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Preventing Diabetes in Children

Posted on January 25, 2018 | No Comments on Preventing Diabetes in Children

It is a well-known fact that diabetes is a disease whose prevalence is increasing at disturbingly alarming rates worldwide. And while much attention is focused on the incidence of type 2 diabetes, especially with the epidemic of childhood obesity, the incidence of type 1 diabetes which is classically associated with children is increasing as well.

This brings us to ask that very important question: Can anything be done to prevent our children from developing diabetes and all the dreaded complications associated with it? Apparently, it really depends on what kind of diabetes we are dealing with. The news is mixed. But fortunately, there is a lot of research going on to answer this very question. Much attention is now focused on the target population where intervention may hold the key -those with “prediabetes”. In other words, those who are at risk for developing diabetes but do not have it yet.

Type 1 Diabetes

Let us start with the new developments and research on preventing type 1 diabetes. Type 1 diabetes is an autoimmune disease that occurs when your body’s system for fighting infection (the immune system) turns against your own body. In this case, the body destroys the insulin-producing beta cells in the pancreas, which eventually leads to increased blood sugar levels. Since it is an autoimmune disease, it is not generally due to a bad diet or lifestyle. Unfortunately thru no fault of your own, you are born with the predisposition to this disease. There are tests to find out if you are at risk for developing this type of diabetes and they are done if you have a parent or sibling with type 1 diabetes. If these tests are positive (specifically looking for the factors that destroy the beta cells) and you have the type of genes associated with diabetes, you are considered to be in the prediabetes stage for type 1 diabetes.

There have been many therapies attempted to prevent or delay the onset of type 1 diabetes. There is some promising news but nothing definite at this time. A lot of the focus has been on trying to “rewire” the body’s immune system so that it does not destroy the beta cells in the pancreas. They have used insulin, different kinds of immune modulating medications, and possible pancreas or beta cell transplantation. These therapies are all experimental and unfortunately have not yet been shown to prevent diabetes.

But there is some good news-it appears that the risk of type 1 diabetes can be decreased with the simple intervention of breastfeeding. In high risk infants, shorter duration of breastfeeding is associated with a slightly increased risk of developing type 1 diabetes. So breastfeeding for longer periods is encouraged to reduce the risk of developing type 1 diabetes. Another research direction is looking at dietary manipulation in infants (different formulas that can be given, as well as probiotics) to see if this can affect future beta cell autoimmunity and ultimately decrease the risk of developing type 1 diabetes. These studies are still ongoing.

It’s a totally different story when it comes to type 2 diabetes. Type 2 diabetes is historically associated with adults. However, due to the epidemic of childhood obesity, it is now increasingly seen in children as well. This type of diabetes occurs when the body cannot produce enough insulin to control blood sugar, or alternatively, the receptor cells ignore the insulin that is produced, leading to increased blood sugar levels.

Which children are at risk for developing type 2 diabetes?
Being Asian is a risk factor. Having a parent or close relative with type 2 diabetes; any child born to a mom who had diabetes during pregnancy (gestational diabetes); and lastly, being overweight and physically inactive are important risk factors. In the latter case, a bad diet and/or lifestyle play a key role. This sounds like a lot of kids nowadays, mostly because it sounds like a lot of us parents as well.

The very good news is that there have been many studies in adults that show that type 2 diabetes can be prevented or delayed with lifestyle modification and/or medications. One of the major trials done was the Diabetes Prevention Program (DPP). The DPP showed that in adults, lifestyle changes in diet, exercise and losing a little weight can reduce the risk of developing type 2 diabetes by a remarkable 58 percent! In other words, a healthy diet, moderate exercise (even 30 minutes done five days/week) and losing 5 to 7 percent of body weight can reduce your risk by almost 60 percent. Can these results also be applied to children?

The consensus is that the results are solid enough that they can probably be applied to any age group. This is very good news indeed.

What can we do?
At the risk of sounding cliche, good health habits remain the cornerstone of any preventive program. And although this advice mostly applies to type 2 diabetes, these steps are general enough that they apply to everyone trying to prevent or delay the onset of most of today’s diseases.

1. Optimize maternal health and nutrition. Preventing disease, in other words, starts as early as pregnancy. There is enough evidence that too much or too little weight gain during pregnancy is not good for the baby. Excessive weight gain is a risk factor for developing diabetes in pregnancy, which puts the baby at risk for developing type 2 diabetes later in life. The baby born too small or too large is also at increased risk for developing type 2 diabetes later on.

2. Breastfeeding is still BEST for baby. A recent analysis of the many studies of the effect of breastfeeding and the risk of type 2 diabetes concludes that breastfeeding in infancy is associated with a reduced risk of type 2 diabetes. Breastfeeding is also associated with a decreased risk of childhood obesity, another risk factor for type 2 diabetes. And as already mentioned, it decreases the risk for type 1 diabetes as well. These are just some of the very compelling reasons that breastfeeding should be encouraged in all mothers.

3. Encourage healthy eating habits. The usual tips apply here. Regulate portion sizes. Eat smaller servings. Eat fruit for snacks. Limit sweets and junk. Drink a glass of water before meals. Encourage drinking water instead of soda, fruit juice or ice tea. With young children, remember that they don’t miss what they’ve never had. So don’t feel too badly about not giving them the sweets you may have had at an early age.

4. Get Moving. Limit TV or computer time to one hour/day. Encourage children to do something physically active everyday – even if that is dancing around the house or walking around the mall without snacking. Remember that physical activity can be done in short stretches (20 minutes at a time instead of the whole hour), so you don’t have to have much time to make a difference. In general, physical activities done together as a family are best, such as taking walks, playing ball or other sports and outdoor games.

As parents, we all hope our children will be born healthy and stay healthy. We do everything to ensure that they get the best opportunity in everything to ensure their future. We should treat their health as importantly as all other aspects of their lives.

And despite all the health problems that many times seem inevitable in this day and age, it is encouraging to know that that there are definite steps that we can take to help ensure our children’s long term health. They are certainly not easy, but the rewards can be lifelong. That’s definitely a goal worth reaching for.

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