Fight against diabetes in children expands

North Carolina will start a new offensive against diabetes in children, announcing today that five other counties will begin replicating a Wake County program that helps reverse early signs of the disease.

The Energize! program, which WakeMed established in 2005, has taught 400 children who were likely to develop Type 2 diabetes how to make more healthful diet and exercise choices. A survey of participants a year after they completed the program indicates up to 70 percent of them had neutralized dangerous health conditions such as high blood sugar, elevated cholesterol and high blood pressure.

State public health leaders will introduce Energize! in five other North Carolina counties: Gaston, Johnston, Nash, Robeson and Wilkes. Each hopes to screen up to 100 children and enroll as many as possible. The expansion, funded by a one-time, $250,000 grant from the General Assembly, will be announced during a news conference this morning as part of the state's observance of the first World Diabetes Day.

Type 2 diabetes was once considered an adult disease that was rarely seen in children. But in recent years, an alarming number of cases have been confirmed in children, causing concern among medical and public health leaders about the future of the nation's youngest generations.

"The consequence of ignoring this problem will be tens of thousands of young adults in North Carolina disabled with blindness, amputations, kidney failure, strokes and heart disease," said Dr. John Buse, a UNC-Chapel Hill endocrinologist and president of medicine and science for the American Diabetes Association. Costs associated with diabetes are estimated at $132 billion, according to the American Diabetes Association.

Exact numbers of children diagnosed with the disease have not been established, but reports from doctors' offices indicate that up to 45 percent of all new pediatric diabetes cases are now Type 2 diabetes, which is associated with being overweight and sedentary. In years past, children primarily were only diagnosed with Type 1 diabetes, which is an autoimmune disorder thought to have genetic roots.

Children in the Southeast, which has higher rates of obesity and inactivity among children, are particularly prone to Type 2 diabetes, according to Trust for America's Health, a national health advocacy group.

Programs such as WakeMed's Energize! are seen as front-line efforts in the battle. During sessions that meet three nights a week, children in the Energize! program are coached to drink water rather than sugar-sweetened drinks and to spend time each day moving instead of plopping in front of the computer or television after school.

The program has shown lasting results that have encouraged health officials.

One year after completing the program, half of participants had either maintained their weight or dropped pounds. About 70 percent of children who started out with elevated blood sugar levels were in the normal range 12 months later. And 70 percent of children with either high blood pressure or cholesterol levels were normal a year out.

Being overweight and having high blood glucose, cholesterol and blood pressure readings all are early indications that Type 2 diabetes may be developing.

"What Energize! shows is that (Type 2 diabetes) can be essentially cured by weight loss and healthy lifestyle," said Dr. Mark Piehl, a WakeMed pediatrician and founder of Energize! "It's something we can detect, prevent and treat with pretty simple common sense things."

Before enrolling in Energize! this summer, 14-year-old Jade McNeill of Raleigh did not exercise at all, was overweight and had high blood pressure and cholesterol levels. After she completed the program, Jade's parents got a family gym membership, and Jade regularly takes aerobics classes or works out. She is not yet at her ideal weight, but her clothes are looser. Her blood cholesterol and pressure are now normal.

There's even evidence that Energize!, in teaching children healthier habits, trickles upstream, motivating entire families to shape up.

WakeMed encourages families to change by asking that parents attend a family night once a week. The program also provides both participants and families with a temporary fitness club membership, at WakeMed, the YMCA or Raleigh Parks & Recreation facilities.

Alethea McNeill, Jade's mother, said her daughter's participation in Energize! inspired a more healthful lifestyle for the whole family. In addition to exercising more, everyone is eating less, now that they know what a healthful portion size looks like. And water is the new beverage of choice.

"We learned so much," said McNeill, a correctional officer at Central Prison who has Type 2 diabetes herself. Another daughter, India, 8, will start Energize! in January.