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Sunday, July 27, 2008

Update on Management of Type 2 Diabetes in Youth

Drs. Peterson, Silverstein, Kaufman, and Warren-Boulton have published an update on the management of Type 2 diabetes in youth. This is very timely for this is becoming an important disease for the youth. The factors for high risk group are a body mass index of more than the 85th percentile plus family history and high risk ethnicity.

Increased physical activity along with a healthy diet plus a reduction in weight and blood glucose level can prevent or delay the onset of the disease. The American Academy of Pediatrics does not propose that the high risk group be screened but advised the physicians to closely monitor these patients because early diagnosis maybe helpful.

However The American Diabetes Association recommends screening these patients every two years. It was further suggested that those diagnosed with diabetes receive behavioral interventions to encourage eating healthy and physical activity.

Since the treatment of Type 2 diabetes is different between adults and children because the management for the latter group is focused on lower insulin sensitivity with advancing physical growth and sexual maturity and the ability to do self-care, it is good to tailor the treatment for each patient.

It is not enough to use just diet and exercise because this works only for less than 10% of the afflicted youth. Oral medication or insulin is usually necessary. Treatments of blood goals target, type of insulin dose, self-monitoring frequency, meal planning to promote good nutrition
and physical activity will differ from patient to patient.

Doing all the self-care tasks can make the kids feel different and coping may lead to depression and eating disorder so a social worker or psychologist can help with adjustment to lifestyle changes. While kids should be able to do self-care tasks, they need to be supervised until they are able to do them on their own.

Saturday, July 19, 2008

Mother's Blood Sugar Linked to Kids' Obesity Risk

July 19, 2008

Anita Manning reported in USA Today that women with high blood sugar levels when they are pregnant are two times more likely to have obese children. This is according to the largest study on the same issue. This research is published in the September issue of the journal called Diabetes Care.

It is not all bad news though because Teresa Hillier, an endocrinologist and co-author of the study said that the tendency to have obese children is reversible when the high blood sugar is treated during pregnancy. Reversible is the word to note here.

Teresa Hillier and her colleagues at Kaiser Permanente's Center for Health researched 9439 mother-child pairs who were enrolled at the center's Hawaii and Regions in the Northwest from 1995 to 2000. The result of their examination is that the higher the mother's blood sugar, the greater is the chance for the child to be overweight by the time he is between 5 and 7 years old. They found this true for all ethnic groups.

The key thing to do is to get the child started on healthy lifestyles. Eating healthy is one that will benefit everyone in the family. Don't get the baby started on too much orange juice as it contains a lot of sugar. This has been the findings of the recent studies. Go easy on cookies too.

The other part of lifestyle to take note is to get the child started on some physical activity. I have seen babies in the swimming pool with their mothers. Then as soon as they are in their toddler years, you can get them started on T-ball games. Oh, they will not be too focused but at least they will be active and not become obese. And you will have fun watching them play. I know I have.

Saturday, July 12, 2008

Heart Attack Raises Diabetes Risk

July 12, 2008

A new study finds that after a heart attack, the risk of developing diabetes and pre-diabetes goes up sharply. Heart attack patients are four-and-a-half times more likely to develop the condition than the general population. The August 25, 2007 issue of The Lancet further reported that the patients are fifteen times more likely to develop high blood sugar.

Before this study, the correlation between diabetes and cardiovascular disease was clear in the sense that people with diabetes are two to four times more at risk to get heart disease. They are also five more times at risk to have a stroke.

Dr. Lionel Opie, director of the Hatter Cardiovascular Research Institute of the University of Cape Town, in South Africa said that having a heart attack means that the chance of getting diabetes later is increased. This has been proven by the study that was conducted.

The study led by Dr. Roberto Marchioli from the Laboratory of Clinical Epidemiology of Cardiovascular Disease, Consorzio Mario Negri Sud, in Italy, collected information on 8300 Italian patients who suffered a heart attack.

These patients were not diabetic prior to the heart attack but a third of these patients developed diabetes or had impaired insulin resistance after more than three and a half years after the heart attack. These results showed the correlation between heart attack and high blood glucose.

The risk factors for diabetes are high blood pressure, age, the use of heart medicines like the beta blocker drugs to lower cholesterol levels and diuretics. Being overweight, an unhealthy diet and heavy drinking of alcohol also increase the risk and smoking increases it by 60%.

It is therefore important to change the lifestyle in order to prevent diabetes. Changing the lifestyle means eating healthy. Speaking of healthy eating, a Mediterranean diet can help prevent diabetes so did Marchioli say. This also has been the opinion of some other experts.

Saturday, July 5, 2008

Chief of Endocrinology & Metabolism at Pennsylvania Hospital Recommends Exercise Tips for Diabetics

Dr. Rosen, a known metabolic diseases expert on forefront for research on treatment of diabetes, makes recommendations on exercise guidelines for diabetics. Here they are:

  • Wear light clothing.

  • Use well-fitted footwear.

  • Do warm-up or stretch before exercise.

  • Drink often during exercise.

  • Have soft candy at hand.

  • Talk to your doctor before doing intense exercise.

  • Build up exercise.

The American Diabetes Association awarded him the Charles H. Best Medal for Distinguished Service when he was its president of the eastern region. Of course you know who Charles Best is. He was Dr. Banting's right hand man when they discovered insulin.

That is why, Dr. Banting was so pissed off when he received the Nobel Prize along with another and Charles Best was not even mentioned. What do you suppose good-natured Dr. Banting did? Well, he shared his award with Charles Best, what else.

Back to Dr. Rosen. He has done significant diabetes research. This has been published in primary journals such as Diabetes and the Journal of Clinical Endocrinology and Metabolism. He said that to make certain that one manages diabetes and stay fit and healthy, follow the exercise tips and consult with your doctor.

Want to know what are the benefits of exercise? Here they are:

  • Lower blood sugar levels

  • Lower A1C levels

  • Improved HDL cholesterol

  • More calories are burned.

  • Strength and flexibility are increased.

  • Improved quality of life

  • Better insulin sensitivity

  • Lower triglyceride levels

  • Improvement in hypertension

  • Cardiovascular system is better conditioned.

With all those benefits, who would not want to do some physical activity? Come on, let's get moving! But first, get a preexercise exam to make sure all is well. Then set a goal, plan how to achieve this goal and have fun with it.