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Expert: Children with diabetes face trouble

By Katie Scarvey
kscarvey@salisburypost.com
KANNAPOLIS — Children with diabetes are not eating as well as they should be, which is putting them at risk for serious health complications down the road.
That was one of the messages delivered Tuesday by Dr. Beth Mayer-Davis at the David H. Murdock Core Laboratory Building.
Mayer-Davis, an expert in childhood diabetes, is the national chairperson of the Search for Diabetes in Youth Study, a long-term multi-center study that is providing much-needed data on diabetes in children, with a focus on nutrition.
Mayer-Davis is a professor of nutrition in the University of North Carolina Gillings School of Global Public Health and a professor of medicine in the UNC School of Medicine. She was also recently appointed by President Obama to the Advisory Group on Prevention, Health Promotion and Integrative and Public Health, which directly supports First Lady Michelle Obama’s childhood obesity initiative.
About 100 people gathered to hear Mayer-Davis present the latest in childhood diabetes research, part of the UNC Nutrition Research Institute’s Appetite for Life Seminar Series.
Diabetes is a serious, chronic condition that affects virtually all of the body systems, Mayer-Davis said. Complications include a much higher risk of developing cardiovascular disease, retinopathy (which can lead to blindness), kidney and liver disease, neuropathy and amputations.
Both type 1 and type 2 diabetes (which used to be called adult-onset diabetes) are on the rise, Mayer-Davis said.
Nationwide, 26 million people live with diabetes, according to the Centers for Disease Control — and another 57 million have pre-diabetes, Mayer-Davis said. That means one in five people are at risk for developing type 2 diabetes.
Type 1 diabetes in youth — the kind that requires insulin injections — is most prevalent in Finland and Sardinia and least prevalent in Hong Kong and China.
It’s estimated that in North Carolina, 3,700 children have type 1 diabetes and 500 have type 2 diabetes.
Certain populations are at higher risk for type 2 diabetes, which is associated with obesity, underactivity and family history. These populations include African-Americans, Hispanics and Latinos, Native Americans and Asian Americans. Native Americans have the highest occurrence of type 2 diabetes.
The study has shown that the children with type 1 diabetes are overweight at the same rates as other children, or even a little higher, Mayer-Davis said.
“That’s a concern,” she said, since those with diabetes are already at a greater risk of cardiovascular disease.
While one might expect that these children might make better nutritional choices than other children, that is not the case, she said.
The vast majority of children with both type 1 and type 2 diabetes are not getting the recommended servings of fruits and vegetables, according to the study. Ninety percent of children with diabetes are consuming too much saturated fat. High consumption of sugary drinks (one or more a day) is also a concern, since it is related to higher overall cholesterol in children with diabetes. Fructose consumption is also associated with increasing levels of triglycerides.
Certain populations are particularly at risk in terms of controlling blood sugar. More than half of Native American youth with type 1 diabetes have what is considered poor glycemic control — which means they are at risk of incidents which can lead to hospitalization.
Youth with diabetes tend to have numerous cardiovascular disease risk factors. Ninety percent of children with type 2 diabetes have metabolic syndrome — a group of conditions that occur together and increase the risk for coronary artery disease and stroke.
The youth with diabetes who are at highest risk are those who adhere poorly to dietary guidelines. Particularly at risk are minority male adolescents 15 and above. Other risk factors include a low level of parental education and low-to-middle family income and low parental involvement in diabetes management, as well as sedentary lifestyle.
Diet in children with diabetes is, then, of utmost importance. Children with diabetes, Mayer-Davis said, need to be able to match insulin to food intake, eat foods high in fiber, consume whole grain breads and cereals, get enough fresh fruits and vegetables and increase physical activity.
The DASH diet (Dietary Approaches to Stop Hypertension) is rich in vegetables, fruits and low-fat dairy products. It is one way to address nutrition concerns.
Mayer-Davis also recommended individualized dietary counseling for children with diabetes and their families.
A new research study called FL3X, is using some high-tech communication strategies to help youth manage their diabetes, including reminders done through cell phone/web interfaces and the use of Google Calendar.
For more information about the FL3X program, go to http://type1fl3x. com.

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