More Kids Than Ever Have Type 2 Diabetes

Doctors seek to establish a gold standard for their care of Kids with Type 2 Diabetes

 

By Erika Gebel, PhD

 

Fifteen years ago type 2 diabetes  in children was almost unheard of. Since then, as the number of cases has crept up, scientists have sought to figure out how best to treat this type of diabetes in young people.

 

A 2007 study in the Journal of the American Medical Association estimated that there are about 3,700 new cases of type 2 diabetes a year among youth in the United States. The evidence suggests that type 2 behaves differently in children than in adults, an insight that may help doctors give kids with type 2 the best possible care.

 

Kids With Diabetes in the U.S., 2009 (Under age 20)

More than 19,000 have type 2

More than 168,000 have type 1

Source: SEARCH trial

 

Rising Numbers
In June, researchers from the SEARCH for Diabetes in Youth study released data showing that type 2 diabetes in 10- to 19-year-olds had increased 21 percent between 2001 and 2009. “Twenty-one percent is substantial,” says Elizabeth Mayer-Davis, MSPH, PhD, RD, of the University of North Carolina–Chapel Hill, who is a SEARCH researcher. “That was really driven by the Hispanic and non-Hispanic white youth.” Type 2 diagnosis rates didn’t increase in Native Americans, Asian/Pacific Islanders, or African Americans during these years. This may be good news, says Mayer-Davis, suggesting that rates may be leveling off, but only time will tell. The researchers also noted that the number of cases of type 2 rose faster among girls than in boys.

SEARCH researchers excluded children under 10 years old from their calculations. “Really, type 2 diabetes is exceedingly rare under the age of 10,” says Mayer-Davis, a former American Diabetes Association president of health care and education. The great majority of people with diabetes under 21 years old have type 1, she adds. In 2009, only 1 in 3,000 people between ages 10 and 19 had type 2 diabetes. With type 1, there were 6 cases per 3,000 people between newborn and 19. However, the ratio of type 1 to type 2 diabetes varies among ethnic groups. In new cases of diabetes among African American adolescents over 10 years old, “about 40 percent have type 1 and 55 percent or so have type 2,” says Mayer-Davis. With non-Hispanic white kids, 80 percent are being diagnosed with type 1.

The main culprit for the rise in type 2 among children, experts agree, is weight. “We don’t even entertain the possibility of type 2 when a child isn’t overweight,” says Silva Arslanian, MD, a pediatric endocrinologist at the Children’s Hospital of Pittsburgh. Obesity isn’t the only factor, though. Many kids are overweight and don’t develop diabetes, says Mayer-Davis, so something must lead the beta cells of the pancreas to stop producing enough insulin to control blood glucose in children who develop type 2. That part, she says, remains a mystery.

A complicating factor is that obesity is rising among type 1s as well, just as in the general population. “It becomes hard to make the distinction,” says Arslanian, between type 1 and type 2 diabetes in children. To confirm that a child has type 2, doctors can check the blood for autoantibodies, the hallmark of type 1.

Prevention and Treatment
Because type 2 in kids is such a recent phenomenon, doctors still don’t have a gold-standard treatment. To address this knowledge gap, scientists conducted the Treatment Options for Type 2 Diabetes in Adolescents and Youth (TODAY) study, which included 700 children between 10 and 17 with recently diagnosed type 2 diabetes. All participants started on metformin to achieve an A1C (average blood glucose over the previous two to three months) of 8 percent or less. Then a third of kids continued metformin, another third took metformin and rosiglitazone (Avandia), and the rest added a weight-loss program to their metformin. Over an average of four years, researchers tracked how many of the children failed to maintain an A1C of 8 percent or less. None of the regimens worked particularly well: By the study’s end, about half the kids in all the groups had experienced a decline in blood glucose control that required treatment with insulin.

The researchers learned that the need for insulin in type 2 comes “three times faster in children than in adults,” says Arslanian. “As of now, it looks like the deterioration in beta cell function in teenagers occurs sooner than in adults.” This suggests that type 2 in kids progresses rapidly. However, at least part of the reason so many kids with type 2 are on insulin is because they have limited options. There is an abundant selection of medications for type 2 in adults. But in children, the only approved diabetes meds are metformin and insulin.

Diabetes complications are a concern in children with uncontrolled type 2. “A higher percentage of kids with type 2 than type 1 have complications,” such as kidney disease, says Mayer-Davis. Children with type 2 often have risk factors for heart disease, such as high blood pressure and high LDL (“bad”) cholesterol. Kids with these conditions are at increased risk for heart attacks and strokes as adults, so Arslanian says it’s important to treat these risk factors with medications that improve cholesterol and blood pressure. The American Diabetes Association also recommends that children with type 2 get annual screenings for diabetic eye and kidney disease.

The future for adolescents with type 2 diabetes is still uncertain. The condition is so new that scientists don’t know what will happen when these kids grow up. But that’s changing, as researchers continue to learn more about the disease in youth. The goal is to establish a gold standard for treatment so that kids with type 2 get the care they need to become healthy adults.

 

Source: http://forecast.diabetes.org/print/3868

Photo credit: Photo: Erik Isakson/Getty Images

 

Dr. Andrew Weil’s 5 Health Essentials

 

Dr. Andrew Weil practices integrative medicine, a field that emphasizes the body’s natural healing power and focuses on correcting the underlying causes of disease rather than just managing symptoms. As a result, Dr. Weil’s recommendations often focus on illness prevention through simple lifestyle choices. He maintains that there are easy things you can do every day at home to improve your health. Here, Dr. Weil shares his five essentials to provide an immediate boost to your well-being! Learn about the tools that could change your life forever.

Essential #1: Iodine
Dr. Weil considers this multi-purpose mineral essential for good health. Iodine regulates all key metabolic functions including blood cell production, muscle function, body heat, and hormones. An iodine deficiency causes weight gain, fatigue, intolerance to cold, and can result in gastrointestinal problems, skin abnormalities and even neurological issues. With so many symptoms, it’s shocking to learn that millions of women are deficient in iodine. The problem is the American diet; so many processed foods don’t contain iodine and our bodies don’t naturally produce it.

One of the major signs of iodine deficiency is an enlarged thyroid gland. Without iodine, the thyroid cannot produce the proper amount of hormones and it reacts by enlarging itself. A person with an iodine deficiency might experience signs of hypothyroidism, a condition where the thyroid doesn’t make enough hormones. These symptoms include puffy eyes, dry skin, brittle hair and nails, and exhaustion.

If these symptoms sound familiar, try this self-test to see if you’re iodine deficient. Tip your head back while looking at the reflection of your neck and thyroid area. Swallow several times. Feel for swelling, lumps or bumps on both sides of throat; these may indicate that you have an enlarged thyroid and you should consult your doctor.

Take preventative steps by ensuring you’re getting enough iodine. The National Institutes of Health recommends adults get 150 mcg daily. Chances are that you’re getting enough iodine already if you have a well-rounded diet. Good sources include dairy products and seafood like tuna, shellfish, lobsters and sardines. For an extra-rich source of iodine, try kelp. With 2500 mcg of iodine per gram, this superfood is considered the best natural source in the world.


Bonus Tip: Asian Mushrooms
For another way to enhance your health, try Asian mushrooms. Prominent in Chinese medicine, these superfoods are believed to increase resistance to stress and boost longevity. Dr. Oz’s personal favorites are Shiitake and maitake oyster mushrooms. Eat them today to unwind and extend your life!


Essential #2: Pistachios and DGL
Problems with digestion, heartburn, stomach pains, and IBS are the classic side effects of the standard American diet and stress. Dr. Weil has a solution – a combination of pistachios and an herbal product made from licorice called DGL.

Low-calorie and full of nutrients and fiber, pistachios are great for digestion. New research indicates that these ultra-healthy nuts have prebiotic characteristics – meaning they can help support higher levels of beneficial bacteria in your digestive tract. Just one serving of pistachios can make a big difference for your aching stomach. And there’s more good news – one serving is 47 nuts, a larger serving size than any other type of nut, which clocks in at only 158 calories and contains more fiber than half a cup of spinach. That fiber, along with pistachios’ unsaturated fat keeps your digestive system running smoothly. The healthy fats also help to lower cholesterol levels.

The next digestive aid is called deglycyrrhizinated licorice. Don’t confuse DGL with the candy; this licorice is an herbal extract that can be used to treat indigestion and heartburn. It acts by increasing the mucous coating in your stomach, lower esophagus and intestinal tract, protecting those tissues from irritation by stomach acid. This soothing effect helps to treat symptoms of GERD and can protect against the damaging effects of NSAIDs like ibuprofen.

You can find DGL at most health food stores. Try slowly chewing a dose of 2 (75 mg) tablets before or between meals. DGL also comes in a powder form – try half of a teaspoon in between meals. While DGL is perfect for anyone who suffers from heartburn, it is not recommended for anyone with diabetes, high blood pressure or a history of heart disease.

Bonus Tip: Know Your Probiotics
Another way to guard your gut is with probiotics. These live microorganisms help restore the friendly bacteria you need in your gastrointestinal tract to keep digestion running smoothly. Look for an effective strain like bifidobacterium to treat an array of conditions. Need a Probiotic - try Unicity http://pamelataylor.myunicity.net/shopping/index.html


Essential #3: Palm Reflexology
Stress is toxic for both your body and mind; managing your stress level is essential to good health. Dr. Weil recommends a reflexology technique based on Chinese medicine. This 5,000-year-old theory applies pressure to specific points on your body, activating channels or “meridians” which help to release tension and promote the free flow of blood and energy. This type of therapy has been used for centuries to provide pain relief, improve circulation, and alleviate muscle tension.

For relaxation, Dr. Weil recommends palm reflexology. The next time you feel stressed, try the following simple technique: Using the thumb and index finger of your right hand, rub the fleshy areas between the thumb and index finger on your left hand. Then, starting at the base of each finger, squeeze and roll upwards towards the fingertip, gently pulling outwards as you go. Next, take your thumb and firmly massage small circles all over the palm of your hand. Repeat the process on your other hand. When you’re finished, clench your fists and hold them for 10 seconds, then extend your hand and spread your fingers for 10 seconds. Shake out your hands gently and finish by taking four deep, slow breaths.

Bonus Tip: 4-7-8 Breathing Technique
Another way to tame your tension is to employ the 4-7-8 breathing technique. Close your mouth and inhale quietly through your nose for a mental count of four seconds. Hold your breath for a count of seven, and then exhale completely through your mouth, making a whoosh sound to a count of eight. This simple breathing exercise is a natural tranquilizer for the nervous system!


Essential #4: The Rules of Raw
Dr. Weil believes that food is medicine, so the raw food movement is something he’s carefully examined. His verdict? He doesn’t recommend eating only raw foods – for two major reasons.

First, you lose much of the best flavor, texture and appearance of your foods if you’re only eating them raw. Secondly, some of the vitamins and minerals are less available to the body in raw vegetables than when they’re cooked.


For example, your body can only obtain lycopene, a carotenoid pigment that protects against cancer, from tomatoes when they’re cooked. Similarly, the carotenoids in carrots are more available from cooked carrots than their raw counterparts. Yet this rule isn’t true of all foods. Leafy greens like watercress and arugula are at their healthiest when left raw; heating them breaks down nutrients and destroys their benefits. If you want to eat some of the healthiest raw foods, try either garlic or asparagus.
 
Garlic is a superfood that promotes immunity and helps maintain healthy blood circulation. The active component in garlic is the sulfur compound called allicin, a powerful chemical that is produced when garlic is chopped, chewed, or bruised. Allicin acts as an antibiotic and helps the body to inhibit the ability of germs to grow and reproduce. The amount of allicin in one clove of garlic, around 1 milligram, is said to have the potency of 15 standard units of penicillin.

Cooking garlic diminishes allicin, so eat it raw to maximize your benefits. For best results, crush the cloves to release the healthy enzyme. The production of allicin is greater if the garlic is exposed to air, so let the crushed garlic stand for 10 minutes before combining it with other foods. Add it to a salad dressing or tomato sauce. You can also try spreading 1/2 teaspoon on some toast with a bit of cheese to make a raw garlic bread. Sweeten it up by adding a spoonful of honey and a dash of lemon.

For another immunity booster, try asparagus. This spear-shaped vegetable is truly a weapon for your health! Packed with antioxidants, asparagus ranks among the top fruits and vegetables for its ability to neutralize cell-damaging free radicals. Asparagus is also rich in folate, which works with vitamin B12 to help keep your brain healthy. Cooking asparagus minimizes its folate, so enjoy it raw. Simply wash the asparagus and snap off the tough part, leaving the easily digestible, tender portion of the stem. For a one-two immunity punch, dip your asparagus in your garlic salad dressing!

Supercharge your vegetables by learning if you should eat them raw or cooked.


Bonus Tip: Power of Flowers
For a colorful way to avoid getting sick, add flowers to your home! Their beauty and scent will raise your spirits instantly!

Essential #5: CoQ10
Dr. Weil’s final essential sounds almost too good to be true – a super-pill to slow aging. The supplement is CoQ10, a substance that protects your heart and brain from oxidative stress, meaning it blocks the free radicals that break down cells and cause aging. Coenzyme Q10 is made by every cell in the human body. It’s particularly concentrated in tissues having high-energy requirements, such as the muscles of the heart and the brain, which requires huge amounts of uninterrupted energy to regulate, integrate, and coordinate ongoing nervous system transmissions.

Researchers have discovered CoQ10 levels diminish with age, while dietary inadequacies, certain diseases and medications can also significantly reduce CoQ10 levels in the body. CoQ10 is found in foods like sardines, beef and peanuts, yet you’d need to consume huge portions to obtain your daily dose through diet. Dr. Weil recommends taking a pill. He suggests the average adult try a supplement of 120 mg daily. To facilitate your body’s best absorption, take a 60 mg soft-gel capsule twice a day with a meal containing fat.

Bonus Tip: Spill Your Oil
Another way to slow your aging is to purge your pantry of all of your toxic fats. Do a smell test on your oil – if it smells like paint, pour it out and get rid of it!


Bonus Tip: Natural Fatigue Fighters
The next time you’re extra exhausted, turn to Mother Nature. These healing remedies from Dr. Weil’s trusted colleague, Dr. Tieraona Low Dog, can fight fatigue and restore your zest for life.

Golden Root
Also known as rhodiola or arctic root, this plant has been used since ancient times to treat fatigue. Studies have really shown that golden root improves mental concentration, physical endurance and helps with general chronic fatigue.
Get a standardized extract and start with a dose of 100 to 200 mg a day for 1 to 2 weeks. Each following week, you can gradually increase by 1 mg as needed. Most people end up taking golden root for 3-4 months and do well with around 400 mg.

Prickly Pear
The fruit of the prickly pear cactus is rich in magnesium, an energizing essential mineral that promotes healthy heart and kidney function. Prickly pear also contains vitamin C, which boosts immunity and provides antioxidant protection against chronic disease including diabetes. Studies show that prickly pear is effective at helping to increase insulin sensitivity. It also fights fatigue by stabilizing blood sugar in people who experience spikes and crashes as a result of their diet.You can find prickly pear at your local health food store. It’s easy to make your own prickly pear juice. First, remove the skin carefully so you don’t get pricked. Strain the seeds and pulp through a cheesecloth; you’ll get about a quarter-cup of juice left from each fruit. You can also buy prepackaged prickly pear juice.

Siberian Ginseng
This herb has a long history of use by athletes and the military. Most products containing Siberian ginseng vary in concentration and potency, so pay extra attention to the instructions on the label or talk to your doctor to determine your best dosage.

Source: http://www.doctoroz.com/videos/andrew-weil-5-health-essentials?page=3#copy