Diabetes

Childhood Diabetes Progresses Quickly

05/24/2019 by Julie RN CDE 1 Comment

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!

Childhood Obesity: 1st in a Series

05/23/2019 by Julie RN CDE 1 Comment

Part 1: If you wait until they are diagnosed, it is too late.

This is the beginning. We call it obesity; children measuring over the 85^th percentile for weight given their age and height. We used to call it morbid obesity because it triggers chronic health conditions that can threaten your life. Weight problems in children can affect their future health, either more immediately or as they become young adults.

The difference between adult and childhood diabetes

When an adult is diagnosed with type 2 diabetes, they are told to lose 10% of their body weight and it may revert to prediabetes. This is not true in children! Type 2 diabetes progresses so quickly in children, many of them are put on insulin within two years.

Prediabetes in adults can last ten years or more. In children, prediabetes progresses into type 2 within 12 months. Plus, by the time they are diagnosed with type 2, their beta cells are already dying off. Type 2 in children, the beta cells can die up to 37% per year. This cannot be reversed with current medications. Hospitals can test to determine if the child has type 1 or type 2. But many of them need insulin as soon as they are diagnosed.

Puberty causes many changes

Weight problems accelerate during puberty. Children who may be above normal weight before puberty can quickly change during puberty due to human growth hormone. Their body grows and develops quickly during this time. Parents should monitor their child’s BMI (Body Mass Index) during this phase. (Note: I recommend parents use the CDC charts for BMI including waist circumference for a more accurate evaluation.) https://www.cdc.gov/healthyweight/assessing/bmi/childrens_bmi/about_childrens_bmi.html

If you see significant changes in their BMI, talk to your child about what they are doing.

Have they increased junk foods?
Are they eating out more?
Are they playing more computer games?
How has their daily life changed?

Daily choices now will affect their future

Encourage them to be mindful of how their daily choices are affecting their future.

Healthy living today will be the key to minimizing future health problems. Children’s weight over the 85^th percentile can cause problems like high blood pressure, which over time triggers other problems like heart disease and strokes. (Narasimhan, 2015)

Severely obese children (the 95^th percentile or more for weight) are at risk for serious health conditions like fatty liver disease. Fatty liver disease in children is linked to early-onset type 2 diabetes and multiple complications from insulin resistance. (Narasimhan, 2015)

Summary

It’s sad but true: research proves that if the parent waits until the child is diagnosed, the damage is already done. Please don’t wait!

Resources

For more information about how weight gain can affect your child’s overall health, check out this article I recently published.

For more information on healthy lifestyle habits in children, part 2 in this series talks about lifestyle changes!

For information about my program Kids at Risk for Diabetes, please check out my course for the whole family.

If you always want to be notified when I publish a new article or blog post, please join my mailing list using the form below!

References

Narasimhan, S. a. (2015, Jun 1). HS Public Access. Retrieved from Youth-Onset Type 2 Diabetes: Lessons Learned from the Today Study: https://www.ncbi.nim.nih.gov/pmc/articles/PMC4319667/

The Link between Pregnancy and Diabetes

07/07/2018 by Julie RN CDE Leave a Comment

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.

Prevent Unplanned Pregnancy

08/10/2017 by Julie RN CDE Leave a Comment

Uncontrolled blood sugars can cause serious birth defects.

It is unfortunate that I find a need to present this information. I have experience working with thousands of teens and unfortunately many of them get pregnant. I am located in the American Bible belt. They encourage schools to teach “abstinence only” in sex education classes. In today’s society, it appears to not be effective in controlling unwanted pregnancies.

Never trust your schools to adequately prepare your children for pregnancy prevention.

All parents need to take an active role in the discussion of sex and the importance of contraception. Do not expect your child to be adequately informed by the school’s sex education classes.

Know your risks. Research shows, if the mother has gestational diabetes, the child is at increased risk for diabetes. There are a variety of risk factors that can be found on the CDC’s website on Diabetes. You can take their survey to evaluate your child’s risks.

Type 2 diabetics are at risk for the most serious complications in unplanned pregnancies. About 7% of embryos developed with high blood sugars also develop Spinal Bifida. There are other brain and heart malformations that are associated with uncontrolled diabetes.

Typically, babies born under gestational diabetes are over nine pounds. Doctors recommend C-sections due to the increased possibility of broken bones during birth (particularly the collar bone).

The most serious health issue is high blood pressure in the mothers. This can be life threatening to the pregnant woman. If the mother develops high blood pressure, she will often times be placed in the hospital on bed rest until the baby is developed enough to be induced. There is a risk of underdeveloped lungs in the newborn and high medical cost for intensive care for the newborn.

There is a wide variety of birth defects associate with high blood sugars.

All diabetics need to seek pre-conception counseling before getting pregnant.

If you are interested, I have a 30 day course for gestational diabetes.

Help for Diabetes During Pregnancy

03/03/2017 by Julie RN CDE 1 Comment

Your Gestational Diabetes Diagnosis can be Traumatic

When you are pregnant, being diagnosed with gestational diabetes is the last thing you want to hear. You are given a crash course on how to manage your blood sugar with diet and exercise. You are so stressed out, you probably don’t remember one tenth of what was said. Your stress continues as you try to “manage” your blood sugar by testing multiple times each day. You feel like your body has betrayed you. All you want to do is have a healthy baby. I know what you’re going through.

Fasting Blood Sugar Test

The American College of Obstetrics and Gynecology (ACOG) is now requiring new clients to have a fasting blood sugar test during early pregnancy to determine un-diagnosed Type 2 and prediabetes in their patients. Due to the average woman waiting to have their first child later in life and the increasing weight problems they face with age, pregnant women are at increased risk for developing sugar problems. (Get my free gift to evaluate your risk for gestational diabetes.)

How Does Gestational Diabetes Affect You and Your Baby?

At about 12 weeks gestation, your baby starts growing rapidly. This requires increasing amounts of energy, and insulin requirements increase accordingly. Around week 24, your body’s insulin production cannot keep up with your baby’s growth.

Typically, the fasting blood test for gestational diabetes happens between weeks 24-28. The ACOG is allowing your blood sugars to increase enough during the day so that your body can not recover through the night. At that time a random blood sugar test over 200 is a positive result for gestational diabetes.

Your baby continues to grow until about 36 weeks gestation. At delivery, the hormonal effects of the pregnancy disappear and the demand for insulin drops dramatically. Postpartum, your body’s requirement for insulin can go below normal. Many women are placed on IV insulin during labor and they need to be monitored carefully during postpartum.

After Gestational Diabetes Delivery

Because your baby has developed in a blood supply rich in sugar, your baby’s pancreas will also go through an adjustment after delivery. You will see the nursing staff taking blood samples from your baby. Don’t get excited. They will monitor your baby’s blood sugar as needed to keep them safe.

Since insulin requirements shift dramatically during pregnancy, true diabetics need to be monitored carefully for adjustments in their medications. Type 1 diabetics need to be under the care of an endocrinologist throughout their pregnancy. Type 2 diabetes should expect to be placed on insulin during pregnancy. They should also expect to have weekly insulin adjustments.

What to do Before You Get Pregnant

To have a successful pregnancy without complications, all diabetics need to have their blood sugars under good control for six months before conception. The success of their ability to control their blood sugar is often determined by an A1C test.

If you need support in controlling your blood sugars before pregnancy, consider my 1:1 phone consultation program. For a free evaluation please schedule a FREE call with me.

Wishing you a happy pregnancy and a healthy baby!

Julie

P.S. Remember to get my list to evaluate your risk for gestational diabetes.

8 Tips to Avoid Gestational Diabetes

03/02/2017 by Julie RN CDE Leave a Comment

Gestational diabetes can be frightening. Typically, women get tested between 24-28 weeks gestation. You can avoid gestational diabetes by knowing your risks and taking action steps to avoid this problems.

Evaluate Your Risk

According to the American College of Obstetrics and Gynecology and the American Diabetes Association your risks include:

Over the age of 25
A body mass index (BMI) over 25
A family history of diabetes in a parent, sibling, or a child
A history of a baby born over 9 pounds
Ethic groups at highest risk include Pacific Islanders, Asians, Hispanic
and certain Native American tribes.
A random blood sugar test over 200
A1C test equal to or greater than 5.7%
A history of Polycystic Ovary Disease
High triglycerides or a prescription to control triglycerides.

It is Proven that Gestational Diabetes can be Prevented

The American Diabetes Association has proven through the Diabetes Prevention Program (DPP) that lifestyle changes can prevent or delay the diagnoses of diabetes. It is believed that gestational diabetes can be prevented through lifestyle changes. You need to make changes early in pregnancy because gestational diabetes is controlled by pregnancy hormones. As your pregnancy develops, it will become increasing difficult to control your blood sugar. Learning how eat for your body’s needs is essential.

8 Tips to Avoid Gestational Diabetes:

Eat 3 equally spaced meals each day
Limit snack between meals. (once you start following the gestational meal plan you will have nutritionally balanced snacks between meals and one at bed time.
Eat a balanced diet (limit sugar, fat and salt)
Include fresh fruits and vegetables as much as possible
Include whole grains
Limit saturated fats
Avoid sugary drinks and rich desserts
Learn to check labels for portion sizes (Do not eat for two! You need to control your weight gain during pregnancy.)

Making lifestyle changes is very difficult. It is said that it takes 3 months to change a habit. My 30 day program is a good first step to supporting you to make sustainable changes.

Consider signing up for my program “Healthy Baby from Preconception to Birth and Beyond”. Or, click here to get my FREE list of 11 early signs of gestational diabetes.

Together we can make a difference in your future.