Texas Children’s Hospital Discusses Diabetes

School nurse taking blood sample of little girl with diabetes | Image by Pixel-Shot/Shutterstock

Texas Children’s Hospital recently held a conference for school nurses to learn more about juvenile diabetes and its management.

Diabetes, as one speaker at the recent 2024 Virtual Diabetes Management Conference for School Nurses explained, is one of the most common chronic diseases among school-aged children.

Bonnie McCann Crosby, MD, noted a direct correlation between the rising prevalence of type 2 diabetes among children and the increase in juvenile obesity rates. For instance, between 2001 and 2017, the prevalence of type 2 diabetes among children and adolescents saw a relative increase of 95.3%.

Obesity increases the risk for type 2 diabetes due to the excess fat in the body driving insulin resistance and thus metabolic dysfunction. Over time, the unprocessed sugar in the blood can build up and lead to serious health problems, such as kidney failure, heart disease, stroke, and more.

Data from the Centers for Disease Control and Prevention shows that the obesity rate among Americans aged 2 to 19 years in 2017-2020 was 19.7%, representing approximately 14.7 million young people. As previously covered in The Dallas Express, Texas children had the eighth-highest rate of childhood obesity in the country, with 20.3% of those between the ages of 10 and 17 classified as obese in 2019-2020.

These childhood obesity rates are expected to continue to rise, with one simulation conducted in 2017 suggesting that 57% of children would be obese by the time they reach 35 years of age.

With these issues in mind, the recent conference centered on how type 2 diabetes might be managed within a school setting.

Noting that one study showed that nearly 80% of youth with type 2 diabetes were obese while 10% more were overweight, another speaker, Sophia Ebenezer, MD, stressed the importance of a balanced diet and regular physical activity to help manage diabetes.

Ebenezer recommended that children with type 2 diabetes exercise for one hour a day and follow “the Plate Diet.” The latter means that at mealtime, half the child’s plate is filled with a non-starchy vegetable, a quarter with lean protein, and another quarter with a carbohydrate. Low-calorie beverages or water are highly encouraged, with Ebenezer noting the high levels of sugar in many popular drinks, such as soda or juice.

Katherine Gallagher, a pediatric psychologist at Texas Children’s, also shared ways school nurses might help students with diabetes cope with the burden emotionally. She stressed the importance of helping them learn to manage their condition by having an active role in their routines and finding confidence in doing so.

This is especially important given that youths go through several changes as they grow older — new people enter their lives, routines shift — and yet their condition is chronic. The “forever” aspect of diabetes, Gallagher explained, can lead to emotional distress and even burnout. As such, school nurses were encouraged to find age-appropriate ways to lighten the load.

For instance, between the ages of 6 and 11, children might be able to start making their own choices about food or monitoring their own carb intake. By age 14, they might be administering most of their own insulin shots.

Ultimately, school nurses represent an integral part of managing diabetes among school-age children, the conference showed.

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