of denial.

They knew diabetes caused “big babies” which placed them at risk for C-sections. But they had tunnel vision; they were focusing on the problems and not the solutions.

The Results

They did not know how to reduce their blood sugar when it was too high. In the end, many of our patients ended up with pre-eclampsia, in the hospital on bed rest, with induced labor when their baby’s lungs were developed enough to sustain life. The result was pre-term babies being delivered to save the mother’s life.

The Solution: Emotional support

These women needed a support system. A place where you can ask questions and get workable solutions from people who have had the same experiences. An on-line support system can be a great resource for finding solutions that work. But you must carefully check the source of your information.  On the web, everyone has an opinion.

Also, due to the pregnancy brain fog, women need on-going training. Many times, they are given information that they don’t need to put into practice right away. They forget important information. They need a place to store a resource of information.

Women need encouragement. In the beginning, their blood sugars are not too bad. They don’t want to test their blood five times a day because it makes their fingers hurt. Many of them stop checking because they are in denial. Unfortunately, as the pregnancy progresses, the blood sugars will get worse.

Many clients complain that they don’t know what to do if their numbers are high. They feel helpless! They need someone to answer questions.

My Solution

“Healthy Babies from Preconception to Birth and Beyond” is an online virtual program designed specifically to assist gestational diabetes patients and type 2 patients who are pregnant or want to become pregnant.

  • They will receive daily emails. (currently this is 27 emails)
  • They can store the emails in a file where they can refer back to them as needed.
  • The course includes tips and activities they can do at their convenience.
  • They will also join a private Facebook group where they can ask questions of each other, share stories, and offer support to each other. I monitor the content for accuracy and provide answers.

Join my mailing list right here and I’ll send you more details about the Healthy Baby course.

If you are curious, but not sure if this program is right for you or your loved one, schedule a free call with me and we can talk through it together.