Children with Insulin resistance and type 2 diabetes
Exercise can be fun
Younger people are being diagnosed with diabetes
Everybody needs glucose for energy and this is provided through different types of food being broken down and processed in the stomach and digestive system. It doesn’t matter what type of food is eaten, meat, vegetables, crisps or chocolate, the ending result is energy .
As the body doesn’t mind too much if you need the energy being produced immediately or not, it just continues to produce insulin to help the glucose into the cells regardless. Energy that is not used is stored for later use in one form or another.
Glucose and Insulin
For glucose to enter the cell help is needed, the cell doesn’t just open up and let the glucose in. Insulin is produced by cells in the pancreas in answer to the rising levels of glucose detected in the bloodstream. The insulin then reaches the cells being targeted by the glucose and act like a specific key allowing the glucose to enter the cells providing a source of energy.
This activation also helps to reduce the amount of glucose in the bloodstream returning it normal levels. Once again this is detected by the Beta cells in the pancreas and the production of insulin is stopped until the next rush of food and the resulting rise in blood glucose.
Diabetes type2 and Insulin Resistance
Diabetes type 2 is a disease that affects how the body is able to use this glucose once it is absorbed into the bloodstream from the gastrointestinal tract. In type 2 diabetes the beta cells in the pancreas are still able to produce insulin but the body does not respond to it normally. This is a condition called Insulin Resistance.
When the glucose cannot enter the cell because of resistance it has no other place to go but to remain in the bloodstream. However, when the blood sugar remains at high levels the pancreas continues to make and release more insulin. Over time this wears on the pancreas cells and in many cases this has led to beta cells in the pancreas being worn out and under productive. When this happens the ability to produce enough insulin is severely affected.
This is a vicious circle as the blood sugar levels are unable to return to normal and the resulting high levels are the first signs and indication that the patient has diabetes type 2. Diabetes type 2 is a progressive disease and once the diagnosis is made the patient will have to monitor and control their blood sugar levels for the rest of their lives.
Although no one knows exactly why some people get diabetes type 2 there is a common belief among researchers that there is a genetic risk. It has been estimated in the United states that between 45 and 80% of children being diagnosed there is at least one of their parents or grand parents with the disease. In some cases it has actually been found out that one of the parents have already been living with the disease and associated symptoms without having registered having the disease. How can this be?
Signs and symptoms
Although type 2 diabetes has been shown to have a certain connection to genetic risk it also has to be mentioned that many suffering from Insulin resistance over time also have been shown to run the risk of develop the disease.
Most people with insulin resistance tend to be overweight and especially those who are diagnosed with type 2 diabetes.
Type 2 diabetes was once upon a time only associated in adults over the age of forty.
While the genetic background is important , the increasing rise in numbers of children and teens being diagnosed worldwide is alarming. This increase has opened the possibility for environmental factors to be seen as an associated risk factor.
Children who are overweight are observed to have constant blood sugar levels that are higher than the normal levels for health in adults. Like adults , if their beta cells have stopped working efficiently the diagnosis of type 2 diabetes is a fact.
Children as young as four years of age have already been diagnosed and the numbers between six and ten are increasing at a frightening rate.
Puberty is seen as an important age in children who are overweight.
These children have many hormonal changes going on in the body and the change in hormone levels during this period has been associated with insulin resistance and decreased insulin action.
When the child constantly over eats the need for more insulin arises. If the pancreas no longer produces enough the diagnosis is made.
Therefore with modern day standards amongst childen with larger appetites and lower physical activity researchers are now seeing the need to draw conclusions that there is an association between lifestyle and the ever lowering of the once adult onset diabetes type 2 , to include children.
Type 2 diabetes is no longer an adult onset type diabetes and the complications run the same risk for both adults and children alike.
Detecting diabetes type 2
Type 2 diabetes is not always easy to recognize, many patients go undiagnosed for years before finding out.
Some people believe that it is better not to know before it is a fact, but this is quite sad.
If more people were diagnosed at the stage of insulin resistance the disease can be controlled much sooner and better. In some cases insulin resistance has been reversed.
Once beta cells are affected and stop producing insulin at normal levels, there is no going back. The cell is inefficient for life and medication is needed to reduce the levels of glucose in the bloodstream.
Why should you allow your child to be tested?
If a child is very overweight and has a BMI ( body mass index ) ovrer 30 this child is more often than not going around with high levels of blood sugar which can severly damage their health.
If this child should develop diabetes type 2 by the age of eight it means that the remaining years for risk of complications associated with this disease are increased many times over.
Complications associated with any type of uncontrolled diabetes are many.
The difference between type 1 diabetes and type 2 in this case is huge.
The child with type 1 diabetes will not be able to produce any insulin and therefore be quicker to get their diagnosis and associated life saving insulin shots.
The child with type 2 diabetes will be walking around with the same illness but produce enough insulin to keep them going but not enough to lower the glucose levels in the bloodstream.
It is the glucose that leads to complications.
Complications associated with insulin resistance and type 2 diabetes
Here it is important to stress that the risk of complications are the same for adults and children.
There are so called macrovascular and microvascular complications.
The microvascular include problems such as eye diseases which can lead to blindness, renal diseases ( kidney problems) and amputations because of problems associated with nerves and small blood vessels.
With macrovascular problems we are looking at risk of strokes, heart attacks and sudden death. This may be due to the increased amount of fat in the blood as well as high blood pressure.
When a patient is diagnosed with all three complications such as type 2 diabetes, high blood pressure and hyperlipidemia they will be told that they have Metabolic syndrome, this syndrome places them in a category at high risk for heart disease.
As you can understand, it is much better to get control of the blood sugar at as early a stage as possible.
Warning signs of Insulin resistance, high blood sugar and diabetes type 2
Although many children may not show any of the following symptoms on a regular basis they may on some occasions be seen.
Even if you are wondering if a child may be affected by the disease it is better to test than just wonder. If you suspect that they are in the risk zone for developing diabetes in years to come you may even be able to reverse any negative trends that have developed and can be reversed.
When should you suspect or take this up with your health care provider?
· The child is is bigger than standard for their age group
· They are calculated at having a bmi over the recommended level for age, height and sex
· The child is reaching puberty and especially if puberty is early and weight is in excess
· Any history of others with type 2 diabetes in family
· Suspected insulin resistance
· Belong to a family with ethnic background and have associated symptoms of insulin resistance
· If the child has any of the following symptoms associated with insulin resistanc
o Acanthosis Negricans ( Dark patches of skin especially on back of neck, between fingers or toes, under arms and elbows)
o Polycystic ovary syndrome
o High blood pressure
o Blood fat disorders
· Urinating frequently: The kidneys more often than not respond to high levels of glucose in the blood by flushing out extra glucose. Even if the child does not urinate more often it may be observed that the amount/volume of urine is much more than expected.
· Drinking more liquid than normal. Higer volumes of urination need to be topped up and replaced
· Tired: When glucose is not being taken up by the cells energy levels will be affected and the result is tiredness. Lethargic and can be mistaken for laziness.
· In one of the above points associated with insulin resistance, high blood pressure is mentioned. This is not often associated with young children but observations of children being puffed out when running can be observed. Although the child may not have clinical high blood pressure they may be struggling more than they should be for their age.
Children living with type 2 diabetes or insulin resistance
Living with this disease is a challenge for the whole family and it is so important that it is treated as such. This disease should not be seen as the childs problem as this can lead to other problems.
There are many ways that the child can learn to live with this disease and it is just that they have to learn. This is not a disease that goes away it requires a complete lifestyle change and a control that comes natural to them to give them the same chance in life as any other person.
The child may not understand why they have to control and test their blood on a regular basis, this can hurt and it can for some be embarrassing.
Children living with this problem have told how they were angry, scared and had feelings of guilt when they were first told that they were diabetic.
When a child is diagnosed it is immediately thought that they have to go on a strict diet, run for miles each day and never eart cake again. Of course this must be frightening. Not only for the child but also for the parents who have to change everything overnight.
Many families tell stories of everyone blaming each other for this happening but it really shouldn’t be like that.
Children pick up much more than we ever imagine and make up their own minds through observation and these realities can be as far from the truth as you could ever imagine.
Therefore it is advisable that the whole family sit down and discuss together with the child how they should continue with their new lifestyle.
The parents will to a degree also have to change their habits.
Mealtimes for example will have to be timed differently and contain different nutritional value foods. Children cannot be placed onto calorie lowering diets like adults. Their food also has to contain nutrients valuable for bone development and growth.
Food should also be enjoyable and not seen as a punishment for being fat.
Fasting blood sugars may have to be measured, they will also have to be measured on occasion before tough exercise regimes and after. The child will also have to recognize hypoglycemia even if they do not take insulin injections. If the diet has been changed to low calorie intake exercise can reduce the sugar levels to lower than required for good health.
Exercise will need to be included daily and the recommended daily quota for a child is 60 minutes with active training over normal rates. This can be divided up over the day and does not need to be one solid hour.
It is also recommended that salt intake is reduced as this will reduce added risk of blood pressure problems.
It can be quite traumatic for children to meet up at every meeting about diets and food but it is advisable for the parents to attend these meetings as they can learn many ways to reduce the feeling of “doing without”.
There may also be feelings of being different among their friends as they have to adapt to their insulin resistance or diabetes type 2.
Therefore it is also advisable for the families to create situations where the child can voice their worries, irritations and fears.
The Impotance of exercise
During physical exercise glucose moves from the bloodstream more efficiently into the muscle being activated. This effect on many occasions can have advantages lasting up to 48 hours.
Since excess body fat can make insulin less effective in moving sugar out of the blood being overweight can make the diabetes worse.
Their lifestyle changes are meant to make a better future for them and this can be achieved.
There are many websites with fun recipes for children with diabetes and there are many sites with exercise programs that are fun.
Wii fitness is also a great way for making exercise fun and this is something the whole family can join in.
Hopefully many children will be helped before the insulin resistance becomes difficult to control and some may even be able to revert back to a healthy lifestyle and live further without this diagnosis.