A new study has important implications for clinical practice in the testing of African American children for diabetes. HbA1c is the main test used to monitor diabetes and guide treatment decisions and it has been found that results can be deceptive in African American children — misleading their doctors into believing that glucose levels are higher than they really are. Test scores were higher than those for white children, even when average blood glucose levels were similar, and this suggests that results might need interpreting differently for African-Americans.
While ordinary blood glucose tests would give the correct results for black children, the new research suggests that an HbA1c test would be misleadingly high, perhaps leading doctors to think that treatment isn’t working as well as it should. This could lead to more aggressive treatment that reduces someone’s blood sugar too much, and leads to episodes of hypoglycaemia.
According to Dr Stuart Chalew, a pediatrician at the New Orleans School of Medicine, “If doctors don’t take both HbA1c and self-monitored blood sugar levels into account, they are likely to unintentionally provoke increased episodes of life-threatening episodes in African-American patients”.
Black people tend to have a higher risk of getting complications from diabetes, which could partly be explained by their HbA1c levels responding differently to their blood sugar. In the long term, this finding may lead to new treatments to prevent diabetes complications.
Tips On How To Prevent Childhood Diabetes in African-American Children
There are two types of diabetes and both are on the rise in African-American children: type 1 and type 2. Type 1 diabetes, also known as insulin-dependent mellitus (IDDM), is a disorder caused by the body’s inability to produce insulin. Insulin, a hormone produced and secreted by the pancreas, is essential for the cells of the body to metabolize glucose to use for energy.
Children with childhood disbetes must take insulin shots every day and check their blood sugar levels several times a day. The American Diabetes Association states that about 10 percent of children have type 1 diabetes. It is nearly twice as prevalent in African-American children age 20 and under than in White children.
Because obesity is on the rise in the U.S., there are an increasing number of African-American children diagnosed with type 2 diabetes (also known as adult-onset diabetes).
According to Susan Marullo, diabetes coordinator at the National Naval Medical Center in Bethesda, MD., “There is no cure for diabetes, but with proper treatment, patients can live a long life.” Ms. Marullo states that both types of diabetes can be prevented if you:
1. Know Your Family History: If there is a history of diabetes, inform your family physician.
2. Screen: Have your physician screen for diabetes if there is a risk.
3. Change Your Lifestyle: Too many children today are entertained by PlayStation, Xbox, and the television in general. Children should be encouraged to watch as little television as possible, preferably no more than two hours per day. Instead, they should be engaged in some type of physical activity.
4. Exercise: Children should be involved in team sports (basketball, baseball, soccer or karate). They can also engage in physical activity with their family. Try family walks, bike riding or walking around a museum together.
5. Control Your Weight: Because children are still growing, maintaining the same weight for one to two years can allow children to grow into their excess weight. Catching a weight problem early will allow modifications before it’s too late.
6. Limit Soft Drinks: Drinking too many soft drinks can increase the chance a child will become obese. Extra calories in sweet drinks, fruit juices, soda and Kool-Aid can cause obesity. Choose water instead of soda.
7. Remember Less Food Can Sometimes Be More: The quantities and variety of foods in the home, as well as eating habits, establish an environment in which obesity may or may not occur. Serve smaller portions. Encourage your child to listen to his body and stop eating when he is full.
8. Don’t Use Food As An Emotional Crutch: Don’t use food as “comfort” to make a child feel better. Talk through emotional situations, rather than allowing kids to eat through them.
9. Act As A Role Model: It’s difficult for children to stick to a diet or exercise plan if their parents are sitting on the couch with a bowl of chips and a sofa. Make healthy eating a family affair.
10. Change Your Diet: Decrease the amount of high-calorie “junk food,” such as potato chips, cookies, candy or cake, your family consumes. Add more fruits and vegetables like carrots, apples, grapes and peaches to their diet. Keep children away from fast and fatty foods.
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