In general obesity means having an excess amount of body fat. However, there is no difference between obesity in children and in adults since body mass index (BMI) is used in both. For instance, some would refer to diabetes as having at least 20% more weight than the healthy range in terms of weight. In addition, is has been defined that an obese boy would have more than 25% of his required weight and in girls its 32% higher than the required weight. Diabetes is common in today’s world, mostly in children. Children tend to get affected with type 1 diabetes; this occurs when the T cells fight and destroy the beta cells in the pancreas, in turn, the pancreas produces little insulin. Without enough insulin in the body, sugar is not metabolized well, hence, meaning that there is not sufficient energy in the body and the toxic acids build up to dangerous levels. This article will discuss the following issues: the relationship between childhood diabetes and obesity, what role does education play, support after diagnosis, the emotional and social effects, lifestyle modifications, the proper diet and finally, co-morbidities.
Education for Patient and Parents
Doctors today have come to a conclusion that there is, in fact, a link between obesity and childhood diabetes. People who are obese are at risk of getting type 2 diabetes or the one known as insulin resistant diabetes, especially if a close family member is affected (Gattullo and Edelman, 2009). In the recent past education has helped those kids with obesity or diabetes or both. Educating patients on the appropriate lifestyle and nutrition is important; since children would learn important things like that diabetes and obesity can be controlled through a healthy weight, better nutrition, regular checkups and not forgetting physical activities. This education also gives vital information like the proper medication to be taken. Education will help these children understand what diabetes is and what obesity means. Patients should understand that the exact cause of diabetes is not known, but if a family has a diabetic history then one is bound to have diabetes. There is type 1 and type 2 diabetes and type 1 mostly occurs in children and adults under the age of 30, while type 2 develops in adults in their 40s or later. Therefore, such an education is important in identifying the link between obesity and childhood diabetes. In the past few years, children with obesity have developed type 2 diabetes, which was common in adults.
Education is not just limited to what diabetes is about but also how one will know that they have this disease. Education will help a child identify the symptoms, also called the diabetes alert. Such symptoms include urinalysis where urine appears to have sugar. Then there is the fasting plasma glucose test that measures the levels of sugar in the blood, but one has to keep the fast or stop eating. The random plasma glucose test is another test to determine the levels of sugar in blood without necessarily keeping the fast (Gattullo and Edelman, 2009). The last test is the oral glucose tolerance test; one is required to keep the fast for a minimum of eight hours then take a sugary drink.
Education will give information on how treatment is to be done and where to get this treatment. Information about diet and lifestyle can help in keeping the sugar levels as normal as possible. However, complications may occur. Hypoglycemia can occur to those under medication. Feeling nervous, shaky, dizzy, sleepy and weak, sweating, suffering from confusion, speech problem and frequent hunger are just some of the signs one should look out for when having diabetes. According to Gattullo et al. (2009), this education provides sufficient information on how to control such a disease. The heath care provider can help in planning low sugar and low fat diets for people who suffer from diabetes and obese people respectively. Alcohol should be kept at a minimum. Smoking damages the heart and kidneys. Hence, it is important to stop smoking. Finally, doing exercises on a constant basis would help in keeping blood sugars normal and in reducing body fat.
Consequently, education on how to prevent additional health complications is vital. From a general point of view poorly managed diabetes can cause damage to heart, kidney, nerves and eyes. Erectile dysfunction is just another health problem in men (Chait, 2012). To avoid such extreme cases it is important that the patient takes the medicine as prescribed, has a full eye exam each year, takes good care of teeth, skin, feet etc. Keeping a keen eye on weight, blood pressure, blood cholesterol level and getting support are some of the preventive measures to be taken.
Parents play the main support and management role to their children. Better parenting leads to a healthy kid. As much as education is important for patients, it is also vital for parents. Better management and preventive skills provided by parents are helpful to their kids (Chait, 2012). Parents are taught how to prevent obesity and diabetes; they are provided with the information about diet, proper medication, lifestyle and exercise patterns. In conclusion, parents directly influence the life of their offspring. Parents would limit television viewing, encourage active participation in sports and physical activities, provide restrictions on fast food visits, provide a well-balanced food, and limit the presence of high fat and sugar snacks in the house.
Support after Diagnosis
For individuals to overcome diabetes and obesity after taking medications, there are different ways to be used. One way is keeping to a diet that has low calories. This will particularly assist people with obesity in reducing their weight. This is determined by the amount of calories consumed. The patient and the health care provided may discuss the amount of calories needed by body daily to reduce weight. The patients have to eat large portions of low calories food (Kumar & Barnett, 2009). This assists in reducing hanger pangs, which affect the diabetes patients. Adopting a good health plan is another way to be implemented after diagnosis. The patients have to keep to healthy diets, eat more vegetables, fruits and whole grain carbohydrates. The diabetes and obesity patients by doing so can improve their health plan and overcome the problems they have. According to ScholarlyEditions (2011), replacing meals is a good idea; it can help obesity patients reduce weight. On the other hand, changing meals often assist diabetes individuals in staying healthy for a long time. Replacing low calories shakes with healthy snacks with low fats and calories may be very helpful.
In treating obesity, taking exercises and increasing physical activities may assist a patient. Many individuals who maintain their weight do this by exercising regularly. Talking long walks may assist in good and non-tiresome exercises. The American College of Sports Medicine recommends that individuals suffering from obesity spend 150 minutes weekly for physical activities. This assists them in preventing additional weight gain. It is also recommended that in achieving a significant weight loss, one has to exercise for almost 200-300 minutes weekly (Kumar & Barnett, 2009). To have an improving body requires a lot of exercises from a patient. A patient is supposed to break up the exercising sessions more often so that he or she may experience a good weight loss required. Even though steady exercises are the most effective methods used in burning calories and in reducing off excessive weights. Any extra movements assist in reducing and burning calories. Behavioral medicine program assists the patient in changing lifestyles by weight loss. Steps needed in examining the current habits that have led to obesity may be implemented for diabetic and obese patients (Kumar & Barnett, 2009). The support to be provided may be behavior therapy. Counseling provided by the health care practitioners assists the patients in addressing the behavioral and emotional issues that are related to eating. Therapy assists the patients in understanding the reasons of being healthy and coping up with anxieties, depression and stress. It assists the patients in learning how to monitor the activities to be carried, and which diet to be used. The patients need to understand the eating triggers and how one needs to cope up with food cravings. This counseling may be done via internet programs or telephone in case the patient cannot reach the healthcare counselor. On the other hand, the patient may find a lot of support from different support groups whereby different people share experiences in the problems they face, either diabetes or obesity. As stated in Scholarly Editions (2011), in certain situations, losing weight and enhancing good healthy living in these patients may need prescription medicines from health care providers. Weight loss medicines are meant to be used with regular exercises, good diet and behavior changes. If the changes are not made in the life of a patient, the medicine prescribed may not work at all. The health care provider may recommend these medicines in case other weight loss and good health methods have not worked.
Emotional and Social Effects
There are many social and emotional effects that are experienced by a child suffering from obesity or diabetes or both. Obese adults and children are targets of systematic and early discrimination. The emotional and social fallout can hurt both adults and children that suffer from obesity and diabetes. Every child is expected to create a concept of their selves and identify themselves. A child is expected to monitor, by identifying oneself, how other people such as peers and friends respond to the ideas or actions he/she conducts. On the other hand, children are supposed to monitor the value judgment accompanied by their peers and friends` perceptions. These actions take place in environments that have societal attitudes, cultural attitudes, social values and conformities. An obese child develops a sense of knowing how to handle his or her body and deal with the trepidations of their body status in contrast to these backdrops (Blogspot, 2013).
Many children know from an early age that obesity and diabetes are not desirable. The awareness issued seems to be mainly generalized from different studies that use stereotypes that have the same negative responses despite the age, body status of a person and gender. As a result, a child termed to be overweight is alleged as a fair game. A lot of obese children have low self-esteem. This is because many children every so often bully or tease their obese peers (Blogspot, 2013). Low self-esteem makes children feel depressed. Many children become conscious of their body status via such mechanisms like name calling and photographs. In the early years, children realize that fatness impacts athletic ability and appearance, but not the global self-worth or social competence. Even though, obesity differs in many children. Low self-esteem may affect the body of a child at a greater extent. This leads to the fact that child`s self-protection, enhancement and efficacy are affected (Guthrie & Bartsocas, 2003).
Another effect of obesity is causing a feeling of overwhelming hopelessness among obese children due to low self-esteem and social isolation. This leads to depression. When a child is depressed, he or she may lose interest in day-to-day activities by either crying or sleeping more (Blogspot, 2013). This psychological stress may affect the social functioning and academic performance of a child then persisting into adulthood. Other children, who suffer from depressions, hide their sadness and look emotionally flat. Moreover, obesity may lead to a child being very nervous and acquire poor social skills than children who have normal weight. These issues may lead to a class disruption in school. It may also lead to social abandonment. Anxieties and depression have major effects on learning and creates vicious cycles whereby the worries of an obese child may lead to poor academic performances (Guthrie & Bartsocas, 2003). Learning of a child may also be interfered. Additionally, many children having diabetes have a lot of feelings developed in their life stages. They may feel different from their friends who do not have the illness. This may be worse in case the glucose level of a child is found to be worse or the disease progresses. Being separated from parents, when attending school, makes obese children have safety related fears. This leads to these children singling out themselves in school as misfits. On the other hand, diabetes in children may lead to rivalries among the siblings and jealousy. This is because parents tend to care more for the child having diabetes that the others. Diabetes is one of the conditions that frustrate children, therefore, leading to aggressive reactions to high and low blood sugars (Guthrie & Bartsocas, 2003).
In plenty of forums, numerous people talk about diabetes and obesity lifestyle modifications (Wadden et.al, 2012). What does this really mean? Does is it actually make any difference? However, it is easier to make modifications to lifestyle than taking actual medication. Health institutions have always recommended weight loss for those who are overweight. A program of lifestyle change is considered the first and important option for achieving weight loss. In some cases, it is referred to as behavioral weight control and constitutes of three primary constituents: diet, behavior therapy and exercise. Fortunately, lifestyle modification for t diabetic people is more or less same as that one for obese people; diet and quitting smoking are just some ideologies of a lifestyle change.
A complete lifestyle modification program encompasses a weekly group or individual session that is designed to modify activity and eating habits (Wadden et al., 2012). The Diabetes Prevention Program (DPP) is an example of a treatment program that allocated participants with low glucose tolerance to metformin, placebo or lifestyle modification class.
The first step in changing patients` lifestyle is to stop smoking. If smoking has tremendous health effects on a healthy individual, it could tremendously affect the diabetic or the obese people. According to Wadden et al. (2012), smoking has tremendous effects on a person; increased cholesterol levels and constricted blood vessels are just some of the examples. In addition, smoking elevates the number of respiratory and cold infections, and the people with diabetes will experience a rise in nerve and kidney disease. Limited joint mobility is yet another effect. In addition, blood sugar levels and blood pressure rise with increased smoking, not forgetting impotence, heart attack or stroke can be influenced by smoking. Nicotine is highly addictive, making it hard to stop smoking, but going with these negative effects it is important to stop smoking by using a nicotine patch, group therapy and behavior modification.
Lose weight is yet another aspect of changing one`s life. It is evident that there is a high chance of developing diabetes if one has or is more than 20% overweight. Insulin sensitivity can be improved by even then smallest weight loss. Improved fitness and overall mortality are just another benefit, but the goals are always to achieve the healthy and appropriate BMI. Unfortunately, those with type 2 diabetes have a difficult time to reduce weight. There are different ways to maintain equilibrium Body Mass Index (BMI). First is discipline, it helps when one establishes a regular schedule for different lifestyle aspects since it helps the body maintain a predictable manner to maintain a healthy BMI (Winslow et. al, 2012). Such aspects would be based on meal, sleep and exercise. Establishing regular mealtimes is important especially in glucose levels. Developing a regular sleeping pattern can help in reducing the chances of getting type 2 diabetes.
Winslow et al. (2012) affirms that another component of a lifestyle change is doing exercises; since it improves the cells` reception to insulin. Exercises help in lowering blood sugar and insulin levels and in increasing insulin sensitivity. Those with a low BMI can lower the chances of getting diabetes by doing exercises. In conclusion, exercises help in reducing health risks and help in losing weight.
Ideally, lower stress would lessen the chances of getting diabetes. Too much stress raises the blood sugar levels, which, in turn, raise insulin levels. Winslow et al. (2012) asserts that it is important to learn how to deal with stress. In my opinion relaxation therapies would help establish a good lifestyle pattern. Counseling and essential daily activities like yoga and body massages help improve overall stress and ensure that stress levels and tension in the body are minimal.
Bad Diets of Diabetes
A person having diabetes should not avoid only sugar, he or she is expected to check and regulate other foods such as food rich in carbohydrates. High cholesterol food is considered to be harmful to the individuals suffering from diabetes. Therefore, people diagnosed with diabetes should avoid using it. Different studies have recently shown that some vegetables and fruits may be harmful to a person with diabetes (Webmd, 2013). In the same way, beverages and fast foods may not have an effect at all. Foods rich in sugar such as donuts, chocolates, cookies, ice creams, pastries among others may be very harmful to individuals suffering from diabetes. The list of high carbohydrate food is dominated particularly by products rich in glucose and fructose like the fruit juice concentrates. These foods are supposed to be avoided because they increase blood sugar levels in body. Even if sugar is not avoided completely, a person should modify the food by ensuring minimal sugar content. Different studies have shown that diabetes lowers the level of good cholesterol and increases the level of bad cholesterol found in the body. This makes a person who suffers from diabetes to have heart diseases because the bad cholesterol is likely to build up obstructions on the artery walls. Foods that have high cholesterol such as poultry, shrimp, butter, cheese, egg yolk and dairy products rich in fat should be avoided because they may affect the body (Clinic, 2012). A research conducted by the Tulane School of Public Health showed that drinking a glass of fruit juice every day may significantly increase the individual’s threat of diabetes.
The research stated that it was better for an individual to eat a fruit rather than drinking a fruit juice. This is because fruit gives the body fiber that is necessary and needed in a healthy body. To add on that, fruit juices are rich in carbohydrates and are bad for people suffering from diabetes. Alcoholic beverages are bad for people diagnosed with diabetes. As a result, the tendency of alcoholic beverages in increasing blood sugar levels and when alcohol is consumed in high quantity, it may affect an individual suffering from diabetes. Taking alcohol on an empty stomach may lead to hypoglycemia (Clinic, 2012). The glucose released in the body is stored directly in liver. Consequently, any liver damages due to a lot of alcohol may lead to problems of controlling the levels of glucose in the body of a person diagnosed with diabetes. There are other fruits, which are bad for individuals who suffer from diabetes. Fruits like dates, mangoes and strawberries may result to spikes blood sugar levels that may affect an individual. Some vegetables like squash and potatoes may also affect a person with diabetes. Another type of food to be avoided is food fried using hydrogenated oils. This is because they increase the level of bad cholesterol in the body. Additionally, these foods are loaded with trans fats termed to be unhealthy (Kumar, 2004).
Good Diets for Diabetes
Keeping to a good diet is vital for individuals with diabetes. Carbohydrates, fats and proteins are good for a diet used by individuals with diabetes. This is because they provide the body with fuel presented in the form of glucose. Glucose is a type of sugar which is the main energy source needed by the body cells. Carbohydrates may be either complex or simple (Kumar, 2004). Simple carbohydrates are lactose, fructose, sucrose and glucose. These carbohydrates are mostly found in fruits and refined sugar. Additionally, starches are complex carbohydrates. These are simple sugars that are joined together chemically. They are mostly found in vegetables, beans, whole grains and nuts. Complex carbohydrates are said to healthy because they are digested slowly providing a balanced energy source. In addition, they have valuable amounts of fiber. During digestion, carbohydrates are broken down into sugar, therefore, having effects on blood sugar (Webmd, 2013).
Fiber is good for a diet to be used by an individual having diabetes. It is a part of the plant foods that are not digestible. In the digestive process, fiber plays a vital role because it assists in moving foods along digestive tracts. Diets that have a lot of fibers are linked with low obesity risks, strokes, heart disease and high blood pressure. Moreover, fiber also delays absorption of sugar assisting in controlling the level of sugar. It also joins with cholesterol and reduces the level of bad cholesterol in the body. Fiber is also a good source of minerals and vitamins (Kumar, 2004). Fiber assists in promoting weight loss by decreasing caloric intake. On the other hand, it assists in preventing constipation and reducing risks of various intestinal disorders. One needs to eat a lot of food that is rich in fiber, when keeping to a diet. These foods are brown rice, whole cereals, fresh vegetables and fruits and cooked dried peas. Eating food with low fats, mainly saturated fat, helps in reducing risks of heart diseases. Vegetable oils are rich in these types of fats. Instead of using salt which is not good for individuals with diabetes; spices and herbs may be used instead. Having three meals a day and two snacks if possible will lead to a good diet. Amounts of calories taken daily are supposed to be regulated, since it may impact the blood sugar levels (Kumar, 2004).
These are diseases or a disease that co-occur with a principal disease but can also exist independently of a particular disease. It is without doubt that diabetic persons often have hypertension. However, hypertension (high blood pressure) can exist also in people who don’t suffer from diabetes. Therefore, high blood pressure is a co-morbidity of diabetes (Munshi, 2012). Cardiovascular disease, nonalcoholic fatty liver disease, hyperlipidemia and obesity are some of co-morbidities of diabetes.
Hypertension is another example of co-morbidity of diabetes. High blood pressure in most cases would raise the blood sugar levels of an individual. Hypertension is often related to high stress levels and heart failure (Munshi, 2012). The adverse effects of hypertension often result to increased cases of diabetes. Hypertension and diabetes often coexist in terms of underlying risks and complications in question. Such complications include micro and macro-vascular disorders. Consequently, management of lifestyle would help in dealing with both hypertension and diabetes.
End-stage renal disease may at times coexist with diabetes. Increased diabetes elevates the risks associated with end-stage renal disease. Diabetes may often cause hypertension that might influence the blood flow that would eventually influence the development of left ventricular hypertrophy. According to Munshi (2012), patients associated with low blood pressure have issues during dialysis.
Diabetes and its vast range of complications are high risk issues for the development of cardiovascular disease. The patients widely known for cardiovascular mortality and morbidity often have diabetes (Prichard, 2000). Even though, diabetes can exist by itself; those with a history of cardiovascular diseases are in many cases associated with diabetes.
Obesity is an increasingly emergent factor in today’s society. Numerous kids are associated with obesity. Consequently, those kids with obesity issues are next in line in developing type 2 diabetes, unless overweight is significantly managed (Prichard, 2000). Obesity builds a foundation on which diabetes can develop. Obesity often causes hypertension, which increases the blood pressure and eventually raises insulin production or can lower the amounts of insulin produced in the pancreas. Obesity and diabetes coexist.
It is not limited to diabetes related co-morbidities, but also to non-comorbidities like depression. The effects of depression often have underlying effects on diabetes. According to Prichard (2000), depression would increase issues related to chronic stress and blood pressure. Another significant issue with such morbid diseases often brings out ideologies related to health care.
According to Prichard (2000), Obstructive Sleep Apnea (OSA) is a common, morbid disease related with type 2 diabetic patients. Treating sleeping apnea tremendously increases mortality and blood pressure control. Those patients with diabetes have been related to having high levels of OSA.
Fatty liver disease is another instance of morbid disease associated with diabetes, especially type 2 diabetes. Such patients may have elevated levels of hepatic transaminase concentrations that lead to fatty liver disease. Most liver diseases have been linked to patients who have original had diabetes. Hence, improvement of metabolic abnormalities can improve such conditions. Weight loss, glycemic control and drug treatments are some of the examples of treatments to be used.
Cancer is yet another disease linked to type 2 diseases. Prichard (2000) affirms that increased risk of liver, colorectal, pancreatic, bladder cancer and breast cancer are some of the extreme diseases linked with diabetes. Both old and young are encouraged to go for cancer screening at the appropriate age. In conclusion, fractures are, unfortunately, unavoidable in patients with type 2 diabetes. Hip fracture risk is very common among men and women having type 2 diabetes.
Diabetes and obesity are becoming popular not only among children but also adults. These trends in conjunction with diabetes and obesity’s psychological, economic and medical effects show the need for policy directives and interventions that are intended to prevent diabetes and obesity. In the United States, some policy recommendations have been implemented in reducing obesity and diabetes. These are taxing unhealthy food, subsidizing the sales of healthy food and increasing resources to be used in enhancing physical activities. In case the health practitioners fail to treat diabetes and obesity as health problems and policy initiatives are not put into place, complications found in diabetes and obesity may increase. Consequently, parental and patient education on matters of diabetes and obesity is important in fighting these diseases. Diabetes is a co-morbidity of diabetes, and the vice-versa is also true. Finally, lifestyle modification is a vital step towards dealing with issues pertaining to diabetes and obesity.