Family History and Diabetes Management
Consistent with the literature, the majority of subjects (11 of 14) had at least one first-or second-degree relative with type 2 diabetes, and quite strikingly, 9 of the 14 subjects’ mothers had been diagnosed with type 2 diabetes. Previous studies have suggested that a positive family history of type 2 diabetes, specifically within Mexican-American populations, is a genetic factor that may be a contributor to the early onset of type 2 diabetes within youth (Glaser, 1997; Treviño et al., 1999). One of the reported risk factors associated with type 2 diabetes among youth includes a positive family history of diabetes in a first- or second-degree relative including being an infant of a mother with gestational diabetes (Beck et al., 2001). Among other risk factors, a positive family history of type 2 diabetes is also used at the Pediatric Endocrine Clinic to differentiate between a diagnosis of type 1 and type 2 diabetes.
Even with evidence of a strong family history of type 2 diabetes, only half of the subjects indicated that they were familiar with the disease before they were diagnosed. In regards to diabetes management, 11 of the 14 subjects reported that they tested their blood sugar at least once per day. Blood sugar control is an important aspect of diabetes management and may help to minimize or reduce diabetes-related complications such as blindness, nephropathy, neuropathy, and cardiovascular complications later in life. Previous studies have suggested that Hispanic populations, as compared to non-Hispanic populations, develop diabetes-related complications within the first five- to 10 years of initial diagnosis (Neufeld, et al. 1998). Individuals who are diagnosed with diabetes during childhood or adolescence may be exposed to hyperglycemia for much longer periods than their adult counterparts thereby increasing their chances of developing diabetes-related complication earlier in life.
Lifestyle, Exercise, and Nutrition Behaviors
Lifestyle behaviors, such as TV/computer viewing and exercise habits revealed that most subjects spent an average of 4.1 (± 2.0) hours per day in front of the television or computer and had not made any efforts to increase their level of physical activity. It has been reported that Mexican-American children spend significantly more time in front of the television set than non-Hispanic white children (Treviño et al., 1999). Perhaps these youth had little interest in organized sports participation or found it challenging to participate in sports activities. Interestingly, eight out of 14 subjects claimed that they enjoyed exercise and 36 percent of subjects would recommend an increase in physical activity to other youth diagnosed with type 2 diabetes. One the other hand, only four subjects reported exercise changes, and three participants increased their activity level through individual exercise activities such as running, walking, and weight lifting.
Dietary changes proved much more common than exercise changes as 11 of the 14 subjects claimed that they had made some significant dietary changes after their diagnosis. Soda and fast-food consumption were listed as foods that most subjects consumed less than three times per week despite an obvious interest in fast-food items such as pizza and hamburgers. The decrease in fast-food and soda consumption may have been related to the changes in dietary behaviors since diagnosis. While vegetable consumption was low among most subjects, vegetables and salad were listed as a favorite food among 5 of the 14 subjects. Participants were more likely to consume fruit and 9 of the 14 subjects reported eating fruit seven days per week. Latino children in general, are reported to eat fewer servings of fruits and vegetables as compared to Caucasian and African-American children (Treviño et al., 1999).