Type 1 Diabetes and Children

Here are a few articles that I have found about diabetes.

Rising Obesity Rates Put Kids At Risk

Childhood Obesity Takes a Toll

Type 2 diabetes, long an "adult" disease, has been affecting more children in the last several years. This is due to an increase in overweight and obese children. Kids are becoming more sedentary and eating more junk food than ever before. With the advent of handheld electronic games, computers and ever more available television channels, kids have more reason to stay inside and sit for long periods of time.
Along with the risk of developing diabetes, being overweight also puts kids at risk for developing other "adult" conditions such as high blood pressure, and high cholesterol levels.
Here are some ways to help your child stay healthy:

Childhood, Unplugged

Parents can help their kids stay a healthy weight by limiting video games and television time to an hour or two a day. Creating opportunities to have fun without electronic diversions can be a family undertaking. Dancing to music or working with art supplies are all ways to fire a child's imagination. Turning off the TV can help kids become more plugged in to the world around them. Let kids earn their TV time. For every minute they play outside, they can watch one minute of television. Thirty minutes of outdoor play will buy them a favorite half-hour television show later that day.

Give Them A Sporting Chance

Encouraging sports that the whole family can participate in can go a long way toward encouraging kids to be active. Some kids feel self-conscious when they are overweight and don't want to participate in team sports. They might feel that they won't be able to keep up, or that they'll let the team down. Sports that place emphasis on individual accomplishment such as martial arts or swimming might be good choices for building a child's confidence as he or she becomes more fit.

Chores Make The Grade

Household chores are another way to get kids to be active. Raking leaves, folding laundry, caring for pets, or helping with the dishes are just a few of the ways kids can assist around the house. Chores are great because kids feel like they're part of the family, they're becoming more responsible and it really does help busy parents accomplish more on a daily basis. Most importantly, it gets kids up and moving. It's a win-win situation.

Healthy Snacks Go The Distance

Offering nutritious snacks like fresh fruit, cut-up vegetables, or low-fat yogurt can help kids learn good eating habits. "Ants on a log" is a favorite healthy recipe that kids can help prepare. Take a cleaned stalk of celery. Fill with peanut butter or cream cheese. Decorate with raisins or sweetened dried cranberries. The celery is the log, the raisins are the ants. Making more meals at home, or packing healthful lunches or snacks for when you're on the go, will help cut the calories that fast food adds. A bag of apples may cost more than a bag of cookies, but the apple is full of vitamins, nutrients and fiber, which in the long run gives more "bang for the buck" by providing more of the things a growing child needs.

Healthy Choices

Making family health a priority will help kids learn to make the right choices now and later when they become adults. Parents hold the key to teaching their kids about living a healthy lifestyle. Doing it together makes everyone a part of it. And it's more fun when everybody is on the same track. Stemming the tide of "adult" diseases is just one of the many benefits of healthy living. Good health can last a lifetime.

Author:  Debra Manzella

Your Guide to Diabetes

http://diabetes.about.com/od/childrenanddiabetes/a/kidsandobesity.htm

Tips For Your Child's Sick Days

When your child is sick with a stomach bug or flu, it's hard to keep a good schedule for eating and taking medications, especially when he or she can't keep anything down. What's the best way to handle your child's short-term illness?

• Check blood sugar every 4-6 hours and keep track of results
• Test for ketones often, especially if your child is vomiting or has diarrhea
• Call your doctor for guidelines for insulin treatment during the illness
• Try to give small amounts of food every 3 to 4 hours to keep blood glucose levels as normal as possible
• Have your child drink plenty of fluids. If your child cannot hold down solid food right now, offer drinks with carbohydrates in them, such as juice, jello, popsicles or broth. If your child is able to eat, offer plenty of sugar-free liquids and water to drink in addition to small, easily digestible snacks.

For a list of good sick-day snacks for your child, visit the American Diabetes Association (ADA).

Diabetes drug pulled off the market

The US Food and Drug Administration(FDA), on March 22, 2000 pulled the diabetes drug Rezulin off the market.  The drug had been used by more than 700,000 patients and been responsible for more than 61 deaths.  Dr. Sidney Wolfe, a critic of the FDA for being too slow, said the drug should have been taken off the market long ago.  He characterized the drug as, "one of the most dangerous drugs."  The problem with the drug was toxicity to the liver.  In an interesting response, Warner Lambert, the maker of Rezulin, has voluntarily agreed to stop selling the drug, but they did comment that they felt the benefits of the drug outweighed the risks.  I am sure that is of little consolation to the families of the 61 people who died.

Author: Unknown

http://www.backsnappingood.com/pages/articles2/diabetes.html

Web MD July 23, 2001, reports on the link between infants who drank cows milk and type 1 diabetes.  Finnish researcher Hans K. Akerblom, MD, at the annual meeting of the American Diabetes Association in Philadelphia reported findings from a new study of more than 200 newborns at-risk for type 1 diabetes that suggested that feeding an infant formula made with cow's milk may up their chances of developing the disease.

The study checked infants after breast feeding.  The babies were fed a formula made either with or without cow's milk. Those fed the formula made without cow's milk were about 50% less likely to develop proteins that are associated with type 1 diabetes. Thus, Akerblom postulates, cow's milk may cause diabetes in genetically at-risk kids. Other studies have already found that infants fed cow's milk are no more likely to develop the disease than infants who are breastfed.

Other studies show that breast fed babies may have higher IQs and stronger immune systems than babies fed with formula.  Additional previous research also suggests that breast feeding during a baby's first year may help lower the risk of gastrointestinal, or GI, tract infections, which affect the stomach and intestines, and atopic eczema, a common skin condition that affects around 10% of all infants and children.

In a timely coincidence the 11th annual World Breast Feeding Week will be celebrated from August 1-7, 2001, in countries throughout the world to increase public awareness of the importance of breast feeding. This annual event is sponsored by La Leche League International (LLLI) and the World Alliance for Breastfeeding Action (WABA).

Author:  Unknown

http://www.backsnappingood.com/pages/articles2/diabetes.html

Uric Acid Restores Endothelial Function in Patients With Type 1 Diabetes and Regular Smokers

Endothelial dysfunction is a characteristic finding in both patients with type 1 diabetes and in regular smokers and is an important precursor to atherosclerosis. The urate molecule has antioxidant properties, which could influence endothelial function. The impact of acutely raising uric acid concentrations on endothelial function was studied in eight men with type 1 diabetes, eight healthy regular smokers, and eight age-matched healthy control subjects in a randomized, four-way, double-blind, placebo-controlled study. Subjects received 1,000 mg uric acid i.v. in vehicle, 1,000 mg vitamin C as a control antioxidant, vehicle alone, or 0.9% saline on separate occasions over 1 h. Forearm blood flow responses to intrabrachial acetylcholine and sodium nitroprusside were assessed using venous occlusion plethysmography. Responses to acetylcholine, but not sodium nitroprusside, were impaired in patients with diabetes (P < 0.001) and in smokers (P < 0.005) compared with control subjects. Administration of uric acid and vitamin C selectively improved acetylcholine responses in patients with type 1 diabetes (P < 0.01) and in regular smokers (P < 0.05). Uric acid administration improved endothelial function in the forearm vascular bed of patients with type 1 diabetes and smokers, suggesting that high uric acid concentrations in vivo might serve a protective role in these and other conditions associated with increased cardiovascular risk.

W. Stephen Waring¹, John A. McKnight², David J. Webb¹, and Simon R.J. Maxwell¹

¹ Clinical Pharmacology Unit, The Queen’s Medical Research Institute, The University of Edinburgh, Scotland, U.K
² Department of Diabetes, Western General Hospital, Edinburgh, U.K

Address correspondence and reprint requests to W.S. Waring, Clinical Pharmacology Unit, University of Edinburgh, The Queen’s Medical Research Institute, 3rd Floor East, Room E3.22, 47 Little France Crescent, Edinburgh, EH16 4TJ, U.K. E-mail: s.waring@ed.ac.uk

http://diabetes.diabetesjournals.org/cgi/content/abstract/55/11/3127 

Pancreatic Islet Production of Vascular Endothelial Growth Factor-A Is Essential for Islet Vascularization, Revascularization, and Function

To investigate molecular mechanisms controlling islet vascularization and revascularization after transplantation, we examined pancreatic expression of three families of angiogenic factors and their receptors in differentiating endocrine cells and adult islets. Using intravital lectin labeling, we demonstrated that development of islet microvasculature and establishment of islet blood flow occur concomitantly with islet morphogenesis. Our genetic data indicate that vascular endothelial growth factor (VEGF)-A is a major regulator of islet vascularization and revascularization of transplanted islets. In spite of normal pancreatic insulin content and ß-cell mass, mice with ß-cell–reduced VEGF-A expression had impaired glucose-stimulated insulin secretion. By vascular or diffusion delivery of ß-cell secretagogues to islets, we showed that reduced insulin output is not a result of ß-cell dysfunction but rather caused by vascular alterations in islets. Taken together, our data indicate that the microvasculature plays an integral role in islet function. Factors modulating VEGF-A expression may influence islet vascularity and, consequently, the amount of insulin delivered into the systemic circulation.

Marcela Brissova¹, Alena Shostak¹, Masakazu Shiota², Peter O. Wiebe², Greg Poffenberger¹, Jeannelle Kantz², Zhongyi Chen¹, Chad Carr¹, W. Gray Jerome^3,4, Jin Chen^4,5, H. Scott Baldwin⁶, Wendell Nicholson¹, David M. Bader⁷, Thomas Jetton⁸, Maureen Gannon^1,2, and Alvin C. Powers^1,2,9

¹ Division of Diabetes, Endocrinology, and Metabolism, Department of Medicine, Vanderbilt University Medical Center, Nashville, Tennessee
² Department of Molecular Physiology and Biophysics, Vanderbilt University Medical Center, Nashville, Tennessee
³ Department of Pathology, Vanderbilt University Medical Center, Nashville, Tennessee
⁴ Department of Cancer Biology, Vanderbilt University Medical Center, Nashville, Tennessee
⁵ Department of Cell and Developmental Biology, Vanderbilt University Medical Center, Nashville, Tennessee
⁶ Division of Pediatric Cardiology, Department of Medicine, Vanderbilt University Medical Center, Nashville, Tennessee
⁷ Stahlman Laboratory, Division of Cardiovascular Medicine, Department of Medicine, Vanderbilt University Medical Center, Nashville, Tennessee
⁸ Division of Endocrinology and Metabolism, Department of Medicine, University of Vermont College of Medicine, Burlington, Vermont
⁹ Veterans Affairs Tennessee Valley Healthcare System, Nashville, Tennessee

Address correspondence and reprint requests to Alvin C. Powers, Division of Diabetes, Endocrinology, and Metabolism, 715 PRB, Vanderbilt University, Nashville, TN 37232. E-mail: al.powers@vanderbilt.edu

Ang, angiopoietin; VEGF, vascular endothelial growth factor

http://diabetes.diabetesjournals.org/cgi/content/abstract/55/11/2974