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From Piqua, Ohio, USA:

I have a friend who has diabetes. He's about 30 and has 2 kids. His mother, 55, recently died directly from diabetes. (Her kidenys, liver, colon, and intestence were bad). She got to that point because she didn't take very good care of herself in her younger years. He's heading the same way. One of his daughters, 11, is overweight (she's about 190 and about 5'4"). They're all American Indian.

What's her chance of getting diabetes? And what's a good diet to help her lose weight? As with him how what's a good diet for him and how can he regulate his sugar? At the moment it jumps from 500 on day to 73 the next to 163 the next. What can I do to help?


You are right to be concerned about your friend and his family. Diabetes is very common in some American Indian tribes and, as your friend has already seen with his mother's experience, it can cause serious problems when it's not well-controlled. But the good news is that there are many things that can be done to protect your friend and his family from having the same kind of outcome. Using the right medicines, foods, and blood glucose testing, your friend should be able to control his blood sugar level to somewhere around 80-120mg/dl before meals. That's a blood sugar near what's normal for people who don't have diabetes. All improvements in control toward normal help cut health risks.

Most people with type 2 diabetes do better if they eat a variety of foods at each meal and distribute the food as evenly as possible through the day, avoiding large meals. It's especially helpful to distribute carbohydrate foods -- like bread, pasta, cereal, fruit, and juices -- evenly. Carbohydrates are the main source of aftermeal blood sugar. Blood sugar goes up when someone eats more food -- especially carbohydrate -- than the available insulin (either the body's own insulin or injected insulin) can handle. And blood sugar can go too low with certain diabetes medicines if too little food is eaten when the medicine is acting. Blood sugar testing shows how the balance between food and insulin is working out.

For more detailed information, you might want to recommend a book for your friend such as Diabetes Type 2 and What To Do by Virginia Valentine.

You also asked what are the chances of his 11 year old daughter developing diabetes. Unfortunately, her risk is quite high, both because other members of her family have had the disease and because of her weight. That part of the answer is easy, but knowing how to best help is more difficult. Losing weight is complicated and difficult for most people and even more complicated in a growing youngster. Cutting way back on food intake is a bad idea for anyone trying to lose weight, but especially so for a young person. It's both emotionally and physically risky.

The best approach for your friend's daughter is for the whole family to make some changes, so the child is not singled out as being unacceptable. More physical activity is the first step. One approach to increasing activity is to take away an hour of telelvision a day and substitute an hour of active play -- bike riding, walking, volleyball -- whatever is possible and fun. It will also be helpful for the whole family to review how they're eating -- making sure that they're eating a healthy variety of foods, frying as little as possible, cutting back on empty snacks like chips, and drinking water or other sugar-free drinks instead of regular soda pop with meals and to quench thrist.

There are a lot of potential approaches that might be helpful and it's not possible to identify them all without knowing the details of your friend's treatment and lifestyle. He would probably benefit from talking to a health professional who specializes in diabetes -- an endocrinologist or other doctor with a special interest in diabetes and/or a diabetes educator. They could help him sort out which approaches might work best for him and his family.

You are a good friend to be searching for helpful information.


Original posting 11 Dec 1998
Posted to Diagnosis and Symptoms and Genetics and Heredity


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Last Updated: Tuesday April 06, 2010 15:09:02
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