Avoiding Type 2 Diabetes in Our Kids
Have you looked at the numbers of people being diagnosed with type 2 diabetes lately? They are staggering. I know it can be hard as adults to look beyond ourselves when we live with it but there are times when it is vitally important that we do. When? When it can affect or has affected our children. Yes, children can and do get diagnosed with type 2 diabetes. The number of our children being affected is even more staggering. They are affected by the genetics of the parent. They are affected by the lifestyle choices we have made for them in the early years. They are also affected when they become old enough to make their own lifestyle choices that may be different than what they were brought up with. Is it a blame game for parents?
How can we prevent type 2 diabetes in our kids?
We don’t always know what we need to know about raising kids in the first place. They don’t come with a manual. So we do the best we can. When you have a family history of type 2 diabetes, we have to figure out a few things. We need to know if there are differences in how type 2 diabetes presents in kids. We need to know how we can prevent it. This was a worry of mine for a long time while my kids were growing up. We also need to know how the food choices we make influences them getting it.
Signs and symptoms of type 2 diabetes in kids
The signs can be the same as adults.1 One of the biggest differences? It’s not uncommon for children to have no symptoms or the symptoms can be very mild, often not noticed by the parent.2 That's the scary part. Most of us do not take our children to the doctor unless they are sick. Because of this, we may be missing an important diagnosis. The recommendation by Diabetes Canada is that children who are at high risk should be checked by an A1C test every two years.3 It’s not fun having to take your child to get blood work done but it has to be done. Yes, there is a cost involved in going to the doctor and going to the lab, but the cost of getting on prevention early is much less than the cost of having to deal with diabetes every day.
Prevention is the best medicine
What does prevention look like? Start as early as possible in your child’s life to avoid diabetes. Parents consider making the decision on how and what to feed their newborn often during pregnancy when the discussion starts with their health care provider.4,5
The impact of breastfeeding
Breastfeeding wins by a landslide because most moms want and plan to breastfeed.6 Breast milk floods the baby’s gut with healthy organisms that will change as the baby continues to breastfeed and matures. Breastfeeding is also protective against overfeeding.7,8 However, society impacts how long babies breastfeed. The problem with starting and sustaining breastfeeding lies in factors that we cannot always control. Both professional and peer support are needed. We also need jobs that allow us to be home with the baby. Right now in the US, many jobs do not allow a new mom to be off on maternity leave for longer than 6 weeks to 3 months.9 When it's time for mom to return work one of three things can happen regarding her commitment to breastfeeding. 1. She quits her job so she can continue to breastfeed, 2. She pumps her breast milk while at work to give the baby expressed breast milk during her absence, or 3. She weans the baby to formula.
Let’s look at each of these. Quitting her job? Not an option for most. How do you afford the food and meds you need when you have diabetes if you have no job? Pumping and giving expressed breast milk can be a good option but you need a fairly liberal boss and a private place to pump that isn’t a bathroom to support that. Many business owners may be supportive in theory but practically speaking the type of job they offer just doesn’t allow for pumping in the workplace to occur. Weaning to formula? There are risks associated with that. Often these risks are not well known or controllable.
No battle, just facts
Now before I go any further, I want to state for the record, I am not being judgemental or against formula feeding. Breastfeeding zealots want you to believe you are poisoning your baby if you give your baby formula. Not so. Formula is an acceptable food if mom has chosen, or been forced, not to breastfeed. I am only going to talk about some facts to consider when formula is chosen in relation to type 2 diabetes and our children.
Here’s what we know about formula. Formula creates an earlier maturation of the baby's gut beyond the age of the baby. What does that mean? It means that the gut of the baby has organisms and bacteria that would not be seen in a breastfeeding baby’s gut, things like E. coli, C. difficile, and other organisms. These are organisms that baby could eventually be exposed to but instead of being protective, they can potentially expose baby earlier to disease.6 A more mature gut can lead to digestive issues earlier in the baby’s life.
It’s more common for there to be rapid weight gain in formula-fed babies which can predispose baby to obesity.7,8 Reasons? Fast flow nipples. Adding cereal to bottles of formula to make baby sleep longer through the night. Parent worries about how much baby should eat versus baby’s cues that “I’m full”. We tend to impose larger amounts on baby than baby wants or needs. We learn very quickly as parents when baby is tired, when baby is happy but we understand less the feeding cues baby gives us.
So, is it all about formula? No. Perhaps it’s about the bottle itself versus what’s in the bottle. Some research says it may be related to maternal distraction more so than what is in the bottle.10 Again, are we missing the baby’s feeding cues? Bottle-fed babies, despite what’s in the bottle, tend to finish the bottle because, as parents, we over encourage baby to eat more out of fear they’re not eating enough. Baby’s norm can become more than full, it can be stuffed.
Beyond the baby stage
As a baby becomes an older child, we as parents have the ability to continue to make healthy eating choices for our children. We can lead by example. Children watch everything we do. They want to be just like us. If they see us eat healthy foods, they will want to mimic that. The same applies if they see us eating a lot of unhealthy foods. I saw a nutrition campaign slogan once that has really stuck with me. “Trust me, trust my tummy.” The campaign basically stated it is up to the parent to decide what the child will be offered for the meal. It’s up to the child to decide how much to eat. Makes total sense to me. How often have we encouraged our kids to finish what’s on their plate? Food is too expensive to waste, right? But we are used to adult-sized portions, not child-sized portions. So do we expect our kids to take in more than they need? It’s quite possible since we currently live in a ‘portion distortion’ society.
The teen stage
As the kids move into the teen years, it is so difficult for parents to control what they eat but we can control what foods are brought into the home. If we don’t buy it and they don’t have access to a lot of unhealthy foods when they’re hungry, they will choose the good stuff while at home. We have laid the groundwork when they were young to make good choices. Realistically when they are away from us, they are going to make their own choices. I have no doubt the choices may not all be good. Try as we might, we can’t control everything. My hope is that because we built healthy eating into everyday life as very young children, it will carry over to help them make good decisions when they are older and away from us.
Can we stop our children from having to live with type 2 diabetes? No, not in all circumstances. We can’t help genetics. But we can give them a good start in life with healthy eating habits that might prevent some from acquiring it. Even if we already have kids, we can change what foods we bring into the house, what they are offered, or at least try to influence their choices. We haven’t missed the boat. Every day is a new day. Every day we can affect change if we want to protect our kids from type 2 diabetes.
Have you experienced any foot complications from diabetes?