Diabetes is on the rise in America and is being detected earlier in life—even here in our fitness-oriented South Bay. In 2012, Torrance Memorial Medical Center treated 1,250 patients with Type 1, Type 2 and gestational diabetes—with 600 of the patients diagnosed last year.
Just 20 years ago, Type 2 diabetes was so rare in people younger than age 20, it was called adult-onset diabetes. Sadly, as more children became obese in America, physicians began seeing a troubling rise of cases in patients as young as 10. In fact, the latest statistics from the National Institutes of Health show 215,000 children with diabetes (both types) by 2010, with new cases of Type 2 diabetes in kids being diagnosed every year.
Many physicians expect the numbers of real cases to be higher—as so many Americans are uninsured and do not have access to proper medical intervention. This is especially troubling, because poorly controlled diabetes is linked to multiple health risks including heart disease, amputations, kidney failure, eye problems and nerve damage. And the longer a person has the disease, the higher the risk—giving children with diabetes the potential of developing debilitating health problems much earlier in life.
Clearly, it’s critical to thwart the early onset of diabetes and to tackle it immediately upon diagnosis. Even here in sunny Southern California, where health consciousness seems to be higher than in many other U.S. locales, South Bay children are not immune to Type 2 diabetes, says Lauren Choi, MD, an endocrinologist with the
Torrance Memorial Physician Network. This is mainly due to our changing American lifestyle, says Dr. Choi, who has been treating patients with diabetes for eight years.
“Type 2 diabetes is rising because of our sedentary lifestyle and poor food choices. Children aren’t able to just go out and ride bikes and play like in the past. Now it’s all scheduled, and we drive our kids to play-dates and don’t let them walk to school, perhaps with good reason. But children are also drinking too much soda, juice and eating chips and junk food,” Dr. Choi explains.
Her adult patients also struggle with a lifestyle that often involves long commutes, long hours sitting in chairs, fast-food lunches or dinners and hectic schedules. Tightened budgets for families often result in many fast-food dinners or quick, frozen food dinners that may be high in fat and sodium.
And as many of us know, food portions at fast food and chain restaurants have increased exponentially. McDonald’s small size of french fries (2.5 ounces) was the only size they served in 1955. Today, the medium (4.1 ounces) and large (5.4 ounces) sizes are popular choices. We can’t expect young children to just realize that American portions have doubled over the years.
“American portions are larger than in most areas of the world,” Dr. Choi says. “I have to advise my patients to follow the half-plate diet (at home), which means half the meal is vegetables, and the size of the protein (steak or chicken) is no larger than the palm of their hand.”
Dr. Choi says that, sadly, many of her patients develop insulin resistance and need to take medications for hypertension and blood pressure and increasing amounts of insulin. “Type 2 diabetes affects the vascular, nervous and retinol systems. It is a slow killer, because it grows slowly. Those who are in denial and don’t address their disease can find themselves facing kidney failure, blindness, heart attack or stroke,” she warns.
Detecting diabetes is the first and hardest step, according to MaryJane Bouman, BS, BSN, RN, diabetes care manager at Torrance Memorial. “There are no warning signs until it’s more progressed,” she explains. “If you are not going to your doctor to get tested, it [diabetes] could continue for years, and it’s much harder to manage once it’s progressed.”
She also warns that not all people with diabetes are overweight—especially if there is a genetic history in the family. But diabetes is typically triggered due to lifestyle. The warning signs are those that are often ignored, such as blurry vision, thirst, low energy and foggy thought. All experts interviewed for this story agree that many people excuse these symptoms as signs of lack of sleep, stress or age.
Since many people feel shame associated with the onset of Type 2 diabetes, it’s even harder to ask for a diabetes screen. But experts say it’s critical to do so, as the disease is manageable.
Bouman explains the concrete “pre-diabetes” signs people should be aware of: “You are pre-diabetic if your fasting blood glucose levels are 100 to 125 mg/dl—which is higher than normal but not high enough to be diabetes. It shows that the individual is at a greater risk of developing diabetes, and they need early treatment and lifestyle modification.”
And Dr. Choi can attest that with appropriate changes in diet and lifestyle, even patients on multiple medications can turn their lives around. In fact, medications can often be lowered or removed after a few months of diet and exercise. For instance, Dr. Choi says one patient, after losing just 30 pounds, was able to reduce his insulin levels and stop taking hypertension and blood pressure meds. This proves what can be achieved when a person commits to change.
Working Within The Community
Change can be hard when managing a hectic schedule and navigating large portions and fast-food temptations. While few people can explain why American portions in restaurants have increased so much, Dr. Choi says it’s up to parents to help their children. Clearly, this means parents have to be educated and committed to change to ensure the entire family doesn’t develop diabetes.
Children can’t be expected to know about portion control or how to cook a low-glycemic, low-carb, veggie-rich meal. Children also can’t be expected to start exercising alone, as some may need physician monitoring and medications. That’s why Torrance Memorial’s Kids ‘N Fitness program is so crucial for South Bay families tackling diabetes.
Helaine Lopes, PhD, ATC, CSCS, has witnessed first-hand how the program she runs for families with overweight children ages 9 to 11 is transforming lives. “It’s amazing. The families get a free membership to a YMCA during the six-week course, and we teach them about living a healthier lifestyle. We separate the parents from the children to talk about health. With the kids, we might pull out a bag of Skittles and ask them just how much sugar they think is inside. The program is eye-opening for the kids,” Lopes says.
Parents learn about the ChooseMyPlate recommendations from the United States Department of Agriculture. At choosemyplate.gov, you can find a wealth of information with food tracker tools, food group information and health tips for weight management.
While Lopes teaches children to make better choices—choosing water instead of soda, milk instead of Gatorade and avoiding fast food—she says diet alone isn’t enough. As the assistant athletic trainer at Palos Verdes High School, a former athletic trainer at University of Southern California (USC) for 20 years and a lecturer in the kinesiology department at USC, Lopes is clearly an expert on fitness and well-being. She explains that the six-week course introduces overweight children, who may be averse to exercise, how to begin slowly and have fun.
Part of the success is that kids make new friends (each course has 12 to 15 kids) and work with a team of nutrition and fitness specialists. Dance, strength training and courses on healthy eating habits and setting and reaching lifestyle goals are held for parents and children.
“Just before the holidays, a 12-year-old child who was 300 pounds when referred to our program was already losing weight and making better choices. It’s so rewarding to see, and I can’t wait to follow up with her,” Lopes says.
And since so many teens become overweight and at risk for diabetes, Lopes is also involved in a Healthy Ever After program that advises food services departments within the Torrance Unified School District. The Torrance Memorial-sponsored program helps Torrance schools improve food choices for students—with the least amount of financial impact for the schools.
Kids ‘N Fitness is sponsored by Torrance Memorial’s Lundquist Cardiovascular Institute and the YMCAs of San Pedro, Peninsula and Torrance/South Bay. To register or to learn more about the Healthy Ever After program, call the Torrance Memorial Community Programs department at 310-517-4711 or 310-517-4605.