Diabetes: A Family Matter

Other than finding out they're being sent to bed early, or that they can't watch TV, 11-year-olds rarely get "bad" news.

Other than finding out they’re being sent to bed early, or that they can’t watch TV, 11-year-olds rarely get “bad” news. But for Brittany Hawpetoss, the news was a real downer: a diagnosis of type 2 diabetes, a disease that affects the body’s production of insulin and can lead to heart disease, blindness, kidney failure and lower leg amputations.

“She was real scared,” says her mother, Michele Lyons, 41, of Keshena, Wis. (pop. 1,394), where they live on the Menominee Indian Reservation. “I was scared too. My stepdad had diabetes. He lost his foot and then his leg below the knee.” Brittany was also angry. “It’s not fair,” she repeatedly told her mother.

Sadly, Brittany has plenty of company. The Centers for Disease Control and Prevention estimate that nearly 24 million people in the United States have diabetes. And though type 2 diabetes was once rare in children, by 1999 up to 45 percent of new diabetes cases in kids was type 2, linked to a rise in childhood obesity and the appeal of the couch instead of the sports field.

“There’s been such a change in diet,” says Dr. Jay Kennard, director of the Menominee Tribal Clinic’s diabetes program, where Brittany initially was treated. “Concentrated sweets and processed carbohydrates put pounds on.”

In Brittany’s case, her genes also were stacked against her: American Indians have the nation’s highest prevalence of type 2 diabetes in children ages 15 to 19.

Now, five years after Brittany’s diagnosis, junk food is a thing of the past. But so is her complaint of “It’s not fair.” That’s to Brittany’s credit and her family’s as well: They’ve made Brittany’s diabetes a family matter. When Brittany talks about the crucial changes she’s made to her diet and exercise, she says we, not I.

“We switched from white bread to wheat and from white rice to brown,” says Brittany, now 16. “We cut down on snacks and fast foods. It wasn’t really that hard. My whole family went along with it.”

Her mom, head cook at a local middle school, replaced fried chicken with baked, cut back on their beloved, but high-in-sugar corn and stocked up on fresh vegetables such as baby carrots and broccoli, and serves lots of green salads. “I’m really into vegetables now,” Brittany says.

The family—father John Hawpetoss, 44, a boatbuilder; brothers Derek, 22, and Hunter, 13; and sister Kateri, 18—made exercise a joint undertaking too.

“My brothers take me outside, and we shoot hoops a couple of times a week,” Brittany says. “And I do exercise videos with my mom. It’s fun. She laughs with me.”

After dinner, Brittany’s father walks with her around the block. He also makes sure she takes her medication at each meal and checks her blood sugar twice a day.

It’s not always easy: Brittany’s mother has to push her to use the treadmill for 15 to 30 minutes a day; her mom often does a stint herself.

Dietary and exercise changes are crucial for diabetics. “When you eat whole grains, fruits and vegetables, you feel better, and you feel full on fewer calories,” Kennard says. And exercise creates leaner muscles better able to metabolize sugar, decreasing the cells’ resistance to insulin that distinguishes type 2 diabetes. Type 1 diabetics produce no insulin at all.

“But it’s the family’s participation that’s particularly important,” says Kennard, who has observed some parents buying healthful food for their diabetic children while eating unhealthful foods themselves. “That doesn’t work. It has to be the whole family doing it together.”

So far, the Hawpetoss family approach is working. Last summer, Brittany lost 25 pounds. And since September, when she started walking a mile and a half each day, her blood sugar readings have remained in a normal range. “Diabetes has put me on a healthy path,” she says.

The Warning Signs

The Warning Signs Brittany Hawpetoss’ family members now check their own blood sugar levels twice a month, concerned that they too may get type 2 diabetes. The signs are the same for adults or children: frequent urination, thirst, hunger and fatigue.

“Sometimes even a child’s drowsiness in class can be a sign to get things checked out,” says registered dietitian Scott Krueger, nutrition services director at the Menominee Tribal Clinic in Keshena, Wis.

Another sign is darkening skin at various spots, such as the neck, armpits or knees, a sign that the body is producing more insulin than it’s using. Blood tests may indicate high cholesterol or triglyceride (blood fats) readings. A child may complain that he can’t see the blackboard—diabetes could be affecting his eyes—or his cuts and scrapes may not heal as quickly as they used to.

Excess weight and little exercise raise the risk of diabetes. At the tribal clinic, Krueger and his colleagues work with patients to improve their diet and exercise routines when they spot the first signs of pre-diabetes, a condition in which sugar levels are elevated but not high enough to be full-blown diabetes. “We see a dramatic reduction in risk from even a 7 percent weight loss,” Krueger says.

“The most important thing is to eat as a family so you know what your kid is eating, and to get your kid to exercise,” he adds. And if you do get diabetes, Krueger suggests this mantra: “I have diabetes, but diabetes doesn’t have me.”

Story by Dorothy Foltz-Gray of Knoxville, Tenn.

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