Is Your Child At Risk for Diabetes?

We all want to pay close attention to our children’s health. But sometimes, in order to care for them, we may have to take a step back and try to look at them the way a doctor might.

You may have heard that type 2 diabetes is increasingly being diagnosed in young people in America. But is your child at risk for diabetes?

Take the time to ask some difficult questions about your child’s health habits: Does your child eat a healthy diet? Is he or she active enough? Is he or she overweight?

“Parents need to pay attention to the habits their children are learning and make sure they are healthy habits,” says Barbara Marshall, MD, pediatric endocrinologist at the MultiCare Mary Bridge Pediatric Endocrine and Diabetes Clinic.

Healthy habits matter. Being overweight and inactive are risk factors for developing type 2 diabetes. family history and ethnicity also play a role for some children. If you do see risk factors, take heart.

“The positive thing we are learning about type 2 diabetes in young people is that lifestyle changes can make a difference,” Dr. Marshall says.

Healthy eating habits
“All children need to eat a healthier diet,” Dr. Marshall says. “The first thing I recommend is cutting out soda and juice because kids are drinking far too many calories a day.”

She also advises parents to:

• Serve fruits and vegetables.
• Watch portion sizes.
• Set regular eating times.
• Avoid skipping meals.
• Have meals sitting down at a table.

Exercise
Kids should get at least 60 minutes of activity a day, Dr. Marshall says. “It does not need to be formal exercise,” she says. “Playing on the playground counts.”

You can help boost activity levels by reducing TV and computer time. When kids spend more than an hour a day in front of the screen, their risk for diabetes increases.

To help keep kids active, you can:

• Assign active chores.
• Have kids walk or ride their bikes to school.
• Find a physical activity the whole family enjoys.

Working together
Healthy habits can also help keep weight at a healthy level, which is crucial for diabetes prevention.

“Weight loss decreases your risk of diabetes, but studies have shown that for young people who are heavy, even weight maintenance reduces risk,” Dr. Marshall says.

Families have an important role to play. “Lifestyle changes have to be family changes,” Dr. Marshall says. “Success comes when the family works together to have a positive impact on their health.”

Diabetes Care at Mary Bridge
Type 2 diabetes is increasingly being diagnosed in young people, but type 1 diabetes still accounts for many cases of diabetes among children.

The good news is that management strategies can help children with type 1 diabetes live healthy lives. The care team at the Mary Bridge Pediatric Endocrine and Diabetes Clinic are specially trained to provide the education and support you need to manage the disease.

The Clinic offers individual education with a nurse-certified diabetes educator and a support group in a child- and family-friendly environment. For more information, visit our Mary Bridge Diabetes Education Program online or call 253.792.6630.

Diabetes: Your Questions Answered

 Each day, more than 4,000 Americans learn they have diabetes. it can be startling news. 

“They each want to know how this diagnosis will change their life,” says Ronald J. Graf, MD, FAACE, an endocrinologist with MultiCare Endocrinology Specialists – Tacoma. That leads to questions—about diet, medications, the risk for complications and more. 

These questions are often most fully addressed in diabetes education classes. But a few frequently asked questions are briefly answered here. 

Will I have to give up sweets?
A healthful diet is crucial. It’s low in saturated fats and trans fats. And it contains balanced portions of proteins and carbohydrates, including sugars. 

“It’s the carbohydrates that have the major effect on one’s blood sugar level, but even simple sugars and sweets are allowed in limited amounts,” Dr. Graf says.

Why is exercise important?
Exercise can lower blood sugar levels and help with insulin resistance, which occurs with type 2 diabetes—the type often related to obesity. Insulin resistance means the body has a hard time using the insulin it makes. 

“Exercise can overcome much of that insulin resistance, as well as burn some of the calories we consume in our diet and store in our fat,” Dr. Graf says. That can lead to weight loss, which in turn may lead to less insulin resistance. It may also improve high blood pressure and abnormal cholesterol levels, which often occur in people with diabetes.

 Will I need to take medication?
People with type 1 diabetes must take insulin. People with type 2 diabetes often can control their disease with proper diet and exercise. With time, though, they may need one or more medications.

“Frequently, even those with type 2 diabetes will eventually require insulin treatment to help control elevated blood glucose levels,” Dr. Graf says.

 Will I be able to avoid diabetes complications?
Most people who follow their health care team’s advice can have relatively healthy lives. Says Dr. Graf: “Living with diabetes usually means making some lifestyle changes and some sacrifices. But these changes are usually for the better and can lead to a healthier and longer life.”

MultiCare offers support to people with diabetes
MultiCare’s Chronic Disease Management Program is currently focused on working with patients who are managing diabetes. We offer a number of support services as part of their ongoing care, including:

• Phone calls to patients to schedule follow-up appointments
• Completing lab work and other tests before appointments so patients get results sooner
• Group visits that offer patients the chance to interact with others managing diabetes
• Free “Living Well With Chronic Conditions” workshops

For more information about MultiCare’s Chronic Disease Management Program, call 253.792.6710. For more information about diabetes care services at MultiCare, visit multicare.org/diabetes-care.

 

Healthier Food at Wal-Mart?

Recently, Wal-Mart announced a five-year plan to offer healthier, affordable food options in its stores across the country.

The plan includes a commitment to reduce the unhealthy salts, fats and sugars in many of its packaged food offerings, as well as to drop prices on fruits and vegetables.

In today’s Room for Debate feature on the New York Times, various experts debate the topic, “Can Wal-Mart Make Us Healthier?” (Note: The New York Times online requires free registration to access content.)

What do you think about Wal-Mart’s plan? Will it help people be healthier? Use the comments section below to share your thoughts.

Technology Friday: Mobile Health

At its most basic, Mobile Health can be described as using Internet connections and video cameras for telemedicine – or it could be accessing an electronic health record (EHR) from a mobile device, reading and responding to questions from patients via email, or secure messages reminding patients about appointments.

MultiCare Health System’s Maternal Fetal Medicine (MFM) became the first clinic in our system to use telemedicine for clinical practice, using a webcam, computer and a special monitor that allows Becky Crosetto, Genetic Counselor from Tacoma’s MFM clinic, to provide genetic counseling to expectant mothers and their families at our Olympia MFM site. This pilot program launched on Tuesday, Nov. 2, and is ongoing.

Crosetto is able to make eye contact with patients, educate them through a presentation, answer questions, and have a conversation, just as if she were in the same room.

“I kind of expected that there might be some resistance but patients have been asking all the right questions at the right times, just as if they were in the room with me,” said Crosetto. “It’s been really seamless.”

Following this first launch, telemedicine genetic counseling visits took place between our Tacoma MFM clinic and the Covington satellite MFM clinic, where five patients were seen on the initial launch day, including three visits with interpreters via teleconferencing.

One unintended consequence of this telemedicine pilot has been increased patient engagement.

“Patients seem to be paying attention – or even more attention than an in-person visit,” commented Crosetto. “The presentation is very engaging.”

On Friday, Dec. 3, MultiCare’s Neurology department launched a telestroke pilot that connects our interventional neuro-radiologists with our Emergency Departments to provide consultations to stroke patients. Using telemedicine allows Neurology specialists to get in touch virtually with doctors located anywhere within our health system to provide support and medical insight by viewing the details of the stroke patient via teleconferencing technology.

Our Pediatric carelines also launched telemedicine for endocrine follow-up visits. This will allow patients to get appropriate follow-up care, without necessarily visiting Tacoma from Olympia or farther away.

“These pilots have enabled us to deliver the right care at the right time to our patients, while minimizing the need for them to travel to receive this care,” said Florence Chang, CIO and Senior Vice President – Clinical Support Services.

This is an exciting time at MultiCare as we continue to provide easier patient access to specialty care, real-time complete clinical data to providers and convenience for providers and patients.

For updates on our work expanding mobile health services, stay tuned to this blog and to multicare.org.