<i>Obese kids and diabetes</i>

Emon, a 12 years old boy has got the weight of 170 pounds with a height of only 4 feet and 8 inches. He is a bit shorter but almost twice than that of the size of his contemporary kids. His favorite foods are chocolate, cake, burger, hot dog, french fries, chips and pizza. His favorite activities are watching television and playing computer games.
When he was younger, people would comment, 'Oh, he's so cute!' His parents indulged his cravings for sweets and junk food. They did not encourage him to exercise or to play with other kids outside, thinking that he might just get injured.
Like the increasing number of obese children, Emon is at the risk of developing blood pressure, heart problems and metabolism disorders like diabetes.
Childhood obesity is increasing at an alarming rate worldwide. It is estimated that, one in every ten children in the world are overweight.
Why are kids getting big?
Beneath the obvious reasons like unhealthy food choices and inactivity among kids, there are underlying factors that contribute to the obesity epidemic.
The environmental factors like urbanisation and mechanisation have definite impact on why kids are eating more junk foods and being less active at the same time. The presence of TV and computers have encouraged more kids to stay indoors rather than run and play outside.
Parents' lack of control and influence over their children's food choices and activities are also major factors why kids are getting fat. If the parents themselves would practice a healthy lifestyle at home, then their children would likely follow them.
Several other factors contribute to the increase in childhood obesity. Alluring advertisement of unhealthy foods, lack of nutrition education and physical activities in the curriculum, lack of playground are some important risk factors.
How is childhood obesity related with diabetes?
The increasing rates of childhood obesity have led to increase of type 2 diabetes in children, though children has also specific and definite type for them, which is type 1 diabetes. The majority of children (some 85 per cent) with type 2 diabetes are overweight or obese at the time of diagnosis. All of these children are at increased risk of diabetes.
The American Diabetes Association (ADA) says that overweight children, who have entered at the age of above ten, are considered at risk for diabetes if they have a family history of type 2 diabetes or have conditions associated with insulin resistance such as high blood pressure, high triglyceride and cholesterol levels.
Evidence shows that children of women, who developed gestational diabetes tend to have higher rates of type 2 diabetes.
In order to decrease the risk of gestational diabetes, it is important for women to get to optimal weight and health prior to pregnancy and once pregnant, to adopt a healthy lifestyle and avoid excessive weight gain. If diabetes develops during pregnancy, rigid blood glucose control is imperative to reduce the risk of future diabetes in the child born to a diabetes pregnancy.
What next, if diabetes is uncontrolled?
Diabetes is a chronic, life-long condition that requires careful monitoring and control. This disease has a unique impact on children and their families.
Diabetes can interfere with the normal developmental tasks of childhood and adolescence, including educational success and the transition to adulthood, if remains uncontrolled.
Uncontrolled Diabetes can lead to very high blood sugar levels. These are associated with long-term damage to the body and the failure of various organs and tissues. Complications include cardiovascular disease, stroke, kidney disease (diabetic nephropathy), disease of the nervous system (diabetic neuropathy), eye disease (diabetic retinopathy) and so on.
What can be done?
Other than type 1 diabetes (at present cannot be prevented), type 2 diabetes in young children and adolescents can be prevented in many cases by maintaining a healthy weight and being physically active.
Studies have shown that type 2 diabetes can be prevented through weight loss and exercise. It should start first at home. Parents should provide healthy food and promote physical activity. One way to do this is to involve the whole family in the effort to eat healthy and exercise.
Healthcare professionals should properly identify the children at risk, track body mass index and provide counseling to children and families.
In order to help the children and their family, and to ensure the best possible physical and emotional health of the child, care should be delivered by multidisciplinary approach with good knowledge on paediatric issues.
For schools, it would help if they could develop programmes that would teach wellness, healthful eating and exercise.
As medication, if insulin would be prescribed, it would be better if patients will take it willingly as early as prescribed. Because, insulin is the first choice for better and strict glycaemic control (maintenance of normal level of blood glucose).
According to the suggestion of American Diabetes Association, basal insulin could be the most effective option for the first line insulin therapy for all kind of diabetes patients. To encourage the healthy eating among families you can follow the following tips:

• Eat meals as a family at a fixed place and time.
• Do not skip meals, especially breakfast.
• No TV during meals.
• Use small plates and keep serving dishes away from the table.
• Avoid unnecessary sweet or fatty foods and soft drinks.
• Remove televisions from children bedrooms; restrict times for watching TV and video games.
• Don't use food as a reward or punishment.
  The writer works with diabetes care, treatment, support and rehabilitation.