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What Schools Need to Know: Children with Type 2

07/21/2017 By Julie RN CDE Leave a Comment

Back to School with Type 2 Diabetes

Each new school year brings new challenges, particularly with diabetic students. Back to School Preparations are different when your child has diabetes. A parent’s ultimate responsibility is to teach their children to be independent, no matter what the situation. My experience with parents of school age children with diabetes varies widely.

Many times, school officials do not know if diabetic students are type 1 or type 2. Although the difference between the two conditions is like night and day, students are treated much the same way. It is unfortunate at this time in the USA, that approved medications for Type 2 in children are limited to Metformin and insulin. Insulin is a serious medication with significant side effects if not administered properly. I understand why parents are fearful for unfamiliar staff to give insulin to their child. For this reason, parents need to teach their child about insulin dosing so that the child will be self-assured and assertive to ask questions of adults when needed.

Kids can learn amazing things. While I was medical staff at a Type 1 diabetes camp, I had some amazing experiences. I worked with the youngest group ages 6-8 years old. Danny (fictitious name), was diagnosed at age 2 years and had an older sister who was also Type 1. Although he was 7 years old, he could already feel his blood sugars dropping when he was outside playing and he knew how to appropriately treat his low. He could “guestimate” what he was eating at each meal and calculate his insulin correctly. He had to be supervised, but at a very young age he had learned how to live with his “organ failure” and still be as normal as possible. Kids can learn with parental support.

Diabetes Priorities Vary with Age

According to the American Association of Diabetes Educators (AADE) diabetes priorities vary with age. (BC-ADM, 2014)

*Preschool and early elementary school students (ages 3-7 years) need to develop self-confidence. They need to learn to trust school staff to take care of their unique needs. Parents have the responsibility to educate other caregivers about their child’s specific needs. Many times blood glucose readings are seen as “good” or “bad”. Children have a strong desire to please parents. Fear of failure can cause children to falsify their numbers. Parents need to teach their children that blood glucose readings are just used to monitor their medication needs and never meant to evaluate their child’s behavior. Developing trust with your child is very important in this phase. (BC-ADM, 2014)

*Older elementary school ages 8-11 years need to develop self-esteem with respect to friends and peer groups. Diabetes management needs to center around a flexible regiment to allow participation in many activities. Their education needs to include how to avoid and treat hypoglycemic events. Parents need to observe blood glucose testing. Parents also need to progress in teaching their children about insulin dosing and self-administration. It is also important to teach their children how to participate in special occasions (example: birthday parties particularly at school). (BC-ADM, 2014)

*Early adolescents (ages 12-15 years old) can be very challenging. Normal hormone changes during puberty will cause blood sugars to be unpredictable. Parents need to be cautious about blaming their child of eating extra foods. Although they may be very hungry due to growth hormone, other hormone shifts will cause major troubles with blood sugars. It is important for parents and children to communicate honestly to avoid emotional problems. Diabetes priorities in addition to blood glucose control include monitoring for body image distortion, eating disorders, risky behaviors and depression. Although students may learn maintaining high blood sugars can create weigh lose, they also need to be taught the dangers of complications from uncontrolled diabetes like blindness, strokes and heart disease.

Family conflicts need to be intervened possibly with a professional family counseling. Turmoil between parent and child is very common at this phase. Children want more independence while parents are very fearful of the results. There is a high divorce rate in families with diabetic kids. Counseling may be beneficial for the whole family. (BC-ADM, 2014)

*Young adults (ages 16-19) Diabetes priorities include integrating diabetes into their lifestyle after high school. Young adults need to learn good coping skills for self-management. Teen and parent conflicts are common even without diabetes. There is a normal separation of the child from the family unit. Teens begin planning for their future independence. It is the parent’s responsibility to transition their teen into independent living. This includes developmentally challenged young adults. (BC-ADM, 2014)

When appropriate, it is very important for parents to educate their child about the effects of alcohol on blood sugars. I have seen so many diabetic college students in the emergency room. If you don’t know the dangers of alcohol abuse with diabetes, I encourage you to educate yourself and your child. For more information, see my blog post on alcohol and blood sugars.

BC-ADM, C.B. (2014). Type1 diabetes throughout the life span. IN S.C. Carole Mensing RN, The Art and Science of Diabetes Self-Management Education Desk Reference (pp. 393-400)

Could cell phones be causing weight gain?

07/07/2017 By Julie RN CDE Leave a Comment

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!

Syndrome X

04/21/2017 By Julie RN CDE Leave a Comment

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

Alcohol and Diabetes a deadly combination

03/19/2017 By Julie RN CDE 1 Comment

I know alcohol is never recommended in children under the legal age. But teens often have access to alcohol, so it is important for them to understand the effects on their blood sugar. This is particularly important when parents are preparing their children for college. I worked in a college town and many students end up in the ER with blood sugar problems.

So many people with prediabetes are in denial. This is especially true in teens. But that doesn’t mean they are exempt from the side effects of uncontrolled blood sugars. Parents need to take an active role in educating their young adults in the problems of alcohol before they head to college…..

Alcohol Can Adversely Effect The Body’s Ability To Regulate Energy

As you know, excess alcohol effects your liver functions. Your body’s energy regulation actually starts in the liver. That is the reason doctors use Metformin as the first medication with prediabetes. Improving the function of the liver by 20% will improve blood sugars by 80%.

Initially alcohol could raise your blood sugar (particularly with beer), but alcohol works in the liver to prevent stored sugars from being released. So it can actually cause low blood sugars during the night while you sleep. It is important to eat a snack of protein and carbs before going to sleep. It is even more important to not sleep in late in the morning (like most college student tend to do).

What You Should Do

Set an alarm, and if you can, check your blood sugar and eat breakfast! Then if you want to go back to bed, no problem. The main problem is that your blood sugar could go too low while you’re “sleeping it off”. That feeling of being hung-over may actually be low blood sugar.

Also, please feel free to email me if you have questions that aren’t answered here!

Low Blood Sugar Symptoms

The side effects from low blood sugar looks similar to drunkenness. This is a dangerous situation. Symptoms of low blood sugar without diabetes include:

Paleness
Headaches
Shakiness or trembling
Blurred vision or Dizziness
Lack of energy or fatigue
Poor Coordination
Irritability, anxiety, agitation
Nausea or vomiting
Excess sweating or perspiration
Problems concentrating, confusion
Decreased consciousness or loss of consciousness

This is really important with kids that are going to college. They will drink alcohol. So educate them about it.

Any questions, send me a message at Julie@kidsatriskfordiabetes.com.

http://www.healthclop.mailto:Julie@kidsatriskfordiabetes.comcom/low-blood-sugar-without-diabete

Children’s brains need 130 gms carbs daily

03/04/2017 By Julie RN CDE Leave a Comment

Children need carbohydrates for proper brain development. We should not be placing our kids on a low carbohydrate diet for weight control. Children need a balanced diet for growth and proper brain development.

What Information Is Out There

Much information on the internet today states that if you have high blood sugars, you should switch to a low carbohydrate diet. There is a ton of information about low carb diets. You could get the impression that this is a good way to control blood sugars. But in children, low carbohydrate diets can be harmful to their brain development.

Blood Sugar Is So Confusing!

I once had a lady come for consulting, complaining of unknown sources of blood sugar. She stated she had checked her blood sugar before eating her dinner. Then she ate a steak dinner with NO carbs. (She was very careful, no dinner roll, no potato, etc.) Then after dinner she checked her blood sugar again and it was much higher. She was so confused.

Have you ever gone to bed at night with one meter reading and woke up the next morning with higher blood sugars? I have had parents believing their child was eating during the night causing this rise in blood sugar. Poor kids were begging for my help!

The fact is, when you don’t eat what your body needs, your body will produce it. Your liver is a large reservoir for energy. When you don’t eat carbs and your body needs quick energy, your liver will release it. This causes your glucometer to read higher than expected.

Our Brains NEED Carbohydrates!

Your brain needs carbohydrates to function properly. The adult brain needs about 100 grams of carbohydrates every day for proper brain functioning. Children need 130 grams of carbohydrates every day just for proper brain growth and development. Imagine your children having a hard time concentrating in school because they are not getting the quick energy they need.

We know it is easy for kids to get a sugar buzz. But there are other sources of carbohydrates they need like fresh fruit, yogurt, cereal, granola, whole wheat bread, starchy vegetables like corn and peas, plus many more.

Low carbohydrate diets are not the answer to prevent diabetes. In fact, many people turn to high protein diets which are usually high in fat (aka loaded with calories). They gain weigh causing insulin resistance. It really is about total calories. Living a balanced life is key, particularly in children.

What You Can Do

Are you motivated to make major diet changes like this? Are ready to teach your children to lead a healthy lifestyle with a balanced diet and increased activities? If you’re ready to make changes but don’t know where to begin, I have a 30 day virtual program that is perfect for the whole family! Click here for more info.

Always be careful when accepting information from the internet as truth. Unfortunately, not everything on the internet is correct!

Please check with your medical provider before making significant changes in your diet.

Making and maintaining lifestyle changes is very difficult. If you need a coach, find someone who will work with you. I’m happy to chat with you if you have questions. Schedule a discovery call with me.

www.kidsatriskfordiabetes.com Julie@kidsatriskfordiabetes.com

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.