Dr Kemi Yusuf, a Consultant Endocrinologist and Physician, Endocrine, Diabetes and Metabolism Unit, Department of Internal Medicine, Ladoke Akintola University of Technology Teaching Hospital, Osogbo talks about risk factors of diabetes in children and pregnant mothers in an interview by AKINWALE ABOLUWADE .
Women with record of overweight babies are said to be prone to diabetes, why is it so?
We always want to screen women who had big babies at delivery in order to know if they have gestational diabetes. Women with gestational diabetes are those with signs of diabetes or who are diabetic when pregnant. This is different from pre-existing diabetes because it occurs or is induced by pregnancy. People with gestational diabetes have the tendency of giving birth to big or overweight babies. In this case, it is the placenta hormones that counteracts the activities of insulin and makes them not to be sensitive to the insulin that their bodies are producing. We usually advise that this category of women should get screened periodically to find out if they are already developing diabetes on their own before pregnancy or not. There is increased risk of developing type-two diabetes in people who had gestational diabetes mellitus. But if care is taken, the person may not progress into full blown diabetes. It is important to note that not all those who developed gestational diabetes developed type two-diabetes later in life. But if they do not watch it by keeping healthy lifestyle, they can eventually progress into it.
Can the types of food that a woman takes during pregnancy induce diabetes?
Those that have family history of gestational diabetes mellitus or those with genetic predisposition can be tipped into developing diabetes if they do not eat the right kind of food during pregnancy. If they eat junks or fast food they can actually have it. If they are obese and overweight pathologically they can develop diabetes.
How about diabetes in children?
Rate of obesity in children is disturbing because it is on the increase. Most of our children are becoming more obese because they are not eating healthy diets; they are eating fast food and junks. Most of them don’t have the luxury of exercising and in the schools, most of them don’t have the luxury of playing around. At home too, there are security bars around; we don’t allow them to play around. Most of them are sitting in front of television for leisure and recreation. They really don’t go out to expend energy and shed weight. So, if they have that genetic predisposition to diabetes coupled with obesity and overweight, they can have type two-diabetes.
They do say that diabetes has no respect for age; what is the veracity of this claim?
Yes, it is the same thing even for children. We see cases of type-two diabetes more in children nowadays. It is because the rate of obesity is on the increase in children. Our children are becoming more and more obese. This is because they are not eating healthy diets; they are eating fast foods or junks. The system of children may react to some of the processed foods and artificial milk that they now eat and get so used to. They may, actually develop antibodies against the artificial milk that they are taking and this can cross-react to some organs in their bodies. Some fast foods have the tendency of making people obese and in the long run increasing the fat in their bodies. That is why most children become overweight and subsequently develop type two-diabetes.
Can children also be subject to taking insulin if diabetic?
Yes, if they have type-one diabetes they can be required to take insulin. Like I said, if they develop the antibodies; if they are eating canned food and artificial milk. The antibodies can work against their pancreas and destroy it. Actually, for type-one diabetes, we don’t really know the cause. All we know is that it usually results from an auto-immune process that eventually destroys the pancreas. It is commoner in children; that means that the pancreas cannot secrete enough insulin to take care of their body metabolism and they are, therefore, dependent on insulin for life. With this, the insulin they cannot generate will be given exogenously (from outside) to meet the body metabolic needs. If the child has type-two diabetes he can be given medication like drugs. Like I said, overtime, those who have type-two diabetes may eventually need insulin for support.
What is your advice to parents who bear the brunt of the disease because their children are diabetic?
My advice, especially to mothers, is that they should ensure that they give their children the right type of food. Parents should ensure that they give their children fruits. As mothers, we should give our children naturally occurring foods; we should desist from giving canned foods and the likes to them. We should not give them artificial and fast food like cake, ice cream and butter. These junks can increase the development of obesity. For those that have increased risk of developing type-two diabetes such foods can eventually contribute to it. Apart from that, we should allow our children to play around. They should not just be sitting at a place watching television from morning till night or not just doing anything. You should let them expend their energy or you can draw exercise programmes for them or take them to recreation centers where they can run around, play and do different forms of exercises so that tendencies of becoming overweight or obese can be reduced. Once they have normal weight, tendencies of having type-two diabetes will be markedly reduced.
Why is so much attention given to diabetes?
Diabetes is a chronic disease and its prevalence is currently on the increase. Currently, about 425 million people are living with diabetes globally. The increase has been ongoing over the years. But in the medical circle, efforts are on to sensitise the people on it and reduce its prevalence. One of the global initiatives on diabetes is the choice of November 14 as World Diabetes Day. The day was set apart to create awareness and fight the prevalence of diabetes the world over. The date is significant because it marks the birthday of the researcher that discovered insulin in 1921.
What is your advice to the people and the policy makers on the disease?
I want members of the public to be aware of the disease and the risk factors of diabetes. We have different types of diabetes and the type-two diabetes is commoner. Over 90 per cent of people living with diabetes have type-two diabetes and one of the risk factors for diabetes is obesity. Women as well as children are not exercising enough. They should exercise and engage more in physical activities that will make them burn out the fat in their bodies. Just as it is advised for children, women or even parents generally should watch what they eat. Our health should not be compromised. We should all engage in healthy lifestyles generally. Then, it is good to have early screening, regular checks, abstain from self-medication. Whether you have diabetes or not, seek knowledge. Apart from taking healthy diets and exercise, those living with the disease can also control it by abstinence from smoking and drinking. When you take treatment regularly and your glucose level is controlled, the frequency of urination is reduced. If medication is abused, it can cause brain damage. We have diabetes patients that win gold medal at Olympic. Follow up is essential for diabetes. Diabetes is not death sentence but requires comprehensive medical review.
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