A growing threat
Texas Children's physicians battle
on the frontline against diabetes

	Dr. Morey Haymond and his team help children fight diabetes.

Texas Children's Diabetes Care Center is at the forefront of researching ways to prevent and control this disease and its complications.

Type 1 diabetes, which accounts for about 70 percent of new diabetes cases in children, occurs when the body does not produce insulin, a hormone that converts sugar (glucose), starches and other food into energy.

In Type 2 diabetes, the most common form in adults, the body does not produce enough insulin because the cells are resistant to the actions of the insulin that is produced. About 30 percent of new cases in children are Type 2.

"Overweight or obese children have a higher risk of being diagnosed with Type 2 diabetes, as well as kids with a strong family history of the disease,” said Dr. Morey Haymond, chief of Pediatric Endocrinology and Metabolism at Texas Children’s and professor and chief of Pediatric Endocrinology and Metabolism at Baylor College of Medicine. “If both parents have Type 2 diabetes, a child likely will be diagnosed with it at some point in his or her life."

Combating childhood obesity is the primary way health care providers seek to prevent Type 2 diabetes. However, only a small number of overweight children are able to follow physicians' instructions and actually lose weight.

"Many kids drop out of weight loss programs, which leaves us no effective way to manage their obesity," Haymond said. "If a family is struggling financially and parents are working multiple jobs just to keep food on the table, the child often is left home alone. They frequently don't have access to good recreational facilities and substitute television, video games, computers and food, which results in excessive weight gain."

Treatment for diabetes includes controlling diet, medications and insulin as well as establishing a lifestyle change that includes an exercise routine. Texas Children's is taking part in a number of studies involving alternative ways to prevent and treat diabetes.

"We are participating in the TODAY Trial, headed by Dr. Siripoom McKay, which is examining several ways to treat children with type 2 diabetes," Haymond said. "This five-year study involves 15 centers across the country and has three groups of subjects to determine if medication(s) plus lifestyle change affect long-term metabolic control."

Another study, headed by Dr. Barbara Anderson, examines how to combat diabetes "burnout," which occurs because of pressures on patients and families to avoid severe low blood sugars (which can cause seizure and coma) and high blood sugars (which cause the long term complications). Dr. Rubina Heptulla also is studying new approaches to insulin therapy involving the creative use of a number of new medications to counteract the rise of blood sugars after a meal.

"We hope to prevent, postpone or minimize the complications of diabetes in our children who have been diagnosed with this chronic and potentially debilitating disease," Haymond said. "We just want to keep these kids healthy."