Managing Type 2 Diabetes

As the prevalence of childhood obesity has increased, so too has a series of health problems for children, including type 2 diabetes. The American Academy of Pediatrics recently issued guidelines for health care providers on managing the care of children with type 2 diabetes. These are the first such pediatric guidelines for a disease that previously affected primarily adults.

Chief of Pediatric Endocrinology, Robert Ferry, MD, says these guidelines reinforce the practice of pediatric endocrinologists for the last 10-15 years.

"Pediatric obesity remains the major public health problem for the current generation of American children and adolescents. Parents should discuss their child's weight and overall growth pattern at routine visits with their healthcare provider," he said.

It's important for parents and children to make healthy choices. Dr. Ferry recommends these effective strategies for obesity prevention and weight control.

• While shopping for food together, discuss making healthy choices.
• Eat three meals and one to two snacks every day. Finish meals within 45 minutes, but keep portion sizes reasonable.
• Try to do things at the same time each day -- meals, snacks, homework, physical activity, and bedtime -- even on weekends.
• Encourage moderate to vigorous physical activity for at least 30 minutes each day.
• Limit recreational TV, phone calls, sedentary video games, and computer use to less than one hour each day. Keep the TV out of your child's bedroom.
• Write down in a logbook all the food your child eats and his/her exercise times.
• See your doctor, nurse, or dietitian on schedule, so they can evaluate your child and the food log.
• Keep serving sizes reasonable. Do not allow your children to serve themselves. Do not force your child to "clean the plate" by eating it all.
• Read food package labels carefully. A small package may have more than one serving.
• If your child wants second servings, let him choose one item from the meal. Still hungry? Wait 20 minutes before giving additional food.
• Decrease the serving size of starchy foods (such as rice, potatoes, bread, pasta). Instead, use naturally colorful vegetables.
• Serve biscuits or rolls on special occasions. Use whole wheat or other whole grain breads.
• Serve whole-grain cereals and oatmeal. Serve cereals with skim milk.
• Eat steamed, broiled, baked, or grilled foods instead of fried foods.
• Use herbs and spices instead of adding sugar, salt, or fat.
• Eat lean meats and vegetables. Cook with olive oil, peanut oil, or canola oil. Stay away from saturated fats like butter, chicken skin, bacon, animal feet, and fatback.
• Eat salmon, light tuna, catfish, or shrimp twice a week. Avoid fish from the same body of water more than once per month.
• Use fruit, sugar-free flavored gelatin, and pudding as desserts.
• Limit fast food and prepared foods (such as frozen dinners) to no more than once each week.
• Limit sugary and fatty snacks such as cakes, cookies, candies, chips and fries. Instead eat low-fat cheese, vegetables with a low-calorie dip, or fresh fruits.
• Serve fruits and vegetables or a cup of skim milk for a bedtime snack if your child is hungry.
• Stay away from sugary drinks like sodas, juices, juice drinks, or sweetened tea. Instead, drink water, sugar-free lemonade, or skim milk.
• Drink milk for calcium every day. Children older than age 2 who cannot drink regular milk should try lactose-free milk, yogurt, or cheese.
• Give water or skim milk with snacks between meals.
• Pack lunches from home for your child.
• Talk to your child's health care provider about the need for children's multivitamins or nutritional supplements (like vitamin D or folate).
• Tell family, friends, teachers, and sitters about your plan for your child to eat healthy food. Ask for their help.
• If your plans for good health for your child get messed up today, don't worry. Get back on track tomorrow.