As the Project Director of the soon to launch Healthy Families of South Texas community telehealth network, I’m proud to share important news about this new program which expands on our previous work funded in part by grants from the USDA. The project will launch with a community registry so everyone can participate; not just people with diabetes. Then in January we’ll launch the second tier which takes our profile based education to another level - a kind of diabetes version of Amazon’s expert profile based recommendations meets Facebook. The third tier involves working with pregnant mothers with diabetes of all types in the hopes of preventing serious complications. Here’s a quick overview for anyone interested in participating. Note that access to this program is being provided at no cost to the registered members and the 3 years of federal grant dollars means it will continue to enhance the lives of people in this part of Texas for many years to come.

What is the Healthy Families Program?

* HFSTX is an education and health monitoring community resource designed to establish a home based support network around people with diabetes and at risk for diabetes.

Program Goals:

* To improve self-care for patients and their families by increasing their knowledge of better lifestyle choices.

* To provide encouragement and reinforcement.

* To extend access to care into the home vs an unrealistic emphasis on office visits.

How does it work?

* Through Internet and cell phone technology and postcards, enroll patients and their families in the Healthy Families Registry.

* Over time, the Registry helps them to enhance individualized profiles making it possible for their team to receive personalized education and support via email, cell phone text messages and post cards in the mail according to their own preferences.

Check back in a week or two to find out the url for the online home for this program as this is still being decided.

This is the next in a series of article excerpts by me discussing all forms of diabetes and metabolic syndrome and which were originally published in the Caller Times and reposted here with permission. You can also download an iPod friendly .zip file of me reading this article here.

In my experience seeing thousands of South Texas boys and girls with obesity and diabetes, I have discovered that childhood obesity starts at birth and maybe even before birth.

Infants born overweight (greater than 9 pounds) are more likely to develop diabetes and obesity earlier in life, as well as develop other serious health problems such as high blood pressure, high cholesterol and polycystic ovary disease than their lighter-weight counterparts. The mothers of these heavyweight babies often have gestational diabetes, which may go away after the baby is delivered, or they develop permanent diabetes within the next 10 years.

Research suggests that the baby’s brain is programmed to eat more when born too small, but if weight is gained too quickly after birth, it will create a new “set point” in the baby’s brain to become a weight much heavier than should happen.

The rest of this article is posted in the archives at the Corpus Christi Caller-Times. Registration is required using your email address and a password that you select and manage.

Prompted by a post over at Living With Diabetes, I realized that very few people know what’s involved in diagnosing and treating kids with type 2 diabetes. These are not just miniature versions of adults with type 2. As growing children, they have very special needs.

I live and practice pediatric endocrinology about 400 miles south of Dallas, Texas. We serve all of South Texas (overall, an area the size of South Carolina). As of August 31st of this year, 47% of ALL new cases of children’s diabetes seen in my practice and at my children’s hospital were due to type 2 diabetes. We have extensive experience with managing type 2 diabetes in children. I’ve written and spoken frequently about this epidemic and its management over the years.

I can tell you two things here:

1) About 15% of cases of what appear on the surface to be type 2 diabetes actually have evidence of the same process that causes type 1 diabetes (autoimmunity directed towards the beta cells).

The implication of this finding is that we may be talking about a blended disease process: that is, insulin resistance (the inciting cause of type 2 diabetes in most persons) combined with a destructive process driven by the patient’s own immune system (the underlying cause of type 1 diabetes in most persons). Ironically, the government funded study investigating the best management of type 2 diabetes in children excludes these children from study.

2) There are good oral medications that can work.

Metformin (also called Glucophage) is remarkably safe and I have hundreds of children with type 2 diabetes using this medicine both safely and effectively. However, at diabetes onset, some children with type 2 diabetes need insulin to stabilize their blood sugar control until the metformin can begin to help them. This is a common scenario and in these cases, the insulin may be weaned off rather quickly without ill effects to the child. Furthermore, insulin therapy may be associated with an unwanted side effect of additonal weight gain: the one thing most of these children don’t need.

However, each case is in many ways unique and factors other than medicine will steer the course of their disease. I now see entire families with type 2 diabetes (parents and children), so the role of the family is never to be underestimated. Also, financial issues will influence the clinical course since many of our children with type 2 diabetes are on public assistance programs (Medicaid or SCHIP) and one of these is on the cusp of disappearing!