Children at risk type 2 diabetes 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
