Children's Health Archives - Active Healthcare

Resilience – The Key to Combatting Adverse Childhood Events (ACEs)

Lisa Feierstein Asthma, Breathe EZ, Children's Health, Diabetes Leave a comment   , , , , , , ,

The CDC’s Adverse Childhood Events Study (ACE study) revealed a remarkable connection between traumatic events in childhood and chronic diseases and social and emotional problems in adulthood. High ACE scores may mean significantly higher rates of heart disease, lung cancer, diabetes, depression and risk of suicide.

As you would expect, the higher your ACE score, the higher your risk of health issues in adulthood. Studies show with an ACE score of 4 or more your risk of a host of chronic health conditions increases by over 200%. Specifically the risk of depression increases by 400%; the risk of suicide by 1000%. Nearly two-thirds of adults have at least one ACE.

Staggering Statistics

  • An ACE score of 4 increases your odds of getting asthma by 73%
  • A traumatic event during childhood (just one ACE) can triple the risk of developing Type 1 diabetes.

Does a high ACE score sentence you to a life filled with chronic disease? 

Pediatrician Nadine Burke Harris believes the answer to that question is a resounding NO. She has personally seen the positive impact of interventional programs where healthcare providers and community resources work together to support those at risk.


Dr. Harris’ approach suggests the following:

  • Screen all patients routinely to determine ACE scores.
  • Provide additional support to families with children with high ACE scores including home visits from professionals, mental health care, nutrition counseling, holistic interventions, and if needed, medications.
  • Educate parents on the negative impacts of chronic stress
  • Increase treatment for patients with asthma or diabetics with higher ACEs scores.

Resilience and Children with Chronic Diseases

Can we train our brains to be more resilient in the face of personal struggles and health problems?  Here are a few tips on how to help your child be more resilient.

Focus on the positive – Encourage your child to connect with friends and other adults.  Support activities and hobbies where your child can build relationships with those with similar interests and build confidence.

Banish Blame –Children may feel guilty that they have a chronic illness. Empower them to live their best life and work through their chronic disease’s challenges.

ACE hugFight Stress – Have your whole family learn a new technique to relieve stress such as yoga, mindfulness, or mediation. Parents need to practice what they preach!

Validate Emotions – Children may have difficulty verbalizing what they are feeling. Listen first and always acknowledge their feelings.

Remain Optimistic – Life is a journey and your child and family may experience setbacks. Help your child set and strive for realistic goals.

Hug Often – Don’t underestimate the value of a hug as a tangible reminder of your love and support. Research shows that giving and receiving hugs reduces stress, and has a host of health related benefits.

We’re All in This Together

ACEs affect all of us directly or indirectly regardless of income level, and impact lifelong health and social well-being. Together, we can lessen these effects by teaching and learning resilience skills, and adopting trauma-informed practices and policies.

Check out some of the resources below for more information about ACE and how to build resilience to combat the effects of chronic stress.

Additional Resources

CDC ACE Study Website
How Childhood Trauma Affects Health Across a Lifetime – Ted Talk by Nadine Burke Harris, MD.
ACE Connections Blog
ACEs Quiz link
Six Skills to Help Build Resilience (narrated)
Building Resilience in Children
Wake County NC Resilience Initiative
Benefits of the 20 Second Hug


Halloween Ideas for Kids with Diabetes

Lisa Feierstein Children's Health, Diabetes Leave a comment   , , , ,

Halloween is a beloved holiday for most kids, especially those with a sweet tooth. However, if you have a diabetic child you may be worried about blood sugar spikes that Halloween candy can bring.

Despite your child’s diagnosis, there are ways for them to enjoy Halloween with their friends and family. All it takes is some preparation and some creativity.

Here are a few ideas for a fun, diabetes-friendly Halloween for you and your family.

enjoy halloween diabetes

Instead of Trick or Treating, try these ideas:

Start a new Halloween tradition: Try a family dinner or movie night for Halloween fun without candy. Even a family board game night can be a great Halloween tradition, especially if the whole family gets dressed up in costumes.

Have a Halloween party: By organizing your own Halloween party, you have control over the treats and activities. This will allow you you to substitute diabetes-friendly alternatives to candy and other sugary snacks. If you offer plenty of spooky games and crafts, even your child’s friends may forget the lack of candy on the buffet table.

Tips for Diabetes-friendly Trick or Treating

Every family and every child with diabetes is different. If you and your child want to make trick or treating part of your Halloween this year, here are some tips that may help avoid blood sugar spikes.

Give neighbors alternative treats for your child: Before Halloween, you can give your neighbors non-candy treats or small toys for them to give to your child. Then, your child can have the fun of collecting treasures around the neighborhood without the worries that over-indulging in candy could bring.

Have a protein-rich dinner beforehand: Protein can help mitigate the effects of excess sugar. So before heading out for trick or treating, serve a protein-rich dinner to get your child’s blood sugar in the ideal range.

Find another home for the candy haul: Even those of us without diabetes know that eating a lot of candy at once isn’t a good idea. Once your child has collected a bag full of candy, there are many opportunities to re-purpose that extra candy for a better cause.

Save for Low Sugar Days – Pack up excess candy and use to combat low blood sugar. This allows your child to enjoy some candy when they really need it.

Halloween Fairy/Sugar Goblin – Many families have invented an imaginary creature that will exchange candy for a toy at night when your child is asleep. This can be a great way to avoid tantrums from lost candy with the excitement of a new toy.

Donation – Help your community by donating your extra candy to a homeless shelter, assisted living center, or other organization in need.

Start Planning Early for a Memorable and Diabetes-Safe Halloween

Every kid deserves a fun and safe Halloween. With these tips, you can make your child’s Halloween one to remember.

Additional Resources

13 Halloween Ideas for T1D Families – T1 Everyday Magic
Added Sugar Amounts Now on Nutrition Facts Panel


Using a Low Carb Diet to Help Treat Type 1 Diabetes

Lisa Feierstein Children's Health, Diabetes Leave a comment   , , , ,

For children with type 1 diabetes, snack time isn’t always simple. Diet is an important part of a diabetes management plan to help avoid blood sugar spikes. But new research by endocrinologists at Boston Children’s Hospital suggests that food can be used as a powerful tool to help keep blood sugar under control.

low carb veggies

About the Study

Endocrinologists Dr. David Ludwig and Dr. Belinda Lennerz from Boston Children’s Hospital conducted an observational study on diabetic children who follow a very low carb diet. The children’s very low carb diets included on average only 36 grams of carbs a day.

The parents of these children were members of a Facebook group for families with diabetic children. The observational data was confirmed by the child’s doctors and analyzed using the latest techniques.

Here are just 3 possible benefits of a very low carb diet for children with diabetes.

Greater Glycemic Control

Children in the study had what the researchers called “exceptional” glycemic control. The common target range for hemoglobin A1c values are below 7%. However, children in the study had average hemoglobin A1c values at 5.67%, within the normal range for children overall.

Researchers are very excited at the prospect of diabetic children achieving normal hemoglobin A1c values with the help of diet. More research is needed to confirm the connection, but the possibility is an amazing development in the treatment of type 1 diabetes.

Less Complications

The study found that children on the very low carb diet had lower hospitalization rates than usual. Only 1% of the children were hospitalized for hypoglycemia and only 2% were hospitalized for diabetic ketoacidosis.

Boost Mental Health

High or low blood sugar is known to negatively impact mood, mental resilience, and overall brain health. For children with diabetes prone to high or low blood sugar spikes, mental health is especially important. For more information and other ways to improve mental health in your diabetic child, see our blog on mental health for teens with type 1 diabetes.

Diet can be a powerful tool in the management of type 1 diabetes.

Ask your doctor about whether a low carb or other specialized diet could be a good addition to your child’s diabetes management plan.

Resources

Very Low Carb Diet can safely curb blood sugar in type 1 diabetes, study suggests – Boston Children’s Hospital
Management of Type 1 Diabetes With a Very Low–Carbohydrate Diet (Original Research) – Pediatrics
New Recommendations from the ADA: Management of Type 1 Diabetes In Children and Adolescents
Added Sugar Amounts Now On Nutrition Facts Panel


Wearable Asthma Informatics – Future of Asthma Care in Children

Lisa Feierstein Asthma, Breathe EZ, Children's Health Leave a comment   , , , , , ,

wearable asthma informaticsAn incredible amount of research has gone into childhood asthma in the last few years, leading to deeper understanding of the condition and better care for children with asthma.
New technology hopes to help predict a child’s asthma attacks before they occur. A wearable asthma informatics system is under development as part of an initiative of the US National Institutes of Health.

What is PRISMS?

This new asthma monitoring system is part of the PRISMS Initiative, which stands for Pediatric Research Using Integrated Sensor Monitoring Systems. A team of researchers from University of California-Los Angeles and the University of Southern California are developing an integrated platform of wearable sensors that can gather data about the environment of children with asthma and help predict asthma attacks.

How does the Asthma Informatics Platform Work?

The platform connects a variety of sensors and equipment using bluetooth and wi-fi, compiling all the data for health professionals. The platform includes the following:

Smart Watch: acts as a hub connecting to all other devices during the day and collects bioinformatics like activity level and heart rate.
Air Quality Sensor: attached to backpack or placed nearby and measures very small particulates in the air that can make asthma worse.
Medication Sensor: receptor in inhaler that records when medicine is taken.
Spirometer: measures the volume of breath twice a day, data is automatically sent to the system.
Smartphone app: includes questionnaires to gather data from the child about their environment.

How will PRISMS help asthma care?

With the data that PRISMS collects, medical professionals can identify patterns and help families identify asthma triggers. In the future, a platform like PRISMS could send alerts when sensors detect that an asthma attack is likely.

Overall, using the data from all children in the study, researchers hope to find new trends in childhood asthma. Patterns realized from the data of the children in the study may lead to new treatments and new environmental policies to keep all children healthy.

New Technology will bring better care for children with Asthma

In the future, portable medical health devices may be commonplace, and the data collected from systems like PRISMS will help make asthma care better than ever.

Resources

Predicting Asthma Attacks in Kids – Chemical & Engineering News
PRISMS Initiative – National Institutes of Health
Got Asthma or Allergies? There’s an App for That!


Tips For Managing Type 1 Diabetes at School

Lisa Feierstein Children's Health, Diabetes Leave a comment   , , ,

Back to School 3

 

The first day of school will be here before you know it. If your child has type 1 diabetes, there should be a few extra items on your back to school checklist to make sure that your child and their school are ready for the year ahead.

Here are a few important tips for an easy adjustment back to school:

1. Make a Diabetes Management Plan

Your child’s Diabetes Management Plan is an essential tool. Work with your doctor to draft a plan containing all important information concerning your child’s diabetes care. Include all medication details, symptoms of low blood sugar, target blood sugar range, and other important details those caring for your child should know.

2. Connect with the school nurse and other staff

Provide a copy of your child’s Diabetes Management Plan to the school nurse, administration, and all of your child’s teachers, coaches, and other supervising adults. If your child’s school does not have a full time nurse, figure out which staff members are best equipped to help if the nurse is not present.

All your child’s teachers should be aware of symptoms of low blood sugar, what your child needs to do to manage their blood sugar, and what help your child will need with those steps, if any.

In addition, your child should wear a medical notification bracelet or necklace that indicates their diabetes diagnosis. This guarantees that even substitutes or other rotating staff will be aware of your child’s condition in case of an emergency.

If needed, consider creating a 504 plan. A 504 plan is an official document that details the exact responsibilities of the school and ensures that your child has the same opportunities as all other students.

3. Pack their backpack with the essentials

Make sure your child has the tools they need for diabetes management during the school day. Build a compact kit full of testing supplies, antiseptic wipes, and backup insulin, as well as glucose tablets or other fast-acting snacks for raising blood sugar.

4. Get your child involved (as age appropriate)

As your child gets older, they should take on more responsibility for their diabetes care. Depending on the age of your child, help them identify their symptoms of low blood sugar. When your child has a greater understanding and more responsibility in their own care, they will have more confidence in the face of adversity at school and beyond.

Give your child the foundation they need to succeed in the New Year

With careful preparation, you can ensure that your child gets the most out of their school days, minimizing the stress from managing their diabetes.

Additional Resources

Tips for Managing Diabetes at School from the CDC
Monitoring Diabetes at School
Diabetic Tips: Making Sure It’s in the Bag


Back to School Tips for Kids with Asthma

Lisa Feierstein Asthma, Breathe EZ, Children's Health Leave a comment   , , ,

back to school 2It’s that time of year again. A fun summer has come and gone and it’s time to start thinking about back to school. While stocking up on school supplies, don’t forget to prepare your child’s asthma plan for the new school year.

The American Lung Association has published a “Back to School with Asthma Checklist” for a smooth adjustment back to school for children with asthma. With careful preparation, your child can focus on enjoying their school days without worrying about their asthma.

Here are some tips for making this school year a good one:

1. Schedule a checkup before school starts

Summer is the perfect time to fit in a doctor’s appointment, since your child’s schedule may be less busy. Be sure to bring any forms required by your child’s school so that you can be prepared for meeting with the school nurse (See Tip #2 below).

Discuss how your child’s asthma treatment plan has been working in the past year. In particular, make sure your child knows how to use their inhaler and spacer properly.

Review your child’s asthma triggers, and make a plan to help your child avoid exposure at school. A summer checkup is a great time to discuss any troubles with allergies, which are common in children with asthma.

2. Get the school nurse on board

If your child is starting a new school, or has a recent asthma diagnosis, make sure that the school nurse is part of your child’s asthma team. First, make sure all necessary forms documenting your children’s medication are submitted timely so they can be processed before school starts.

With the help of your child’s doctor, write an Asthma Action Plan and share it with the school nurse. If your child’s school does not have a full time nurse, include the receptionist or other staff members in the Asthma Action Plan as well.

3. Don’t forget after school activities

If your child participates in an after-school activity, make sure your child’s coach or activity leader has access to your child’s Asthma Action Plan. It’s very important that those supervising your child know what an asthma emergency looks like and how best to help your child.

Make back to school easy with these tips

After a fun summer, transitioning back to school can be hard for many kids. If your child has asthma, keeping these tips in mind can make it easier.

Additional Resources

Back to School with Asthma Checklist – American Lung Association
Does Back to School Mean Back to Allergies?


It’s Not Just Water Vapor: Risk of Secondhand Vapor Exposure

Lisa Feierstein Asthma, Breathe EZ, Children's Health Leave a comment   , , , ,

It is hard to imagine that many people still believe that the vapor produced by e-cigarettes is harmless. They believe that the sweet smelling cloud produced by someone vaping nearby is just water vapor. The secondhand vapor from e-cigarettes actually contains many of the same chemicals that are found in traditional ones. These contaminants include propylene glycol, vegetable glycerin, nicotine and many different flavoring agents.

E-Cigarettes: Continued Health Threat for YouthNo one should be inhaling any of these toxic substances because they will all cause inflammation in your lungs. Asthma sufferers and those with allergies are especially at risk of exposure to lung irritants. Studies by the National Academies of Science indicate that e-cigarette use increases asthma symptoms such as coughing and wheezing.

The good news is that e-cigarettes are different from traditional cigarettes in one way, they only emit vapor when they are being used. 

New Research Based on the Florida Youth Tobacco Survey

The Florida Youth Tobacco Survey data (link to data) was the basis for some recent research to determine the connection between electronic nicotine delivery systems (ENDS) and asthma symptoms. The survey data indicates that e-cigarette use was up almost 600% from 2012 to 2018 in youth ages 11-17. The rate of youth trying e-cigarettes is also up over 350% in the same date range.

Survey Data Demographics:

  • Study based on surveys from almost 50,000 youth and teens.
  • 33,500 respondents were in High School and another 36,000 were in Middle School.
  • Respondents were evenly split by gender.
  • One-third identified as Hispanic, one-third are white, and one-fifth as African American.
  • About 75% of survey participants lived in large or mid-sized metro areas.
  • The research focused on the 11,000 respondents diagnosed with asthma.

 

Study Definition of Exposure to secondhand vaping aerosol:  Exposure to someone vaping either in the same room or in a car within the last month.

Secondhand vaping exposure increased the likelihood of an asthma attack by 27%, regardless of whether the children themselves smoked or vaped.


Tips for Parents

Juul e-cigaretteThe statistics on the rates of vaping are staggering. In 2018 the CDC reported that 20% of high school students vaped in the past 30 days. Smoking rates in the same age group are actually lower at only 8 percent. The rate of teen smoking continues to fall; it is 50% lower than it was in 2011.

The national rate of smoking in adults is 14% (2017), down from 20% in 2005. In contrast only 2.8% of adults use e-cigarettes.

Nicotine is toxic to children, even at minimal exposure levels. Their developing bodies are even more susceptible to environmental pollutants like nicotine and the other dangerous components of e-cigarette vapor.

  • Encourage your children to avoid secondhand vaping aerosols just like secondhand smoke from traditional cigarettes.
  • Educate family members and friends who vape to do so away from children and especially not in enclosed spaces.
  • Communicate with your children about the dangers of smoking and vaping so they know the risks.

 

If your child has asthma, consider adding limiting exposure to vaping in your child’s asthma action plan – due to the possibility of it triggering an asthma attack.

Additional Resources


Mental Health for Teens with Type 1 Diabetes

Lisa Feierstein Children's Health, Diabetes Leave a comment   ,

Research shows that diabetics are at higher risk for mood disorders and other mental illness. During the often tumultuous teenage years, it’s important for parents and caregivers of teens with diabetes to understand how diabetes and mental health interact.

Why mental health is crucial for teens with diabetes

teen mental healthAccording to the American Diabetes Association, diabetic teens tend to show 2-3 times the rate of psychological distress than their peers without diabetes.

Living with diabetes is not easy and can add to the other stress that teens experience. Stress has a negative effect on diabetes, leading to a feedback loop if both a teen’s stress and diabetes are not managed correctly.

Here are some tips for supporting the mental health of teens with diabetes.

Encourage independence

Every teenager wants to be more independent, including those with diabetes. New technology can make it easier than ever for teens to take on a larger role in their diabetes care. Cell phone apps can sync to continuous glucose monitors (see our previous blog “The 411 on CGM” for more information), allowing teens to take initiative while their parents are kept in the loop with automatic updates.

Prioritize self-care

The busy lives of teens can leave no room for personal time to recharge. Especially during stressful times like finals, encourage your teen to take short breaks. Spending a few minutes to take a walk, listen to music, or do something else enjoyable can do wonders to lower stress.

Build a foundation of self-esteem and acceptance

Insecurity can cause teens with diabetes to try and hide their condition from peers. From a young age, educate your child about diabetes and how each part of their diabetes management plan is important. This will instill self-confidence and a greater sense of self-understanding in your child.

Be aware of warning signs

Early detection of psychological distress is important, especially for teens with diabetes. If you notice your teen has lost interest in their favorite activities or has unexpectedly lost or gained weight, check in with your teen and consider getting the help of a professional if needed.

Take care of your own mental health as a caregiver

Several studies have shown that caregivers of children with diabetes have a higher likelihood of depression. While caring for your child, don’t neglect your own mental health. Try joining a local support group for parents of children with type 1 diabetes. Talking with other parents in the same situation can do wonders to boost your outlook.

Wellness of body and mind for diabetic teens is possible

The teenage years are the best time to develop good habits for both physical and mental health. For teens with diabetes, these good habits allow a smooth transition into self-sufficient diabetes management in adulthood.

Additional Resources

ADA Position Statement

JDRF (Triangle/Eastern NC ) – Support Resources for Parents of Children with Type 1 Diabetes

CDC: Diabetes & Mental Health

Teen Focus: Dangerous Duo Type 1 Diabetes and Drinking

Can Diabetes Give You The Blues?

The Lowdown on Stress and Diabetes


Summer Camp for Everyone – Even Kids with Asthma!

Lisa Feierstein Asthma, Breathe EZ, Children's Health Leave a comment   , ,

Many families may already be planning for the upcoming summer. Attending camp is one of many rites of passage for children, and those with asthma shouldn’t have to miss out. We’ve previously shared tips for families of children with asthma on choosing and preparing for summer camp. This year we’d like to highlight a couple of summer camp options in North Carolina.

Camp Victory Junction: Heart/Lung/Kidney – July 14 – 18 2019

Children with chronic medical conditions, such as asthma, and others with serious illnesses that would preclude them from attending a traditional summer camp program should look into the options at Camp Victory Junction.

This summer, children ages 6 to 16, with asthma can register for Camp Victory Junction in Randleman, NC. The week of July 14-18 is designated especially for kids with heart, lung, kidney, and immunological diseases. Camp Victory Junction provides a typical camp experience within a medically-safe environment.

Visit the camp website (https://victoryjunction.org/ ) for additional information about the schedule and registration.

Camp Coast: Helping Kids Control Their Asthma

The Vidant Medical center Pediatric Asthma program and Children’s Miracle Network in Greenville NC sponsor Camp Coast. This program includes day camps at a variety of locations like school and wellness centers. Weekend retreats are also offered throughout the year.

The fall weekend retreat is for children ages 7 to 17, along with their parents. This unique program includes all the activities you’d expect to experience at camp, along with educational sessions about asthma and tips to improve control of the disease.

Camp Coast is staffed by volunteer physicians, nurses and respiratory therapists.  These respiratory professionals are on hand to provide medical care and also observe campers’ medication administration to ensure proper usage for optimal treatment.

Transportation from Greenville to the camp location in Columbia, NC is available.

Visit their website for additional information and to contact camp staff about registration information. (https://www.vidanthealth.com/Programs-Support/Childrens/Camps)

Additional resources:

Children’s Asthma Camps – Find A Camp – Nationwide

5 Keys to a Fun and Safe Summer Camp Experience for Kids with Asthma and Allergies


New Recommendations from the ADA: Management of Type 1 Diabetes in Children and Adolescents

Lisa Feierstein Children's Health, Diabetes Leave a comment   , , , , , ,

The American Diabetes Association recently shared an updated position statement on the management of type 1 diabetes in children and Adolescents. This statement is an update to their previous position statement issued in 2005. Their statement highlights the common sense idea that children are not just mini-adults. Treatment plans for children with Type 1 diabetes need to be tailored to both their current situation and their future growth and development.

The following areas were highlighted in the updated statement of recommendations for children and adolescents with Type 1 Diabetes (T1D):

  • Diagnosis of Diabetes
  • Blood Glucose Level Management
  • Lifestyle Considerations
  • Self-Management of Diabetes
  • Complications and Comorbidities
  • The Transition from Childhood to Adolescence and Adulthood

Diabetes Blood Glucose Testing

New Recommendations for Blood Glucose (BG) Management in Children and Adolescents

Most children’s T1D should be treated with insulin regimens with either multiple daily injections or via insulin pump therapy. Healthcare professionals should measure A1C levels of their non-adult patients at 3 month intervals. The target level of A1C should be 7.5 %. Patients or their caregivers should monitor BG levels multiple times a day, typically 6 to 10 times.

Medical devices such as insulin pumps and continuous glucose monitors (CGM) can be very helpful in the management of T1D. The ADA recommends that the CGM be considered in all children and adolescents, even though not using insulin pump therapy. Studies have found that compliant use such devices correlates with better BG control, lower A1C levels and reduction in hypoglycemic events.

Adjunctive Therapies for Children with T1D

One highlight in their recommendations between the management of type 1 diabetes in children versus adults is in regard to adjunctive therapies. They do not recommend the use of adjunctive therapies, such as the medication metformin in children. Clinical trials showed that despite the advantages of such therapies to help with weight loss or other diabetes comorbidities, there are more risks than benefits for children.

Check back next month for our follow-up blog talking about the unique behavioral aspects of managing diabetes in children and adolescents. We’ll focus on the challenges of self-management of their disease and other related health and wellness concerns.

Additional Resources

411 on CGM
Exercise for Children with Diabetes
ADA Position Statement


Teen Focus: Dangerous Duo – Type 1 Diabetes and Drinking

Lisa Feierstein Children's Health, Diabetes 3 Comments , , ,

Drinks in GlassesYou might suspect that drinking alcohol would cause your body to react similarly to consuming other carbohydrates. Alcohol is filled with calories. The surprising difference is that alcohol needs to be processed by the liver. Teen type 1 diabetics who drink can actually experience a drop in their blood glucose (BG) levels as their liver focuses on processing the alcohol and doesn’t work on its other function – releasing glycogen into the blood stream.

Another worry is the length of time it takes the liver to process alcohol. Did you know that your liver can be busy for one to one and a half hours handling just one alcoholic drink? Teens who drink multiple alcoholic beverages risk a low blood sugar event.

The symptoms of inebriation are similar to those of low blood sugar – sweating, lightheadedness, shakiness, weakness, anxiety, hunger, headache, problems concentrating, and confusion – which can make it more difficult for teens to sense that their blood sugar is trending too low. The best answer is to test BG levels.

Top Tips for Teens

If your teen decides to attend a party or share a drink with friends, they can minimize the negative impacts by heeding these ideas:

  • Make Moderation your Mantra – alternate alcoholic drinks with water or other non-sugary beverages to prevent dehydration. Wait between drinks to allow your body to catch up.
  • Food is Your Friend – Eat healthy snacks including fats and protein before, during and after drinking. Consider enjoying a drink along with a meal instead. Eating prior to bedtime will also help prevent hypoglycemic events during sleep.
  • Don’t Guess -Test – Bring along testing supplies – don’t rely on how you feel as an accurate gauge of your BG level, test to confirm. A Continuous Glucose Monitor can be a great tool to monitor BG levels.
  • Alert your Friends – Educate your friends on the symptoms of low and high BG level events. Have a buddy that can help just like a designated driver to watch for worrisome symptoms. They can remind you to test and eat snacks. Consider wearing a diabetic alert bracelet or necklace.

If you vomit it is even more important to test BG levels and consume non-alcoholic drinks to rehydrate.

Tips for Parents

Communicating with teens about drinking is a challenge for all parents. As with most difficult topics, open, and honest communication goes a long way. Talk about your concerns in advance – before any party invitations. Educate yourself and your teen about the effects of drinking in general and the special considerations for those with type 1 diabetes.

Even if there will be consequences if your underage teen drinks, consider creating an agreement so that they know they can contact you for help if they run into trouble. This will keep them safe and keep their diabetes in control. Seek support from your teen’s healthcare providers and/or diabetes educators if needed.

Once your son or daughter knows all the potential and possibly life-threatening side effects to their health from drinking, we can hope they will seek out other activities that aren’t focused solely on drinking.

Additional Resources

JDF – Teen Tool Kit
The 411 on CGM
American Diabetes Association – Teens & Parties


E-Cigarettes: Continued Health Threat for Youth

Lisa Feierstein Breathe EZ, Children's Health Leave a comment   , , ,

Juul e-cigarette

Kids are now facing a new threat that is taking over high schools and middle schools across the United States – a new type of E-cigarette called Juul. Many parents may lack information on how E-cigarettes are spreading throughout their children’s schools and in their own neighborhoods.

Some teens and young adults find the E-cigarette Juul attractive because of its sleek design. The device can be easily charged on a laptop and go unnoticed by parents and teachers. Teens are drawn to Juul for a number of reasons, like its trendy decal skins, and the multiple flavors.

Studies have shown that most teens and young adults do not know that they are smoking nicotine, they think they are smoking water vapor when they are using Juul. Since nicotine is the prime ingredient in these devices, parents and school administrators are concerned.

Not only can nicotine be extremely addictive but it can be very harmful to teens and young adults in many ways such as:

  • Memory loss and attention loss for a developing teenage brain
  • Also increased risk for future addiction to other drug

Schools Educate about the Dangers of Juul E-Cigarettes

Parents and school administrators should worry about the long term effects of students using Juul or any other E-cigarettes.

Schools are trying their best to prevent usage of E-cigarettes on school grounds. Some schools have even installed detectors that scan the air for chemical changes and alert an administrator. Schools are also holding classes to review the dangers of using Juul with their students. They are also holding workshops to educate teachers and support staff on what a Juul is and how it works.

For more information about E-Cigarettes, the Juul device and the effects of using it check out the website www.tobaccofreekids.org

Additional Resources:

The Double Threat of Vaping

More information on E-Cigarette usage among youth from the Surgeon General

Image of Juul e-cigarette: By Mylesclark96 [CC BY-SA 4.0 (https://creativecommons.org/licenses/by-sa/4.0)], from Wikimedia Commons


Added Sugar Amounts Now on Nutrition Facts Panel

Lisa Feierstein Children's Health, Diabetes Leave a comment   , , , , , , , , , ,

Nutrition News: Added Sugar Now on the Nutrition Facts Panel

FDA_Nutrition_Facts_Label

By U.S. Food and Drug Administration [Public domain], via Wikimedia Commons

You may have already seen an updated Nutrition Facts label on products you’ve recently bought. Effective July 2018 the FDA will require that the Nutrition Facts label include a new category – added sugar. This category will be shown in the Total Carbohydrates section – on a separate line.

The FDA says that added sugars, “include sugars that are either added during the processing of foods, or are packaged as such (e.g., a bag of table sugar), and also includes sugars from syrups, honey, and concentrated fruit or vegetable juices.”

This is another step in a series of efforts to help all of us make better food choices and minimize our risk of obesity and chronic conditions such as cardiovascular disease and diabetes. Many medical studies have shown that those chronic diseases of adulthood often begin in childhood. The American Heart Association (AHA) also believes there is strong evidence that atherosclerosis starts in childhood – and a poor diet, especially one with a high sugar intake may be the culprit.

How Much is Too Much?

American Heart Association Recommendations on Sugar Intake for Children

AHA guidelines suggest a limit of 25 grams or less of added sugars per day for children – only 6 teaspoons. These new recommendations also advise limiting the intake of sugar sweetened beverages to one or fewer 8 oz. servings per week.

Furthermore, for kids under age 2 the recommendations are even more stringent – the AHA recommends avoiding all added sugar. For perspective, one 12 ounce sweetened beverage could contain 40 grams of sugar (9 teaspoons.)

How does that compare with the typical intake of added sugar by children? Studies show that most kids are consuming an average of 80 grams of added sugar per day – more than 3 times the recommended amount.

Focus on Natural Sugars: Reducing Sugar Consumption for Children with Diabetes

fruitChildren with diabetes already need to monitor their food intake to manage their condition. By moving focus away from processed foods with lots of added sugar to whole foods like fruits, vegetables and dairy items, children will get better nutrition. Whole foods with naturally occurring sugars also provide vitamins, minerals, fiber and antioxidants instead of empty calories.

Remember to read nutrition labels as you shop and try out new fruits and vegetables. Watch portion sizes and limit sugar sweetened beverages. Why not get your entire family on the healthy eating bandwagon for a healthier future?

Additional Resources

The New and Improved Nutrition Facts Label – Key Changes

AHA Statement on Added Sugar Consumption by Children

Diabetes Rates Rise Among Children and Teens


Fun Kids Asthma Awareness Activities

Lisa Feierstein Asthma, Breathe EZ, Children's Health Leave a comment   , ,

What’s better than sharing a fun website with your kids? Here is one to help them learn more about asthma for Asthma Awareness month. The name of the website is NoAttacks.org which is sponsored by the EPA.

When you visit the website you will be drawn in by all of the bright colors and fun activities. You will see different sections that you and your child can click on to learn more about asthma attack prevention and also tips on how to come up with an asthma action plan.

asthma triggers

Kids’ Stuff

In this section you’ll find downloadable books to read and coloring books.
There are also other fun activities from crossword puzzles to seek and find that will help you and your child learn more about asthma and asthma awareness.

air quality

Media Center

In the media center, watch and sing along with The Breathe Easies. The group sings about how to stop your asthma triggers in your home.

The Breathe Easies songs are available in five different languages, English, Spanish, Lakota, Navajo, and Anishinaabe.

breathe easies


Diabetes Rates Rise Among Children and Teens

Lisa Feierstein Children's Health, Diabetes Leave a comment   , ,

The New England Journal of Medicine recently reported that new cases of both type 1 and type 2 diabetes are on the rise in youth. Estimates indicate that in the United States, 29.1 million people live with diabetes. About 208,000 of those are younger than 20. While Type 2 diabetes has a strong correlation with excess weight, type 1 diabetes is an auto immune condition.

The study’s goal was to reveal trends in newly diagnosed cases of diabetes within various ethnic groups. Research revealed that from 2002 to 2012 the rate of new cases of type 1 diabetes in youth went up approximately 1.8 percent each year. During the same time period, the rate of new cases of type 2 diabetes went up quicker, at 4.8 percent.

Diabetes Rates Rise: Other Findings in the Report:

  • Higher Type 1 Rates in Male Participants. Across all groups, the rate of new cases of type 1 diabetes increased more annually from 2003-2012 in males (2.2 percent) than in females (1.4 percent) ages 0-19.
  • Hispanic Youth Showed Largest Increase of Type 1. Among ages 0-19, the rate of new cases of type 1 diabetes increased most in Hispanic youth, a 4.2 percent annual increase.
  • Type 2 Rates Highest Amongst Native Americans. Among ages 10-19, the rate of new cases of type 2 diabetes rose most sharply in Native Americans (8.9 percent), Asian Americans/Pacific Islanders (8.5 percent) and non-Hispanic blacks (6.3 percent).
  • White Youth Showed Smallest Type 2 Increase. The smallest upturn was seen in whites (0.6 percent).
  • Higher Type 2 Rates in Female Participants. The rate of new cases of type 2 diabetes rose more sharply in females (6.2 percent) than in males (3.7 percent) ages 10-19.

Increased Health Care Burdens and Reduced Quality of Life

Living with diabetes from a young age sets up a longer lifetime of increased health care costs. It also creates potential for diabetes related complications. Efforts are underway by organizations like the Centers for Disease Control (CDC) to find ways to prevent or delay youth from developing Type 2 diabetes, which has become more common in recent years.

Since the cause of Type 1 diabetes is still unknown, more work is needed to find out possible disease triggers that leave the body unable to produce adequate insulin. This study’s insights into the varying rates of diabetes by ethnic group may lead to new research directions.

Additional Resources:

New England Journal of Medicine Incidence Trends of Type 1 and Type 2 Diabetes among Youths, 2002-2012

CDC National Diabetes Prevention Program

Exercise and Blood Sugar Control for Kids with Diabetes


CDC Reports Drop in US Asthma Rates

Lisa Feierstein Asthma, Breathe EZ, Children's Health Leave a comment   , , , , , , , , , ,

The Centers for Disease Control (CDC) recently released data on the state of childhood asthma in their CDC Vital Signs: Asthma in Children – United States report. The news is good – there has been a drop in asthma rates. The number of children that experienced an asthma attack in the past year has declined with the overall rate dropping 8 % since 2001. Asthma is a prevalent chronic lung disease effecting 6 million children in the United States.

While this is good news in terms of quantity of attacks, the data did reveal that despite fewer attacks one in 6 with asthma still end up in the emergency room and one in 20 are hospitalized for their condition each year.

Other Findings in the Report on Asthma Rates:

  • The rate of hospitalizations for children with asthma fell from 10 percent in 2003 to about 5 percent in 2013.
  • Children with asthma are missing less school – on average 2.6 days per child in 2013.
  • More kids with asthma are learning the signs and symptoms of an asthma attack and how using an asthma action plan can improve their control.

Green, Yellow or Red: What is Asthma Control?

Traffic LightWell controlled asthma means that your child is in the GREEN zone of the asthma action plan. Good control implies that your child’s symptoms such as coughing, wheezing or shortness of breath occur only two or fewer days per week.

Other indications of well controlled asthma include restful sleep where symptoms don’t wake your child at night. Asthma should also not affect any of your child’s daily activities. Lastly, your child shouldn’t need to use their quick-relief inhaler very often, no more than two days per week.

Knowing your child’s best rate of air flow, as measured by a peak flow meter, is another tool to monitor their asthma control. Air flow measurements that drop below 80 % of their personal best levels may indicate it is time for medication.

Is your Asthma Action Plan Up to Date?

Every child with asthma needs their own customized asthma action plan. Your healthcare provider or asthma educator can help you create one – or help you update an existing plan.

Key Asthma Action Plan Details

  • What medicines to take and under what circumstances
  • List of asthma triggers
  • What early symptoms to watch out for
  • Instructions on how to manage a serious attack and when to seek emergency care
  • ‘Personal Best’ air flow as measured by a peak flow meter for comparison

Additional Resources

CDC Vital Signs: Asthma in Children – United States

Community Care of North Carolina: How to Create an Asthma Action Plan

FAQ: Are You Asthma Aware?


Exercise and Blood Sugar Control for Kids with Diabetes

Lisa Feierstein Children's Health, Diabetes Leave a comment   , , , , , , , , , , , ,

There are many good reasons for anyone with diabetes to participate in a regular exercise program. But what are the important considerations about exercise and blood sugar control for kids with diabetes?

children-exercising-diabetes

Exercise can stabilize blood sugar levels and help maintain a healthy weight. Excess body fat prevents insulin from working to its full potential to control blood sugar. Another benefit of regular exercise is stress reduction and relaxation. Exercise is fun, especially when you are playing your favorite sport with your friends!

Preventing Low Blood Sugar – Hypoglycemia

Every diabetic knows the importance of planning in the successful management blood sugar. Regular blood sugar testing, or the use of a continuous glucose monitor, along with meal planning are all parts of comprehensive diabetes management plan. One consideration for active children, especially those participating in organized sports is the prevention of hypoglycemia.

Activities done for a long period of time, even at a moderate pace can cause the blood sugar levels to drop precipitously, even hours after the activity has ceased.

Keep coaches in the loop. They can assist with extra testing and have quick sugar snacks available, like fruit juices, hard candy, or honey. Coaches should know the signs of both low and high blood sugar, and keep handy instructions about what to do if either situation occurs.

Symptoms of Low Blood Sugar (hypoglycemia):Sweating, lightheadedness, shakiness, weakness, anxiety, hunger, headache, problems concentrating, and confusion

Symptoms of High Blood Sugar (hyperglycemia):Frequent urination, fatigue, increased thirst, blurred vision, and headache

Hyperglycemia and Dehydration

When your muscles work hard they signal for the body to release extra glycogen from storage in the liver. If this excess glucose is not needed, and the amount of insulin doesn’t match the blood glucose, hyperglycemia (too much blood sugar) can result.

Shorter intense activities – like sprinting or weight lifting may actually cause a rise in blood sugar. The body sees the energy expenditure uptick and releases stored glycogen from the liver. If the activity level is not maintained, the body can’t use the excess sugar and blood sugar levels go up.

Unfortunately the body tries to remove the excess glucose through increase urination – which can contribute to dehydration. As with all athletes, children with diabetes need to stay well hydrated during any physical activity. The excitement of competition can produce extra adrenaline, which can also raise blood sugar.

Planning is the Key

Your healthcare provider may recommend a change to insulin dosing on the days when your child has practice or a game where there will be a higher level of physical activity. Tracking blood sugar levels before, during and after activity can give valuable information to your child’s healthcare provider to adjust dosing schedules.

Get to know how your child’s body reacts to different kinds of activity. To prevent the worry of blood sugar swings consider adding a continuous glucose monitor (CGM) to your child’s diabetes management program. (link to 411 on CGM blog) A CGM will provide 24/7 updates on blood sugar levels and trending information.

A Lifetime of Fitness

Family Taking a WalkEveryone can appreciate the long-term benefits of fitness – improved functioning of your heart, lungs, and other vital body systems. Exercise enhances flexibility and increases muscle strength.

Even if your child does not play on a sports team you can still plan activities as a family to keep everyone moving. Ask your child to suggest activities for your family as they are much more likely to happily participate in activities that they already enjoy.

Additional Resources:

WebMD’s Safe Exercise Tip List for Children with Type 1 Diabetes

How to Exercise Safely with Type 1 Diabetes

The 411 on CGM


5 Keys to a Fun and Safe Summer Camp Experience for Kids with Asthma and Allergies

Lisa Feierstein Allergies, Asthma, Breathe EZ, Children's Health Leave a comment   , , , , , ,

Summer may seem years away when you are wearing a scarf and lots of layers on a cold winter’s day. It will be here before you know it. What is your favorite memory of summer camp? Do you have happy memories of canoeing, campfires or maybe even sleeping under the stars? Summer camp is a time for all children to spend time on their own, make new friends and try out new activities.

As a parent of a child with asthma you already have many ongoing concerns about their daily environment and its impact on their lung health. Your apprehension is normal. As we have discussed in other asthma related posts, advance preparation is always the best strategy when choosing any activity for your child with asthma.

Summer Camp Fun

  • Consider both Traditional and Asthma-focused Camps

    An asthma-focused camp may include educational components and have specially trained staff. Traditional camps can be okay too, especially if they are willing to make accommodations for your child’s asthma.

  • Not All Camps are Created Equal

    Remember that some camps may be more asthma friendly than others. Consider your child’s specific triggers and allergens. Those who are very allergic to animals might be better off at a nature camp vs one centered on horseback riding. Those with high mold sensitivities might be better off at a camp with air conditioned cabins.

  • Review Camp Medication Administration Guidelines

    Check in with camp staff in advance to find out how medication is administered. Research how they manage daily, rescue and emergency medications. Ask your questions before camp begins. Find out which medications your child can keep with them and self-administer. Ask if they can keep rescue inhalers and epi pens with them at all times.

  • Food Concerns – From Campfire Treats to Dining Hall Delicacies

    Don’t forget about food allergies. Check out the meal and snack offerings. If your child can’t enjoy typical camp treats due to allergies see if you can send along some substitutes in advance so your child won’t feel left out.

  • Before, During and After

    Work with your child’s healthcare provider or asthma specialist to create a before, during and after plan for camp.

    Before: Are all of their medications up to date, including dosage changes related to your child’s growth since last summer.

    During: Update or create an asthma action plan to include situations that might arise at camp if your child is exposed to a trigger or allergen – whether known or new.

    After: At the conclusion of camp check in with the staff to ask how things went. This will help you plan for future camps. Don’t just ask about your child’s asthma. Ask your child about their favorite (and not so favorite) parts of their time at camp.


Camp Victory Junction

Children with chronic medical conditions, such as asthma, and others with serious illnesses that would preclude them from attending a traditional summer camp program should look into the options at Camp Victory Junction.

This summer, children ages 6 to 16, with asthma can register for Camp Victory Junction in Randleman, NC. The week of July 15-19 is designated especially for kids with heart, lung, kidney, and immunological diseases. Camp Victory Junction provides a typical camp experience within a medically-safe environment.

Additional Resources

Traveling with Asthma

The Sunshine Vitamin

Children’s Asthma Camps – Find a Camp (Nationwide search)

Participating organizations include: American Lung Association, American Academy of Allergy, Asthma and Immunology, American Academy of Pediatrics, Asthma and Allergy Foundation of America, and the American Thoracic Society.

About Camp Victory Junction

Victory Junction enriches the lives of children with chronic medical conditions or serious illnesses by providing life-changing camp experiences that are exciting, fun and empowering; all in a medically-safe environment at no cost to the camper or their family.

Located in the hills of Randleman, North Carolina, Victory Junction is spread across 84 acres, allowing children to do what they do best— be kids, play, imagine, make friends and enjoy the adventures and experiences of camp life.


Summer Camp for Everyone: Even Kids with Diabetes!

Lisa Feierstein Children's Health, Diabetes Leave a comment   , , , ,

CampfireMany of us have fond memories of summer camp like singing around campfires, roasting marshmallows, creating arts and crafts treasures and swimming in cool refreshing lakes. Perhaps we’ll try to suppress the memories of itchy mosquito bites, rain soaked clothing, and ‘interesting’ food offerings. Good or bad, summer camp is definitely a rite of passage.

Even though the New Year has just begun summer will be here before you know it. It might be time to plan how your children will be spending their summer. If you are a parent of a child with diabetes, you have more to consider than the typical parent as you choose a summer camp program for your child.

Advance Preparation Will Reduce Anxiety and Worry

It is completely normal for parents to feel anxious about dropping their child off at an overnight summer camp. As we have discussed in other posts about diabetes , the key to managing diabetes centers on planning and preparation.

  • Research Options: Take time to investigate camp choices based on your child’s interests. Don’t focus solely on managing their disease.
  • Ask for help: Determine what services or accommodations your child may need during camp.
  • Document Needs: Gather documentation and create a written plan of care with your child’s healthcare provider.
  • Communicate: Connect with camp staff and open lines of communication as soon as possible.
  • Network: Check in with other parents that have sent children to programs in consideration. Ask your healthcare provider for additional ideas.

 

The American Diabetes Association notes that any camp should be prepared to make reasonable modifications so that any child with a chronic disease, like diabetes, can take full advantage of camp programs and activities like any other child.

Camp Victory Junction

Children with chronic medical conditions, such as diabetes, and others with serious illnesses that would preclude them from attending a traditional summer camp program should look into the options at Camp Victory Junction.

This summer, children ages 6 to 16, with diabetes can register for Camp Victory Junction in Randleman, NC. The week of June 17-12 is designated especially for kids with diabetes. Camp Victory Junction provides a typical camp experience within a medically-safe environment.

Additional Resources:

Traveling With Diabetes

Diabetes Tips: Making Sure Its In The Bag

American Diabetes Association: Rights of Children with Diabetes in Camp

Find a Camp – Nationwide Search

About Camp Victory Junction

Victory Junction enriches the lives of children with chronic medical conditions or serious illnesses by providing life-changing camp experiences that are exciting, fun and empowering; all in a medically-safe environment at no cost to the camper or their family.

Located in the hills of Randleman, North Carolina, Victory Junction is spread across 84 acres, allowing children to do what they do best— be kids, play, imagine, make friends and enjoy the adventures and experiences of camp life.


Diabetic Resolutions to Start 2018 off Right

Lisa Feierstein Children's Health, Diabetes, Men's Health, Women's Health Leave a comment   , , , ,

ShutterstockThe New Year is right around the corner. This is a time for reflection and planning. Have you thought about what you would like to change in the coming year? Many people resolve to get more exercise, eat healthy, lose weight, spend more time with family and friends, etc. at the beginning of a new year. Diabetics usually are a little more specific with their resolutions. Here are some ways to start the year in optimal health.

Check in With Your Doctor

  • If you aren’t already, make sure to see your doctor two to four times this year
  • Review and continue to follow your testing schedule, tweaking if necessary
  • Make note of your most recent A1C, blood pressure, and cholesterol numbers
  • Start or review your meal plan with your diabetes educator, tweaking if necessary
  • Don’t forget to get a renal function and microalbumin test

 

Get Moving!

  •  Ramp up physical activity.  Remember something is better than nothing at all.
  • Take your medications exactly as they are prescribed

 

Care for Your Whole Body

  • Get an annual eye exam
  • Go to the dentist twice per year
  • Examine your feet for cuts and/or sores daily
  • Brush and floss daily
  • Get your flu shot

 

Don’t Bottle Up Stress! Deal With It Right Away Using One of These Techniques

  • Deep breathing
  • Learning to say no
  • Asking for help when you need it
  • Making time for you
  • Getting enough sleep (7-8 hours is ideal)
  • Exercising (with other people if that motivates you)
  • Seeing a counselor or social worker if none of the above approaches are effective

 

Although this is a long and possibly daunting list, it is realistic and doable.  With the help of your doctor, you can get 2018 started off on the right foot.  Share your resolutions with someone to hold yourself accountable.


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