Kids at Risk For Diabetes

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

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Focus Forward!

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Focus Forward on your future versus living by default.

The world can be a very scary place. I have a fear of heights. If I were walking on that bridge I would be frozen if I started looking around. Focus forward and be determined to put one foot in front of the other.  Your health is like that too.

Most of us live by default, taking care of the business at hand, instead of planning for your future. But when it comes to your health, prevention is the best medicine.

We all do preventative health, like taking vitamins or brushing your teeth or vaccinating our kids. We know the value of prevention. But it is easier to live by default. For example, not making a plan to include exercise in your daily routine is so much easier than failing to do your exercises.

None of us want to face failure! When you make plans you run the risk of failing to complete it. So we just don’t plan for our future. I call this living by default.

We get busy! Or we fill our days with things to do. But what if you set a priority on your future health? How would that change what you do every day?

Sometimes we need a motivation and sometimes our body gives us a hint like high blood pressure. Your doctor puts you on a prescription for blood pressure and you start to think about what you are doing that contributes to it. Doctor says cut down on fatty foods and avoid salt and of course lose weight.  We might watch our diet, we might try to avoid adding salt. What if your doctor said, “High blood pressure is the first sign of heart failure.” Would you take it more seriously? Would you start to look at your genetics to identify who died of heart disease? What did they do wrong?

Many chronic conditions are a result of things we do in our everyday lives that contribute to our future health over years. For example: take weight gain.  Most of us gain a little more weight each year of our lives. When you live by default, you have the attitude of ‘I’ll get around to it later.’ When you focus on your future health, you don’t let it build up. You see what is happening and take action.

Sometimes you are motivated by your own body. Personally, I have arthritis in my knees and when I gain weight, my knees hurt and I start doing less due to chronic pain. I don’t want to live that way.  I make a conscious choice to change it. But many people need a support buddy.

A support buddy is key to avoid living by default. You can do this through a social media group or individual counseling. My point, “Focus Forward!” on your future for your family. Your family needs you at your best!

Genetics is not everything. You can overcome your genetics through healthy living. Make the decision to make your life a high priority.

Remember – Knowledge is Power

Could cell phones be causing weight gain?

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Can cell-phones cause weight gain?

I-phones have been around for 10 years now. They have revolutionize our lives. Never before did we have the internet in our pocket and accessible at all times. Multiple articles have been written about people doing stupid things while being glued to their phone.
Is it possible that i-phones are the cause of weight gain? Think about it.

When counseling people concerning the need to increase exercise, they are advised to be aware of their amount of “screen-time”, which includes television viewing, computer games, movies, and even i-phones. Increased screen time means you are not up and moving around.

There are many many changes that have happened in our society in the past decade or two. Think back on how the life of your parents or grandparents was different. I bet your grandmother did not have to work outside the home plus she cooked most of their meals from scratch. I know when I was young, my mother and grandmother made extra money doing other people’s laundry at their homes. We felt lucky to eat out once a week. Most restaurants want you to really enjoy their food (as compared to their competitors), so they add extra sugar, salt and fat. If you are eating most of your meals out, you are getting those hidden calories. Are you beginning to understand the cause and effects of some of our cultural changes?

Other cultural changes include increased serving sizes. For example, the original cupcakes were about a third of the calories of the ones today. Many jokes have been made about super-sizing servings. But it is real and happening every day. Customers have demanded it therefore the food industry will provide it. For example – do you recognize “Grand biscuits” as normal size and the regular biscuits are too small? Have you looked at the difference in calories between the two sizes?

The internet in our pocket means quick fixes. Unfortunately with weight issues, there are no real results from quick fixes. Fad diets can sometimes result in in quick weight loss but it will not be maintained. To maintain weight loss, you need to change your daily habits. Chances are you are eating more calories on most days than you are burning up. One clinical sign of this is high triglycerides. If you require medication to control your triglycerides, you are eating more on most days than what you need, which will result in slow weight gain.

I believe many of our problems today stem from the changes in our society. You need to be willing to identify changes in your life that will result in a slow weight loss. This may include putting your i-phone down, increasing your activities and becoming aware of hidden calories.

My next blog will be about why fad diets don’t work in today’s world.

Watch for it!

First-aid box for emotions

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First-Aid Box for Emotions

In today’s world of high stress, we often need reminders to take care of our emotional needs. Making a first-aid box for times of depression will help you be prepared for those times when you have the blues.

Please note: if you are suicidal, please seek professional help!

Here are some suggestions, please feel free to add you suggestions to this list!

A Journal. As a teen, many of us had a journal. Writing helps us to allow our mind to go in different directions. So many times, when you give yourself the opportunity to slow down through writing, your own thoughts will reveal your best solutions. If you need a subject to get started, you can always count your blessings. Many times thinking about the advantages you have will change your perceptions. Being depressed is a result of your perceptions. Changing one thought can change your whole day.

Mementos! Make a box with a few of your favorite things. Mementos help us recall better times. Sometimes it is the soft touch of a stuffed toy or the smell of something that brings back your memories of good times. Pictures help us remember those people who connect with us on a personal level. Take pictures of bigger items, and make real copies of your pictures so you can hold them in your hands. There are many different kinds of mementos, but try to keep your box small.

Music! Your favorite songs will improve your mood. Songs from your childhood can bring a smile back to your face. Whatever music from your past, keep a copy of it. Remember to play your music when you are blue. Also, if the electricity goes out, have a printout of the lyrics. You can sing them and really put a smile on your face and everyone else. Music is powerful. Remember to use it!

Inspirational quotes and encouraging articles or books. We all have quotes we admire. Write them onto 3” x 5” cards and include them in your first-aid box. Make notes of inspiration from books you have read. Print off an encouraging article and keep it in your box. Any time you find something that gives you a lift, write it down and add it to your box. If you are religious, include Bible verses.

Candy? Be careful, foods can draw bugs. But individually wrapped candies could be added, in which the quick acting carbohydrates can give you a lift. Just don’t get carried away!

Contacts. Be sure to keep a written list of people you can call. Sometimes we lose track of people. It is important to reach out for help. It may be someone from your past. Keep their contact information in your first-aid box.

Our situation in the United States could change quickly. Nobody knows what is going to happen next. Bad storms could knock out the electricity for days. Earthquakes could change everything. It is always best to be prepared. Taking time now to consider your emotional needs will help you and your family. Others will appreciate your efforts too.

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.

Children at Risk for Chronic Disease Due to Obesity

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Children at Risk for Chronic Disease Due to Obesity

In previous generations, the medical profession had few occasions to monitor children for adult health issues. Today, children are experiencing increasing problems with high blood pressure, high cholesterol and other health problems related to obesity. Although obesity is ever increasing in children, many times our health care system is lagging behind in identification and approved treatment.   

Obesity is the main cause for kids being at risk for Type 2 diabetes and heart disease. Children are classified as overweight who are above the 85th percentile for age and sex. To be classified as obese, a child’s BMI will be over the 95th percentile for age and sex or their weight is greater than 120% over ideal for height(1). But being at risk for diabetes is much more than just a weight issue.

First: If one or both parents have been diagnosed with diabetes, then the child has the genetics putting them at risk for diabetes.

According to the SEARCH study, at least 75% of youth diagnosed with type 2 have at least one close family member who has diabetes. (Close family members include mother father sisters or brothers.)  (searchfordiabetes.org)

Second: If the child’s BMI (body mass index) is over 28, it indicates that their life-style places them at additional risk. 

BMI can be misleading on its own. You should also consider waist circumference. (http://www.cdc.gov/healthyweight/assessing/bmi/childrens_bmi/about_childrens_bmi.html)

(http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2851850/) 

Third: If they have high blood pressure. This one is tricky because blood pressure can be affected by many things including anxiety. If you or your child become anxious about going to the doctor, then chances are your blood pressure will be elevated. Taking several deep breaths before taking the blood pressure can help. It is important to get an accurate reading. 

If you would like to monitor a child’s blood pressure, there are automatic machines available at most pharmacies and many department stores. I recommend using one of these machines because they are more reliable (ensure accurate readings) as compared to home monitors. Doctors are wanting blood pressure reading less than the 90th percentile on at least three measurements.(2) You can refer to the CDC guidelines for these recommended values.

(http://www.cdc.gov/nccdphp/dnpa/growthcharts/training/modules/module3/text/bloodpressure.htm)

The rule of thumb for children age 7-15 years old is: multiple 2 times your child’s age and add 90. This gives you the median for systolic pressure (the upper number). For the diastolic (lower number) subtract 30-45 from your systolic number. This is just an average number, the number you get can be higher or lower (for more information see: http://www.fpnotebook.com/CV/Exam/PdtrcVtlSgns.htm)

Fourth: Dyslipidemia. Now that is a big word! It means high cholesterol or high triglycerides. You need a fasting blood test to check for these conditions. Ask your doctor for this information.

Fifth: High Blood Sugar. Teens with a fasting blood glucose (FBG) 100 – 125 mg/dL or a random blood test greater than 199 mg/dL are at risk. For children younger than their teens, you should consult your pediatrician for this information. A1C is a non-fasting blood test. The results will vary with the age of your child. 

A1C is not recommended to use to diagnose diabetes in children so it may not be covered by insurance. It is a good indicator if your teen’s tolerance to sugar is a problem. Younger children run higher blood sugars and the A1C test is not recommended for them. The readings for A1C are determined by the age of the child and industry standards have NOT be determined (as of this writing).

American Diabetes Association recommends testing asymptomatic youth for Type 2 if they are overweight plus any 2 of the following risk factors:  

  • Diabetes screening should be repeated every three years.
  • Family history of Type 2 in first or second degree relatives
  • Native American, Latino, African American, Asian or Pacific Islander ethnicity
  • Mother with a history of gestational diabetes during the child’s gestation
  • Signs of insulin resistance or conditions associated with insulin resistance including acanthosis nigricans, hypertension, dyslipidemia, polycystic ovary syndrome or small for gestational age birth weight(3)

Symptoms of high blood sugar include:

  • Unusual Thirst (they can’t drink enough)
  • Frequent urination (going to the bathroom more than once in the night)
  • Headaches, especially after eating sugary foods
  • Tired, no energy; especially after a meal
  • Unusually hungry; (I have seen these kids start eating two full lunches – this indicates a hormone imbalance)
  • Anxious (there are times when they want food NOW)

For more information about how to teach your kids and your family good habits for a healthy future, check out my healthy kids and family 30 day virtual program.

1) American Diabetes Association. Standards of medical care in diabetes – 2013. Diabetes Care. 2013;36 (suppl 1): S11-S66.

2) Expert Panel on Integrated Guidelines for Cardiovascular Health and Risk Reduction in Children and Adolescents; National Heart, Lung, and Blood Institute. Expert Panel on Integrated Guidelines for Cardiovascular Health and Risk Reduction in Children and Adolescents: summary report. Pediatrics. 2011;128 (suppl 5):S213-S256.

3) American Diabetes Association. Diabetes Care. 2013;36 (suppl 1) S11-S66