Shaping a Future Without Diabetes

  • By Alyssa Grams
  • 19 Jun, 2017

Written by Caitlin Crawshaw

A pediatrician with international training and experience is making a world of difference with practice and research in Edmonton.                   

All photography in post by Cooper & O'Hara
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. 

Haqq’s fascination with medicine didn’t waver and she set out to become a pediatrician a er high school. Knowing she needed to earn an undergraduate degree before entering medical school, the high-achieving student applied to several Ivy League schools in the United States and happily accepted an o er from the Massachusetts Institute of Technology (MIT). At 18, she le home for Boston where she would study biology for the next four years at one of the most prestigious research universities in the world. Haqq says the institution emphasized problem-solving over rote learning and fostered deep appreciation for research that would serve her well in her career.

Degree in hand, she returned to Canada to earn a medical degree at the University of Calgary before completing a pediatric residency at the Children’s Hospital of Eastern Ontario (Ottawa). at’s where she discovered endocrinology, a subspecialty of medicine that focuses on the complex interactions between hormones in the body and related health problems (including diabetes, thyroid disease and early and late-onset puberty). “I really liked endocrinology because it made sense. It had a logical pathway,” says Haqq. “You can correct de ciencies in hormones — like insulin in patients with diabetes — very logically.” On top of this, she was struck by how much the eld helped sick children: “You can do a lot to impact a patient’s quality of life and help them early on.”

Haqq began her career as a clinician-researcher at Duke University in North Carolina before returning
to Canada in 2009 to take a post as a clinician-researcher at the University of Alberta. In her role as a pediatric endocrinologist at the Stollery Children’s Hospital, many of Haqq’s patients have Type 1 or 2 diabetes. “We have a great multidisciplinary clinic here, so we have a team that includes social work, nurses and dieticians," she says. Haqq also treats children with a wide range of other hormonal issues, as well as those with early-onset child obesity stemming from rare genetic disorders. She has a special interest in Prader-Willi Syndrome (PWS), a genetic condition that is the leading cause of childhood obesity. “These children [with PWS] have food-seeking behaviours and experience progressive obesity over time, as well as the complications of obesity, like insulin resistance, Type 2 diabetes and cardiovascular problems,” says Haqq.

As an associate professor with the Depart- ment of Pediatrics, much of Haqq’s research focuses on the genetics of childhood obesity and she is known internationally for her work on PWS. A few years ago, her team was one of the rst in the world to identify high levels of ghrelin, a hormone that stimulates appetite, in children with PWS. “Parents of these children have to control their entire food environ- ment. ey lock cupboards and refrigerators because their kids are constantly hungry and seeking out food all of the time,” she says.

Since then, Haqq has continued to study ghrelin, including how it functions in the bodies of kids with PWS and potential treatment options for suppressing it. “We’re interested in novel therapies, be it dietary or pharmacological treatments, that might target ghrelin in children with PWS,” she says.

This is an important undertaking as the disorder commonly leads to obesity, which is associated with a host of health problems. Curiously, insulin resistance and diabetes are o en not an issue for children with PWS. “Despite their obesity, these kids seem to be metabolically protected from diabetes, compared with other children with obesity,” she says. To understand why this is the case, Haqq is looking to
an area of science called metabolomics, which examines the chemical “ ngerprints” le behind by the body’s processes (like digestion of food). These ngerprints may o er important insights about how certain gene mutations a ect a person’s metabolism.

“We want to identify critical, meta- bolic pathways that may be disrupted by certain gene mutations and predispose people to obesity or Type 2 diabetes,” says Haqq, who is teaming up with University of Alberta metabolomics expert Dr. David Wishart. is information might one day allow doctors to treat patients more e ectively with personalized interventions.

YOU CAN DO A LOT TO IMPACT A PATIENT’S QUALITY OF LIFE AND HELP THEM EARLY ON. ” 

Haqq also works with a number of other researchers at the Alberta Diabetes Institute (ADI) including Dr. Carla Prado, an expert in body composition and energy metabolism in adults. “We’re looking at the unique body composition of children with PWS,” she says. While obesity is usually associated with high amounts of “bad” or visceral fat (which the body stores around organs), children with the disorder have high amounts of subcutaneous or “good” fat (stored under the skin). Children with PWS also store fat in the fibres of their muscles.

With so many facets to Haqq’s research program, she relies on a highly skilled research team and collaborates with experts in other institutions. She also requires funding from many di erent sources to make ongoing advancements in the eld. Since setting up her lab in late 2009, Haqq has received consistent support from the Alberta Diabetes Foundation, which has funded numerous graduate students, summer students, pilot projects and more.

“Our current research environment makes funding more challenging,” says Haqq. “It’s amazing to have the support of the Alberta Diabetes Foundation.”


#ABfoodfight

By Alyssa Grams 09 Aug, 2017

University means a fresh start. You can put anything you want behind you, and instead look forward to who you want to become. Even if you aren’t moving away from home and you are entering your first year of university, many aspects of your life will still change.

It is important to remember that with the many changes university brings, your diabetes management may have to change too. A new living situation, new stressors, and new faces can cause your health to dip. But we have 3 tips to prepare you for living with diabetes in university.

By Alyssa Grams 09 Aug, 2017

Protein is a source of endless debate. Some bodybuilders say if you’re trying to bulk up, it should be the bulk of everything you eat. Others say the power of protein is overestimated. How did we get so mixed up about a few amino acids?

The fact is, it’s an essential nutrient that keeps your body functioning well by building and repairing muscle, hormones and enzymes, as well as your skin, nails and hair. But obviously there’s some confusion so I offer this to you: a protein primer.

By Alyssa Grams 01 Aug, 2017
Article by Robyn Braun, PhD
By Alyssa Grams 25 Jul, 2017

One of the first projects funded by the Alberta Diabetes Foundation when it was founded in 1988 was the clinical research of Dr. Ray Rajotte, which it funded for 12 years. Dr. Rajotte pioneered the first-ever islet cell transplant, which was the biggest breakthrough in diabetes research since the discovery of insulin. That work, plus an expanded islet cell transplant team and the addition of anti-rejection protocol, ended up becoming the international standard of care for islet cell transplantation.

Since 2000, when the protocol was developed, Alberta Diabetes Foundation has invested in a capital campaign to build the world-class building that now houses the Alberta Diabetes Institute. Since then, the Foundation has endeavoured to continue to invest in world-class research for both type 1 and type 2 diabetes right here in Alberta.

Alberta Diabetes Foundation works in tandem with the best-in-class Alberta Diabetes Institute to allocate funding where and when it is needed most, ensuring that important diabetes research and projects do not become stalled. The Alberta Diabetes Foundation is able to fund projects, even at early stages, often filling in gaps left by traditional granting organizations. The researchers in Alberta are confident that a world without diabetes is possible and, today they are doing more than providing sustainable solutions to treating diabetes -- our researchers are on their way to a cure.

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.
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