Risky Business

  • By Alyssa Grams
  • 26 Jun, 2017

Article by Caitlin Crawshaw. Illustrations by Julia Minamata.

The prevalence of both Type 1 and 2 diabetes is increasing in Alberta. Here’s what you need to know about the risks facing children, pre- and post-diagnosis.             

At the Stollery Children's Hospital at the University of Alberta, paediatric endocrinologist Dr. Andrea Haqq diagnoses and treats many of these children. "We're a very busy clinic as we'e been seeing more cases of both Type 1 and 2 diabetes over time," she says. Children with either form of diabetes exhibit many of the same symptoms, including weight loss, frequent urination, and excessive thirst. Occasionally, parents report that their kids are suddenly wetting the bed at night after being potty trained. 

Doctors don't know for sure which children will develop diabetes or why. However, a number of risk factors are associated with both forms of the disease and can help predict which kids are more likely to get sick. In some cases, doctors and parents can take action to decrease a child's risk.

Type 1 Diabetes

Environment

Children with Type 1 diabetes require frequent injections of insulin as their bodies don't produce enough of the hormone to process glucose (simple sugar) from food.

It's an autoimmune disease, so immune cells in the body that normally fight harmful things, like bacteria and viruses, mistakenly destroy insulin-producing cells in the pancreas," says Haqq. Unfortunately, the origins of the disease continue to mystify researchers. "We know genetics may play a role in the process, and certain environmental factors like viruses may trigger the disease, but little is known about the exact causes."

Although family history is considered a risk factor, it increases a persons's risk of developing the disease only slightly. Geography is another risk factor as certain communities have higher numbers of people with Type 1 diabetes (including Edmonton), but researchers don't yet know why certain environments create increased risks.

Haqq explains that most people with Type 1 diabetes are diagnosed as children, with the majority diagnosed between the ages of four to seven, and 10 and 14. "These are certain peaks to the disease," she says. Researchers don't know why this is, but speculate that it may have something to do with childhood and diseases and hormones associated with puberty.

With so little known about the causes of Type 1 diabetes, doctors can't offer parents or caregivers any strategies for avoiding its onset. "When we see new children with Type 1 diabetes, it's always important to understand that they didn't do anything to bring on the disease," says Haqq.


Risk Factors for Type 2 Diabetes

Genetics

Unlike Type 1, there's a very strong genetic component to Type 2 diabetes. Having another close relative with the disease or a mother who had gestational diabetes during pregnancy seem to raise a child's risk of becoming diabetic. A child's ancestry can also make him or her susceptible, as Type 2 diabetes tends to be more prevalent among certain ethnic groups (including people of First Nations and South Asian descent). There are also a number of rare genetic disorders that predispose children to obesity such as Prader-Willi syndrome (PWS) (Haqq's research on the disease is internationally known).

Obesity and Unhealthy Eating

Doctors know a little more about Type 2 diabetes, in which the body makes insulin but its cells can't use the hormone properly to break down glucose. Risk factors include poor eating habits and a sedentary lifestyle, but the biggest risk factor is childhood obesity, which has been greatly increasing in Alberta and throughout much of the world. Where a person gains weight raises his or her risk: "Certain fat distributions seem to be particularly bad, like fat in the abdominal region," says Haqq. But genes aren't destiny.  Haqq explains that even children with prediabetes who show signs of insulin resistance without having full-fledged diabetes can sometimes avoid the disease with lifestyle changes. Healthy eating, regular activity, and maintaining a healthy weight can mitigate genetic risks of developing Type 2 diabetes. For children who are already overweight or obese, Haqq suggest weight maintenance, not weight loss. She also notes that Body Mass Index (BMI) isn't an absolute measure of health, as a growing body of research show that active people in a higher BMI range can be healthy, too. 
Risk After Diagnosis

Whether children are diagnosed with Type 1 or 2 diabetes, they are at an increased risk of a host of health issues over time. Haqq explains that people with diabetes are prone to heart disease, cardiovascular problems, high blood pressure and damage to their nerves, kidneys and eyes. 

Mainting optimal blood sugar levels is critical to avoiding these medical complications over time. "We work hard to help people control their levels well in childhood because they have many decades of living with the disease ahead of them," Dr. Haqq says. At the same time, doctors need to be careful not to lower blood sugar levels too much as this can impede a child's cognitive development (growing brains need a certain amount of glucose to thrive). 

Children with Type 2 diabetes may also face complications related to obesity including cancer, sleep apnea, stroke, gallstones, osteoarthritis, and infertility. "Obesity is a chronic disease, no different from hypertension," Haqq says. Even when people manage to lose large amounts of weight, our complex biology as human beings make us prone to regaining the weight over time. "People generally have to do something to maintain their body weight," says Haqq. "Obesity requires a lifelong treatment."

#ABfoodfight

By Alyssa Grams 19 Jul, 2017
Article compiled by Breanna Mroczek  with information from Dr. Mathew Estey, Clinical Chemist and Co-Director of Chemistry at DynaLIFE Medical Labs, and Dr. Christopher Naugler, Calgary Zone Clinical Department Head, Pathology and Laboratory Medicine, Medical Director
By Alyssa Grams 19 Jul, 2017
Post by Erika Brown
By Alyssa Grams 17 Jul, 2017

Symptoms

Imagine this. Recently you’ve noticed that your child hasn’t been acting quite like their usual self lately. You can’t quite pinpoint it, so you chalk it up to a rough week. But maybe that rough week turns into two.  You start to think on their behaviour more and you grow more concerned; they are always asking for extra water or juice at breakfast, they seem to be constantly hungry, they’re rushing off to the bathroom more frequently, and they are tired as soon as they step in the door from school.

Although these symptoms may seem common for children who may not have had a good night’s rest or for those going through puberty, that’s not always the case. These symptoms should be taken seriously, and if you notice these in your child for a prolonged period of time, you should discuss a glycated hemoglobin (A1C) test with your doctor. An A1C test will determine your child’s average blood glucose level over the past 3 months. If your child’s A1C level is 6.5 or over, if could mean that they have Type 1 diabetes.


Diagnosis

As a parent, your child’s Type 1 diabetes diagnosis can be earth shattering for both you and your child. So many thoughts can go through a parent’s head; why does it have to be my child? How is my child going to live with this? How am I going to be able to give my child everything they need now that they have this condition?

Every parent and child will go through this journey in their own way, but it is important to know that Type 1 diabetes is a disease that can be managed, and proper management will allow your child to live a healthy life. As for the questions, you have as a parent, we would like to help by providing you with a few answers.


Why does my child have to be diagnosed with Type  1 diabetes? Where does Type 1 diabetes come from? What could wehave done as parents to prevent it?

Type 1 diabetes is not a preventable disease. It is a mixture of genes and environment. Although scientists do not know the exact cause of Type 1 diabetes , they do know that genes and environment play a role . They have figured out that individuals who have a certain type of HLA complex (human leukocyte antigen on chromosome 6) may be susceptible to Type 1 diabetes. This complex can create an autoimmune disorder that is triggered by a viral infection.

Simply put, when your body tries to fight the viral infection, it may also attack beta cells in your pancreas—cells that make insulin. This process usually takes several years before symptoms develop. The right combination of genes (HLA complex) and environment (exposure to a viral infection) can contribute to the onset of type 1 diabetes.


How is my child going to live with this condition?

Diabetes will be a day-to-day change in you and your child’s life. Your child will require insulin injections. You might even be required to administer insulin injections for your child depending on recommendations from the doctor. You will also want to revaluate the lifestyle that you and your child live. Focus primarily on the diet and exercise your child gets. And remember to stay on top of these few daily tasks you will need to complete:

  • Administering insulin
  • Monitoring blood glucose
  • Making sure that your child is eating a healthy, balanced diet with diabetic guidelines (incorporating things like carb counting can help to manage blood glucose levels)
  • Ensuring that your child is getting exercise on a daily basis (involving them in two sports can mean practice up to four days per week and games on weekends)

Although it may not happen everyday, your child will go through highs and lows with their diabetes. Both diabetic highs and lows are serious and can be life threatening

Symptoms of a diabetic high and low are:

  • Tiredness
  • Irritability
  • Blurry vision

Symptoms of a diabetic low also include:

  • Headaches
  • Excessive sweating
  • Paleness
  • Shaking

You and your child’s first encounter with can be frightening. If you prepare yourself to know that symptoms and you are able to react accordingly, you can make your child feel safer in the earlier stages of this condition.


How am I going to be able to provide everything my child with everything they need to take this condition on?

The biggest change a parent can have on their child’s life is setting a great example. Your child relies on you and looks up to you. As a parent you should eat healthy, exercise, and take on proper responsibility for your own health. Your own accountability will benefit your child in the short-term and long-term. Additional support from friends and family will also help your child manage emotional and physical effects of the diabetes diagnosis. You may also consider joining a diabetes support group or participating in a run to fund diabetes research.

Advice from the following people can help ease the stress of your child’s diabetes:

  • An endocrinologist
  • A pharmacist
  • A nurse
  • A certified diabetes educator
  •  A registered dietitian
  •  An eye doctor
  • A dentist
  • A community of those who have children with Type 1 diabetes

As a parent, the best thing you can do for your child is simply to be there for them. Communicate with your child in a way that is supportive and will help to boost their self-esteem. Allowing your child to be open and honest with you will make treating diabetes that much easier.

No parent wants to see their children suffer. Remember that diabetes was not something that your child was marked for, and it isn’t your fault as a parent. As a family, you can work through this disease together, and put your child down a path of success.

By Alyssa Grams 10 Jul, 2017

Article by Breanna Mroczek. Photography by Darren Greenwood Photography.

By Carmen Johnson 04 Jul, 2017

You’ve seen the ads: “Cut out bananas and banish belly fat forever.” It seems like the world is going bananas over a simple piece of fruit.

It’s a bit strange. They’re almost identical in carbs to a delicious pear, but nobody seems to be preaching safe pear practice. So why do bananas get a bad rap? Why do people suddenly find them so un a-peel-ing?

Don’t be Split on Bananas

Many have tried to bruise the banana’s reputation by spreading the rumour that they’re loaded with carbs and sugar, instantly leading to weight gain and sending your blood sugars into a spiral. This is nothing more than a far-fetched fruit fallacy.

For one, at just 105 calories, a medium banana puts a mere 5% dent in a 2,000-calorie diet ( 1 ). Yes, bananas do contain starch and sugar, which does cause blood sugars to rise, but that doesn’t mean you should steer clear! First off, our bodies need carbs to function. Second, there is a world of difference between the sugar  in fruit and that found in pop, cake or candy. Unlike sweets, bananas are rich in naturally-occurring sugar, plus 3.5 grams of fibre and a ton of nutrients needed for good health.

Bet on Bananas

Fibre—like that found in bananas—is essential for weight and blood sugar management. It helps prevent overeating by making you feel full for longer. It also helps to slow the absorption of sugar. Just-ripe bananas and other carbohydrates with a low GI value (55 or less) cause a lower and slower rise in blood glucose and insulin levels ( 3 ).

Another boast for the banana is that it packs, on average, more than 400 milligrams of heart-healthy potassium . That’s almost 10% of your recommended daily intake! Potassium is vital for normal muscle, nerve and brain function and is essential for maintaining healthy blood pressure .

Since many Canadians may not be getting enough potassium in their diet ( 2 ), bananas are a tasty way to up your daily dose

Go Bananas!

Still think bananas are to blame for all your weight woes? Here’s the truth: No one food is responsible for the number on the scale.

A diet high in fibre-rich fruits and vegetables —including bananas—is a key ingredient for a healthy body weight and reduced risk of chronic disease.

Bananas are a carbohydrate-rich food. If you're watching your blood sugars, be mindful of your portions. Otherwise, there's no monkey business when it comes to bananas. Unless you have been told to limit them by your doctor, there’s no reason to shun this simple fruit.

Some tasty tips to enjoy bananas:

  • Use mashed ripe bananas to boost the flavour and nutrition in your favourite muffin recipes.
  • Freeze overripe bananas for smoothies or baking.
  • Add chopped banana to your oatmeal while it’s cooking. This releases natural sugars so you can cut back on added sweeteners.
  • Roll up a banana with some protein-rich nut butter in a whole grain tortilla for an easy breakfast on the run.

For a healthy version of your favourite summer treat make sure to check out the Breakfast Banana Splits  recipe in the P ure Prairie Eating Plan   Cookbook.

 

References

1) Health Canada, Canadian Nutrient File (2015). Banana, raw . Accessed June 7, 2017 from https://food-nutrition.canada.ca/cnf-fce/serving-portion.do?id=119

2) Health Canada, Food and Nutrition (2012). Do Canadian Adults Meet Their Nutrient Requirements Through Food Intake Alone? Accessed June 7, 2017 from http://www.hc-sc.gc.ca/fn-an/surveill/nutrition/commun/art-nutr-adult-eng.php

3) University of Sidney, Glycemic Index Database (2017). Banana, raw. Accessed June 7, 2017 from http://www.glycemicindex.com/index.php

 

By Alyssa Grams 04 Jul, 2017
Based on guidelines from Diabetes Canada. Illustration by Breanne Kelsey.
By Alyssa Grams 26 Jun, 2017

For most of us, our phone is our world. It connects us, informs us, and even gets us up in the morning. So it’s no wonder that our phones can help us manage our diabetes too! With over 50 apps available, there’s the perfect app for everyone. Some apps cost you money, but you’re already spending enough on your treatments! So here’s 5 free apps to help keep you on track.

By Alyssa Grams 26 Jun, 2017

Article by Caitlin Crawshaw. Illustrations by Julia Minamata.

By Alyssa Grams 21 Jun, 2017

Last week’s article touched on the different types of artificial sweeteners that are meant to work as sugar substitutes. We also talked about some of the reasons it may be a good idea for diabetics to stay away from artificial sweeteners. Now, we will dive a little deeper into the problems these sugar substitutes could have on your health and the balance of the good bacteria in your gut.

The most popular study to make this claim happened in 2014. The study showed that mice who ate saccharin (a component of some artificial sweeteners) developed a glucose intolerance. The sweeteners created an imbalance in the gut bacteria of the mice. These bacteria are responsible for converting food to fuel or fat.

The team wanted to make sure this also applied to humans, so they continued the study on seven healthy people who consumed the maximum serving of saccharin suggested by the FDA for six days. Four of these individuals were on the road to glucose intolerance—a step towards a diabetic diagnosis.  

The team concluded that this was only a preliminary study but did create grounds to explore this research further.

By Alyssa Grams 19 Jun, 2017
Growing up in Vancouver, British Columbia, Dr. Andrea Haqq eagerly anticipated bisects to her pediatrician -- and not for the sticker at the end of the appointment. "I was always really interested in medicine," she explains. While her peers clambered off the examination table at the end of check-ups, Haqq lingered with questions about paediatric medicine and her doctor was more than happy to chat with his curious patient. By the time Haqq reached high school. her paediatrician was lending her medical texts on paediatrics and medical education, and had become a mentor as she considered her career path. 
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