Study: Heavy teens have trouble managing diabetes

Here's another study makes confusing assumptions and ends up blaming obese teenagers for their disease. Sigh, as if kids don't have enough to get beat up about.

I attached the article as a Word document. The original is here:
http://www.sfgate.com/cgi-bin/article.cgi?file=/n/a/2012/04/29/national/a121725D47.DTL

It's the SF Chronicle's take on an article in the New England Journal of Medicine: www.nejm.org

2878-Heavyteens.doc (35.5 KB)

But the results of the study are pretty alarming - under current regimes nothing seems to work very well. One possible conclusion which no one made is that a radically low carb diet may be necessary for these teens to meet basic treatment goals.

Right, I wonder what sort of "diet" the kids were on who were in the metformin and diet group? And some of these kids have pretty heavy-duty diabetes, it seems, if they're already taking insulin. I wonder if they're really T2s? When I read the nejm article, I found no reference to what they considered "lifestyle changes." It could have simply been adherence to the carb-laden ADA diet, which as some of us have discovered is a quick path to failure.

I have not read the study ,I maybe missing something , however I have seen recent reports on TV of parents serving their kids Nutalla on brown bread for breakfast ?? ...Parents not reading food labels ?? ...very sad . This has nothing to do with ADA or any other diet ...this has to do with education .

Cosumme Jan gave a link to the study & also as an attachment.

Nutella TV ads in the US promoting it as a breakfast option. Wonder if it's any worse than breakfast cereal & toaster pastries that are also marketed to kids & parents. No one seems to be doing an expose on that junk, or any other processed food kids eat.

Seen plenty of unhealthy food recommended by the ADA & CDA. Is sad.

Gerri ...true ...cereal breakfasts , toaster pastries ..same stuff as the Nutella stuff and who knows what else...what I am getting at is the eating prior to diagnosis of the different diseases . Parents not teaching kids to make healthy life choices, because they have not taken the time to being educated and sharing their knowledge .

I found this link really interesting: https://www.healthtap.com/user_questions/53270-to-prevent-type-ii-diabetes-is-it-more-important-to-avoid-sugar-and-carbs-or-to-avoid-fat It's basically a conversation between two doctors about what causes type II diabetes. There are a variety of factors and it's no one's "fault," but it seems like weight gain is definitely associated with developing type II.

But what do I know ...not being a parent :) ????

...( living with d almost 30 years )

The big question is a "chicken or the egg one". Was the weight gain the cause of pre diabetes or a result of it. You can argue either side, but at this point I think it's safe to say, we really don't know.

I saw this too and wondered if the sort of teenage "propensity" to eat like wolves, piles of junk food, with little regard for "sense" or whatever might make an additional complication for this situation?

In my experience, teenagers eat whatever is on the table. They don't do the shopping or the cooking. Not many of them have enough money to eat fast food all the time. So if they're getting bad food choices, the chances are very good they aren't the ones who are at fault. What is a teenager supposed to do? Turn down what's being served and ask for better food? I think none of the 3 groups that were studied got enough information or treatment to help them succeed. But it's hard to tell because there are no details about the diet. The whole notion of throwing a few pills at someone and telling them to exercise and watch their diet is severely lacking, but adults at least are in charge of their own lives.

As I observed being in the Netherlands the past few weeks : ...kids /adults/ grandparents still use their bicycles and legs to move from place A to B ...It's about what one is used to.

Cosumne Jan - are you upset by the fact that they are poorly controlled with just pills and diet, or that the article suggests that they became T2 diabetic because of being obese?

That's a good question, Nicole. Had to think about it. I think what bothers me is yet another poorly constructed study that concludes the subjects failed. "Hey, we gave them pills and advice and they didn't get better, so they must not have followed it." What was the "advice"? Would the subjects have succeeded even if they'd followed it to the letter? Lots of adults don't succeed with their diabetes, or with obesity, because (in my mind) they don't understand how to deal with carbs. It's got to be even harder for kids. I'm imagining kids who either come from families where everyone is fighting obesity, or from families like mine where everyone ate twice as much as I did, got half as much exercise, but I was the only fat one. (I wasn't diabetic until I was 55 or so.) Maybe I'm taking the article too personally.

C J ...I am a person without " diabetes credits " ,but am living it for almost 30 years, I am a peron , who has lived for 70 plus years and I think with life experiences I say ...Mom and Dad ...where are you ??? ...I was not ever fat either, however am very insulin sensitive and I thank my parents for making sure : I walked to school , I attended gym classes, I attended bally classes , I wrote my bike , I used my legs...and I am a war babe , who went hungry !! ..and please don't take the web article too personally !!!

The article is about Type 2. Different set of issues than T1's deal with. Insulin resistance that leads to weight gain is terribly hard, not to mention all the finger pointing & shame too many of our T2 brothers & sisters have to endure.

There was additional information in a couple of articles in the NY Times and Wall Street Journal about the study. The teens did substantially worse than adults using the same regimes which was a suprise especially as those who were unable to keep their A1cs under 8 or 8.5 included many who were highly compliant.

One doc noted that 50 years ago, kids didn't make better food choices. Rather they lived in a more active and less calorie laden environment.

I don't think there was any attempt to or interest in blaming the teens for their diabetes. I also don't think it makes sense to ignore the fact that increasing rates of childhood obesity has contributed the the increase in T2 among teenagers. Having to deal with T2 at 55 is bad enough; it is much more difficult to have to deal with it at 16 and have an additional 40 years to develop complications.

A delay of 30 years counts for quite a bit.

If you are refering to my comments Gerri ...?? I am not shaming type 2's ...I am " shaming" the parents of these kids for the food choices , the life style choices, prior to being diagnosed with this or other diseases ...as still " young at heart " pointed out ...Go and visit the Netherlands and Hawaii as I very recently did and you will get the picture , I hope ....North American kids are NOT moving ...

Know you're not shaming T2s. Just saying that being a T1 is different & we don't have to deal with insulin resistance that results in weight gain. Been to Amsterdam & to Hawaii.