shinyhappypeople Posted October 31, 2014 Share Posted October 31, 2014 So, took DD to the Dr. last week. She is overweight so I had her tested for diabetes. The dr. also tested her thyroid (TSH, not sure if he ordered free T3 and free T4 as well). Test results: A1C (I think this tested her glucose levels over the last 3 months?): 6.0 - prediabetes Fasting glucose: 89 TSH: 5.68 - high Yes, she has a follow-up appt. next week. But I will be obsessing this weekend, so humor me :) First, let's pause here and do a happy dance because she does NOT have diabetes! :party: Ok, that was fun. Now to my questions: Can anyone recommend good resources about prediabetes, and are there any specific food choices or diet information to help her prevent becoming diabetic? I'm thrilled to have the INFORMATION that she is pre-diabetic (information is power, right?), but I'm not sure what to do with the info, kwim? I need reputable books, web sites, etc. Thyroid.... could high TSH be what's making it SO hard for her to lose weight? Since July she's eaten a very healthy diet overall, and has increased her exercise and has lost very little (maybe 5 lb), mostly just maintained her weight. Thoughts? Free advice? Quote Link to comment Share on other sites More sharing options...
umsami Posted October 31, 2014 Share Posted October 31, 2014 How old is she? Maintaining weight if she's still growing is actually good. Absolutely, thyroid could make it more difficult for her to lose weight. You could speak with her pediatrician about metformin, as it's been shown to lower BMI in kids as well as works to make her body more sensitive to Insulin. Honestly, for an adult 89 is a good fasting BS. I'm not sure what the ranges are for kids. Walking/exercise will help your HbA1c. One of the easiest diets is the plate approach where you have 1/2 to 2/3rds of the plate filled with non starchy veg and fruits. http://www.andjrnl.org/article/S0002-8223(98)00267-3/pdf Good luck. :) Quote Link to comment Share on other sites More sharing options...
shinyhappypeople Posted October 31, 2014 Author Share Posted October 31, 2014 She's 11, 5 ft 1/2 in., 165 lb :( Her goal weight is 130, because if she gets down to that weight and maintains a healthy lifestyle, she'll grow into it. Make sense? Googling metformin and the plate method now... thanks for the tip :) Quote Link to comment Share on other sites More sharing options...
gardenmom5 Posted October 31, 2014 Share Posted October 31, 2014 one thing I recently read - which does affect weight. artificial sweeteners can kill probiotics in the gut. ( articles I read addressed specifically splenda.) some probiotics can also affect weight. iow: if you don't have enough of them, you will gain weight. (among other things.) I already knew high fructose corn syrup has mercury. (from the caustic soda used to extract the sugar from the corn. dudeling was drinking some pop when he had a blood draw specifically to measure his mercury levels. his dr was freaking out over the results. the mercury and HFCS link for me, came after all of this.) as well as messing with how the body metabolizes sugars. so, cut out the artificial sweeteners, and reduce the natural sweeteners (even honey and agave are still sugars.). Quote Link to comment Share on other sites More sharing options...
Truscifi Posted October 31, 2014 Share Posted October 31, 2014 I would not focus on losing weight. At her age she may still just grow into it, and even if she doesn't focusing on weight right now may not send the best message, kwim? I would focus on continuing to make healthy diet changes - a healthy diet is not necessarily a diabetic-friendly diet - and getting at least an hour of exercise a day. And of course continuing to address medical issues. The thyroid can definitely make it hard to lose weight and cause lots of other issues too. Frame it in terms of feeling her best and being healthy so she can enjoy her life more. Quote Link to comment Share on other sites More sharing options...
umsami Posted October 31, 2014 Share Posted October 31, 2014 http://www.jwatch.org/na33165/2014/01/29/metformin-treat-childhood-obesity Quote Link to comment Share on other sites More sharing options...
gingersmom Posted October 31, 2014 Share Posted October 31, 2014 I wanted my son to lose a few pounds due to potential high cholesterol (he's 15). I don't use the diet word, as a family we tweaked what we eat. He gets a ton of exercise so that was not an issue. He is down 10 pounds so far in about 6-8 weeks. He weighs himself at most once every 4-5 weeks. Quote Link to comment Share on other sites More sharing options...
gardenmom5 Posted October 31, 2014 Share Posted October 31, 2014 I would not focus on losing weight. At her age she may still just grow into it, at 165 lbs, a girl is not "just going to grow into it". even 2dd, who is 5'11" (and muscular), weighs less than that. but I agree, focusing on a healthy diet, cutting out junk, getting exercise (do muscle building workouts. muscle burns more calories), and it should naturally come off/adjust to a healthier weight. Quote Link to comment Share on other sites More sharing options...
lewber Posted October 31, 2014 Share Posted October 31, 2014 I'm not sure what the levels are for children, but that TSH level in adults would definitely be treated. The upper range is now 3. Most people seem to do best below 2. It would definitely lead to weight gain, and make it hard to lose. I'd go to a pediatric endocrinologist is there is such a thing. Quote Link to comment Share on other sites More sharing options...
Twigs Posted October 31, 2014 Share Posted October 31, 2014 … A1C (I think this tested her glucose levels over the last 3 months?): 6.0 - prediabetes Fasting glucose: 89 … First, let's pause here and do a happy dance because she does NOT have diabetes! :party: Ok, that was fun. Now to my questions: Can anyone recommend good resources about prediabetes, and are there any specific food choices or diet information to help her prevent becoming diabetic? I'm thrilled to have the INFORMATION that she is pre-diabetic (information is power, right?), but I'm not sure what to do with the info, kwim? I need reputable books, web sites, etc. Thyroid.... could high TSH be what's making it SO hard for her to lose weight? Since July she's eaten a very healthy diet overall, and has increased her exercise and has lost very little (maybe 5 lb), mostly just maintained her weight. Thoughts? Free advice? I am not a health care professional, but I am diabetic. Please keep doing your own research. (This turned out to be a long reply, probably the longest I have ever written!) I think I need to be a downer here (because diabetes is so, so serious). Your daughter may not have diabetes now, but she probably does have the genes for it (some people, including me, say if you have the genes for Type 2, you are diabetic). Does Type 2 run in your or your in-laws families? This is my experience: I was dx Type 2 earlier this year at 50+ years old. I have had infrequent medical care my whole life. When I was growing up, I only went to the MD for vaccinations or when I was sick. I probably had well-checks when I was a bably, but none after age 2 or 3. When I was 18, my glucose was about 180 (high), but the doctor did no follow-up testing. I am convinced I was diabetic then, but the thinking at that time was that young people did not get Type 2. Fast forward to 2009. I developed a retinal hemorrhage that required a vitrectomy and laser treatments on my retina. (I have mild diminished vision in that eye due to the laser treatment; never forget, high blood glucose is one of the leading causes of blindness) The eye MD said it looked like diabetic retinopathy. I then went to a PCP. I had been dieting at the time, so my A1C was about 6.0-6.5. The PCP did not dx me Type 2 or do anymore testing or diabetic follow-up. So this spring, I ended up at urgent care with a UTI and that MD dx me diabetic. I went to my PCP and my A1C was 9.2. Now I have the Type 2 dx. In the 3-4 months following diagnosis, I brought my A1C down to 5.9, lost 20 pounds with diet (low carb) and exercise (just walking) only, no medications. I am telling you my story because I was probably just like your daughter when I was her age, except "young people and children did not get Type 2" hence they don't need to be treated for it. If I was considered to be Type 2 as a child, given the proper diet and exercise lifestyle, I might never have developed the complications of diabetes. On a daily basis, having diabetes is minor - however, the complications cause blindness, amputations, kidney disease, … and death. I am telling you this, not to cause you more fear and worry, which won't help you or your daughter, but to encourage you to continue your own education and lifestyle changes that can make a difference. From what I have learned, the complications take some years to develop. Controlling blood sugar can significantly delay (perhaps prevent) the complications. Do your own research and figure out the best approach for your unique situation. My 1st suggestion is to sign up at http://community.diabetes.org/ , ask questions there and read others' questions and responses. I have learned lots there. You can receive free info from American Diabetes Organization Association - https://donations.diabetes.org/site/SPageServer/?pagename=LWT2D_English&loc=db-slabnav - be sure to choose print (mailed to your address) or online. The ADA does recommend the high carb diet, so beware. Here are a couple of blogs written by diabetics, with experience managing their own diabetes http://lizzysdlounge.com/category/newly-diagnosed/ http://loraldiabetes.blogspot.com.au/2006/10/d-day.html Here are some sources with “official medical†information. Sometimes official advice is given by people who do not have to live with the complications an/or have a conflict of interest (with drug companies), (These comments, of course, are my own personal opinion) so you still need to keep on researching. http://www.hopkinsmedicine.org/gim/core_resources/Patient%20Handouts/ http://my.clevelandclinic.org/health/diseases_conditions/hic_Diabetes_Basics/endo_education http://www.cdc.gov/diabetes/basics/index.html Again, lifestyle changes will make a big difference. Making the lifestyle changes is easy compared to the complications. This is a quote I keep telling myself: "I am the captain of my ship, and only I can sail it." I have learned enough so that I can be captain; I will seek advice from doctors, diabetic educators, nurses, etc. but I will not turn over control to them (as in eating high carb, taking medications that I don't need, etc.) until necessary. At this stage, you will have to be the captain for your daughter, but teach her so that she can be her own captain at the proper age. Get her A1C checked regularly, (every 3-6 months), so you can watch for trends. Best wishes. Quote Link to comment Share on other sites More sharing options...
Twigs Posted October 31, 2014 Share Posted October 31, 2014 OK, I have more to say! See if you can get a 5 hour glucose tolerance test for your daughter (or 3 hour). She will drink a sweet beverage and have her blood drawn every 30 - 60 minutes for 3-5 hours. The test will show how long it takes for her glucose to return to the normal level. The GTT was the definitive test for diabetes for years and actually shows how the body responds to carbs. Since the diagnosis is prediabetes, I would follow-up with the GTT. If this were my situation and the doctor would not order the GTT, I would do it myself from a place like MyMedLab. The cost is showing up for me at $81. Again, this is cheaper than complications. Please know (you can tell from the length of my response) how much compassion I have for you and your daughter, and how serious the complications are. I don't want your daughter to end up at 50 years old, saying "I wish I had eaten/exercised better since I was younger". Best wishes. Quote Link to comment Share on other sites More sharing options...
Momof3littles Posted October 31, 2014 Share Posted October 31, 2014 I have PCOS, am of normal weight/normal BMI, and eat lower carb due to insulin resistance. Because of PCOS/IR, I'm more likely to become diabetic than most people. We have a lot of metabolic syndrome issues in my family (hypertension, high cholesterol, high triglycerides). I'm thankful that my diagnosis has been a HUGE clue to things for my family. My parents have improved their health by tackling the insulin resistance angle in their own lives. Like many women with PCOS, I take metformin, because out of whack insulin levels screw with other hormones. Without met, I don't ovulate. With met, I have pretty normal cycles. So I'm not diabetic, but I do take metformin. When I started it years ago, it was miserable for several weeks. I was incredibly nauseous, but I'm glad I stuck with it. I went off of it in one pregnancy (that was the advice at the time for women with PCOS), and when I resumed I did extended release, which I tolerated much better in those first weeks back on it. I also eat lower carb, grassfed meats, try to be mindful of my omega ratios because diabetes is a strong risk factor for heart disease. We eat a LOT of greens (salad, spinach, kale, collards, chard, you name it). You can't go wrong there really ;) Dinner is often a protein and two veggies, sometimes with a salad as well. Or a large salad with protein. Lots of people state that it is fine for diabetics to have beans, sweet potatoes, whole grains in smaller servings, etc. but for me that isn't the case. I don't test my blood sugar, but after years of dealing with IR, I know that I react with a big old insulin spike when I eat quinoa, brown rice, wheat, sweet potatoes, fruit, etc. If i eat an apple, i eat half a smaller, tart apple like a granny smith, and I pair it with a no sugar nut butter or some cheese, for example. I stick with lower sugar fruits like berries. I use coconut and avocado oils in lieu of oils with less favorable omega content. I eat a lot of vegetables. Pastured eggs when possible. eta: definitely exercise, and I'd aim for a mix of some cardio type activity (walking, swimming, etc.) with some resistance training to improve insulin sensitivity in cells. Tackle it from that angle vs. her weight IMO, because there are many of us who aren't overweight but still have bodies that have issues with insulin resistance! Quote Link to comment Share on other sites More sharing options...
Ottakee Posted October 31, 2014 Share Posted October 31, 2014 I would ask for a referral to a pediatric endocrinologist. I am almost sure they will treat the thyroid as normal TSH is 0.3-3.0 so her level is quite high. A peds endo would also be able to address the pre diabetes and they often have nutritional counseling, etc. available. The thyroid might help her lose weight. In the meantime I would focus on the WHOLE FAMILY (not to single her out) eating healthier and getting daily exercise. Quote Link to comment Share on other sites More sharing options...
umsami Posted October 31, 2014 Share Posted October 31, 2014 at 165 lbs, a girl is not "just going to grow into it". even 2dd, who is 5'11" (and muscular), weighs less than that. but I agree, focusing on a healthy diet, cutting out junk, getting exercise (do muscle building workouts. muscle burns more calories), and it should naturally come off/adjust to a healthier weight. 5'11" and 165 would be a perfectly healthy weight for a person, male or female. You can subtract a few inches and it is still a healthy weight. While I like the thought of all you wrote, I'm going to be point blank and say those changes do not work for everyone. In fact, lifestyle changes and pretty much all pediatric obesity interventions have failed miserably. That's why the metformin article I linked said that a modest reduction in BMI is far greater than seen with lifestyle modification. Just as there has yet to be one diet that shows significant weight loss long-term in medical journals. Usually they consider success something that is 6 months or 12 months long, and a modest loss of 5-10%. For kids who are obese or morbidly obese, 10% does nothing. Why don't you see anything more long term? Because they (like most dieters) gain it back. Weight Watchers, whose approach to pediatric obesity is extremely sane (they had two books on it..and it was all the typical stuff of adding in more fruits/veggies, less screen time, being active), etc. abandoned even focusing on children because they found that kids ended up fatter later on. If it had potential to work, you know they'd capitalize on it for $$$. "The company’s decision to limit access to children was made after it conducted a thorough investigation into the state of the science in this area and found it to be almost uniformly disappointing. Several studies using interventions that were intuitive and assumed to be helpful to overweight youth, such as structured nutrition education and exercise programs, sometimes involving schools and parents, are producing the opposite effects." You can get a doctor's note with a goal to attend Weight Watchers as your DD's age. You have to go to in-person meetings. In terms of sane no weird food group eliminations, it's probably one of the better diets out there. Here's another article looking at one of the multidiscipline approach programs which are so rare. Here, success is stabilizing BMI. I guarantee you if the majority showed a loss in BMI, they would not use stabilizing as a success factor http://www.ncbi.nlm.nih.gov/pubmed/25335786 One of the best innovative programs I've seen is the rowing program out of Boston. But it's only in Boston. But, the only thing that has shown significant long term weight loss for adults or children is bariatric surgery. They used to do Lap-Bands on teens, and have switched to the sleeve gastrectomy. Do I think it's something OP should consider at this point? Nope. It's good to focus on lifestyle changes for health. You might get lucky, it might lead to long term weight loss. More likely, if one regularly follows good habits, one will not be as obese as one could potentially be. So, we're talking somebody who is hopefully just overweight or even obese, rather than morbidly or super morbidly obese. But IMHO you also need to focus on building up a DD who sees her value beyond her body size. Who doesn't look at everything as a diet….as feast vs. famine. It will take time. My guess is in the next few years we'll see a lot more treatments which target the microbiome of the gut. Quote Link to comment Share on other sites More sharing options...
Twigs Posted November 1, 2014 Share Posted November 1, 2014 Here are some more resources that I hope you will find helpful. Peter Attia: Is the obesity crisis hiding a bigger problem?The Aetiology of Obesity Lecture Series - be sure to start with part 1. Why We Get Fat: Adiposity 101 and The Alternative Hypothesis of Obesity. (Skip the 8 minute intro and go straight to the talk!) Best wishes. Quote Link to comment Share on other sites More sharing options...
countrygal Posted November 1, 2014 Share Posted November 1, 2014 She needs to be treated for the hypothyroidism. Please push for that! Being hypothyroid causes blood sugar issues, high cholesterol, etc... and makes losing weight difficult or impossible. Trust me, I know!! I agree that the whole family should clean up their diet together as well as exercise/do physical activities together vs. TV and computer time. Quote Link to comment Share on other sites More sharing options...
Perry Posted November 1, 2014 Share Posted November 1, 2014 You can get a doctor's note with a goal to attend Weight Watchers as your DD's age. You have to go to in-person meetings. In terms of sane no weird food group eliminations, it's probably one of the better diets out there. Precisely the reason Weight Watchers doesn't work very well. They let you eat carbs. The best weight loss approach for kids is a low carb, normal calorie diet combined with exercise, for the entire family. That means getting rid of bread, pasta, potatoes, rice and junk food. Eat lots of good protein with healthy fats and some fruit. While diets in general have a low success rate overall, there are many, many people who have successfully lost weight and kept it off. Good luck! Quote Link to comment Share on other sites More sharing options...
gingersmom Posted November 1, 2014 Share Posted November 1, 2014 Precisely the reason Weight Watchers doesn't work very well. They let you eat carbs. That's seriously what you believe? Quote Link to comment Share on other sites More sharing options...
Perry Posted November 1, 2014 Share Posted November 1, 2014 That's seriously what you believe? Yes. What part of it do you disagree with? Quote Link to comment Share on other sites More sharing options...
shinyhappypeople Posted November 1, 2014 Author Share Posted November 1, 2014 I'm not going to put her on a very low carb diet. Whatever we do has to be sustainable, and very low carb diets aren't, at least not for most children. One advantage DD has is that she's a natural athlete and genuinely enjoys working out hard. We have trouble finding groups for her to work out with. Most stuff for kids is way too gentle for her tastes. Martial arts has been really, really good for her, though. Regarding the prediabetes, I'm taking this very seriously, but I'm also a glass-half-full person. The test results could have been much, much worse AND we finally have some actual quantifiable information to work with. Now that I have more specific information about what we're dealing with, I can respond to it appropriately. I have a lot to be happy about and grateful for. Quote Link to comment Share on other sites More sharing options...
Perry Posted November 1, 2014 Share Posted November 1, 2014 I'm not going to put her on a very low carb diet. Whatever we do has to be sustainable, and very low carb diets aren't, at least not for most children. I agree, it wouldn't be sustainable long term. It's only for weight loss, not maintenance. Quote Link to comment Share on other sites More sharing options...
Ravin Posted November 1, 2014 Share Posted November 1, 2014 I was diagnosed with low thyroid at that age. The doctor put me on synthroid and I shot up six inches in nine months. Low thyroid definitely messes up and allows down metabolism. Quote Link to comment Share on other sites More sharing options...
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