OSA and Sugar - Oh My!!!

[jamiswolf]

My 12 year old daughter is severely insulin resistant. She has acanthosis nigracans(dark patches of skin from high insulin levels), very high androgen levels, high cholesterol, and PCOS (yes, already diagnosed despite the young age). And her body weight is . . .

NORMAL. 50th percentile, normal BMI. Not an extra ounce of fat on that body.

We eat a healthy diet, organic and pastured, very few processed foods, very little junk.

Yet she is already on the road to diabetes.

There is NOTHING she did or we did to cause this. She inherited rotten genes from my side of the family, my mother and I have this too.

People are quick to blame obesity and poor diet for diabetes, but sometimes the chicken comes before the egg. In our experience (I was very insulin resistant and very thin until we started messing with my hormones trying to have children), the insulin resistance causes the obesity and not the other way around.

Another thing my mom, my daughter,and I share is a genetic disorder that includes a very narrow airway, so we all probably have sleep apnea (daughter has not been tested yet, mom snored like a freight train). So maybe that's a contributor too?


People (including doctors) are quick to blame diabetes on obesity, what will they tell my daughter?

(Wait, I know the answer to that. One urgent care pedi we had to see for an acute Illness told me my daughter can't have PCOS because she's not fat. WRONG!)

Janknitz,
I am so sorry that you and your daughter are suffering through this insulin resistance problem. I am retired and so do not keep up with the latest research. I was wondering and hoping that you could post some links to this problem.

I worked for two years on an Indian reservation (IHS hospital) and we all assumed that it was diet that was the cause for all the type 2 diabetes that we saw. Now I am lead to believe otherwise?

Please help me with links that you have surely researched.
J

[Todzo]

My 12 year old daughter is severely insulin resistant. She has acanthosis nigracans(dark patches of skin from high insulin levels), very high androgen levels, high cholesterol, and PCOS (yes, already diagnosed despite the young age). And her body weight is . . .

NORMAL. 50th percentile, normal BMI. Not an extra ounce of fat on that body.

We eat a healthy diet, organic and pastured, very few processed foods, very little junk.

Yet she is already on the road to diabetes.

There is NOTHING she did or we did to cause this. She inherited rotten genes from my side of the family, my mother and I have this too.

People are quick to blame obesity and poor diet for diabetes, but sometimes the chicken comes before the egg. In our experience (I was very insulin resistant and very thin until we started messing with my hormones trying to have children), the insulin resistance causes the obesity and not the other way around.

Another thing my mom, my daughter,and I share is a genetic disorder that includes a very narrow airway, so we all probably have sleep apnea (daughter has not been tested yet, mom snored like a freight train). So maybe that's a contributor too?


People (including doctors) are quick to blame diabetes on obesity, what will they tell my daughter?

(Wait, I know the answer to that. One urgent care pedi we had to see for an acute Illness told me my daughter can't have PCOS because she's not fat. WRONG!)

The article in “Sleep” points out that the constant desaturations of OSA appear to tend one toward metabolic syndrome other things held constant.

From: http://www.amazon.com/Fat-Chance-Beatin ... 159463100X @ Page 7 of 320

“ Here's the kicker. Being thin is not a safeguard against metabolic disease or early death. Up to 40 percent of normal-weight individuals harbor insulin resistance – a sign of chronic metabolic disease – which will likely shorten their life expectancy. Of those, 20 percent demonstrate liver fat on an MRI of the abdomen (see chapter eight). Liver fat, irrespective of body fat, has been shown to be a major risk factor in the development of diabetes. You think you're safe? You are so screwed. And you don't even know it. “

From: http://www.amazon.com/Fat-Chance-Beatin ... 159463100X Chapter One

“ Juan, a 100-pound six-year-old Latino boy whose mother is a non-English-speaking farm worker from Salinas, California, comes to my clinic in 2003, He is wider than he is tall, I ask the mother in my broken Spanish, “I don't care what your kid eats, tell me what he drinks.” No soda, but a gallon of orange juice per day. On calories alone, this accounts for 112 pounds per year of body fat. Of course, some of that is burned off, and it might influence total food intake. I explain to the mother, “La fruta es buena, el jugo es malo (the fruit is good, the juice is bad). Eat the fruit, don't drink the juice.” She asks, “Then why does WIC [Women, Infants, and Children, a government entitlement program for the poor run by the U.S. Department of Agriculture] give it to us?”

One kid, one mother, one question, my life was changed – and the need for this book was born. “

[Janknitz]

I worked for two years on an Indian reservation (IHS hospital) and we all assumed that it was diet that was the cause for all the type 2 diabetes that we saw. Now I am lead to believe otherwise?

Please help me with links that you have surely researched.

Jamis, I have tons, but I'll try to pull together a few good resources this weekend.

I think diet plays a huge part. Native populations are said to have the "thrifty gene" to help them survive lean times. So the "gun" may be the genetic makeup, but diet "pulls the trigger".

I was a picky eater as a child, and basically would only eat carbs. My parents were so happy I would eat SOMETHING, that they didn't pay much attention to what it was. My diet was horrible when I was a kid, and I was allowed to drink Coca Cola whenever I wanted (and I did!). Even though I was thin, I'm sure that was a contributor.

We tried always to feed our children healthfully, so I'm not certain what "pulled the trigger" for my daughter. One other thing they think is that it may be environmental toxins. I was not able to nurse my kids (PCOS interfered with my milk supply) and I sometimes wonder if the plastics in the baby bottles were the toxic "trigger" for her--despite her much cleaner diet, my daughter's lab values are much worse than mine ever were. I can't imagine what else--I'm allergic to many chemicals, so we clean pretty "green" with homemade cleansers for the most part. I went to High School in Salinas, interestingly, and farm workers there are exposed to unholy amounts of pesticides. They are definitely seeing the results in their children's health and lots of issues with neurological development. Their diet plays a big role too, but I think the toxins should not be ignored. We lived on the edge of lettuce fields, and the planes spraying pesticide used to turn around over our house--so I probably had plenty of toxic exposure, too.

I lived in Hawaii for a while, and there were similar insulin resistance problems with native Hawaiians--there almost certainly related to diet as the environment is pretty clean (on the Big Island, at least). Hawaii wisely started a public health campaign to get people back to their native diets--they had pork, fish, seafood, poultry, eggs, vegetables, starches were taro and breadfruit. If people dropped the junky SAD food and readopted their native diets health markers improved dramatically. Eric Westman MD found the same for Native populations in Canada--there's a documentary, I'll look for the title.

I was watching one of those reality shows about a school for obese kids and the saddest story to me was a very obese native American girl--you could tell she had terrible IR--lots of dark patches of skin and I think she was on the brink of diabetes. They had her on a low fat high carb diet and she was miserable--hungry all the time and not really losing weight, when she got back to the reservation she made up for it and ate tons of fry bread and gained like crazy. While fry bread is a modern thing, if she had gone back to eating a more native diet (way before fry bread came on the scene) her health would have been so much better and she would have been much healthier and happier.

[Todzo]

We tried always to feed our children healthfully, so I'm not certain what "pulled the trigger" for my daughter. One other thing they think is that it may be environmental toxins. I was not able to nurse my kids (PCOS interfered with my milk supply) and I sometimes wonder if the plastics in the baby bottles were the toxic "trigger" for her--despite her much cleaner diet, my daughter's lab values are much worse than mine ever were. I can't imagine what else--I'm allergic to many chemicals, so we clean pretty "green" with homemade cleansers for the most part. I went to High School in Salinas, interestingly, and farm workers there are exposed to unholy amounts of pesticides. They are definitely seeing the results in their children's health and lots of issues with neurological development. Their diet plays a big role too, but I think the toxins should not be ignored. We lived on the edge of lettuce fields, and the planes spraying pesticide used to turn around over our house--so I probably had plenty of toxic exposure, too.

From: http://www.amazon.com/Fat-Chance-Beatin ... 159463100X

From Chapter 15 "Environmental "Obesogens"

" The formula Isomil is 10.3% sucrose (Coca-Cola is 10.5% sucrose). It's a baby milkshake! Add to that the genistein in the soy formula, and put all that in a baby bottle containing bisphenol-A. Is that six-month-old looking more like a perpetrator or victim? "

[Janknitz]

Good point, although both my children were bottle fed, only one has these issues. I would have given anything to nurse them instead, it was simply impossible.

[Todzo]

Good point, although both my children were bottle fed, only one has these issues. I would have given anything to nurse them instead, it was simply impossible.

He also mentions pesticides in chapter 15 "Environmental "Obesogens" along with other pollutants and even the possibility of virus and all!

I just started another book (see: http://www.amazon.com/Bugs-Bowels-Behav ... B00D2C1DKY ) dealing with the way that our microbiome affects all of the systems in our body. We are just beginning to understand what is happening to us.

It really looks like moving totally inside, becoming sedentary, and freeing sugars from their natural fibrous containers makes a very bad and toxic combo!

I also sometimes wonder if OSA might be a result of metabolic syndrome perhaps in combination with other stressors. One thing is for sure, once the OSA/Metabolic Syndrome dance starts it is hard to stop!!!

[Todzo]

And I am sure all the antipsychotics that kids are getting isn't helping their health and is putting them a great risk for diabetes.

http://online.wsj.com/news/articles/SB1 ... 0977618320

49er

I am remembering that Dr. Park became interested in OSA by seeing complications caused by it in pregnancy. I am remembering that a recent study of pregnancy and OSA showed those with OSA to have a much much greater possibility of landing a child in the ICU after birth!

Right now I am wondering if OSA might stem from metabolic syndrome? You have inflammation. You have changes in brain chemistry (so chemoreflexes and muscle control might change). You have association with all kinds of other diseases.

I started this thread hoping to remind us all to be careful to eat our fiber, move more, and watch the sugar intake during this upcoming holiday season. I hope it also results in better mood management for young men so they can better love their mates, and better health in the young mothers and mothers to be out there. Perhaps we can keep the resultant children further away from “chemical intervention” for a while longer.

[Todzo]

I mean - Perhaps we can keep the resultant children further away from “chemical intervention” forever!

[Catnapper]

So, is it necessary to weigh and measure everything you eat or drink to manage your glucose levels?

I take Metformin but boy does it give me digestive problems! Actually every one of these diabetic medications I have tried make me sick one way or another.

My doctor tells me I am doing fine with whatever I am doing, but I worry that my readings are too high. Do I need to change to an endocrinologist?

I think I need a mentor to help me along this way.

Catnapper - Joanie

[JohnBFisher]

... So, is it necessary to weigh and measure everything you eat or drink to manage your glucose levels? ...

Nope. You estimate the carbohydrates in a meal and make certain that you don't drive your blood glucose numbers too high. Essentially you will need to test fairly regularly (immediately before and two hours after each meal) so you can learn what drives your blood glucose levels. Everyone reacts differently, though there are common trends.

... My doctor tells me I am doing fine with whatever I am doing, but I worry that my readings are too high. Do I need to change to an endocrinologist? ...

Under most insurance plans it is your right to talk with an endocrinologist.

... I think I need a mentor to help me along this way. ...

Or a diabetes educator, who can enroll you in a class to learn more about managing your diabetes.

I really would recommend learning more about diabetes, if you need to manage your blood glucose levels. I particularly like the following book (available as a Kindle downloadable book):

http://www.amazon.com/The-First-Year-Es ... 569242658/
http://www.amazon.com/The-First-Year-Ty ... 001T9NS1E/

[Catnapper]

Thanks John. I found the book on Amazon used for $0.01 plus $3.99 shipping and ordered it.

Catnapper - Joanie

[JohnBFisher]

Thanks John. I found the book on Amazon used for $0.01 plus $3.99 shipping and ordered it. ... Catnapper - Joanie

Joanie! I see you are the last of the big time spenders! .. .. And that's how I would do it. I think you'll like it. It's pretty informative, has lots of information, but is not overly technical.

[Janknitz]

I take Metformin, and if I eat too many carbs I get instant retribution in the form of GI distress. In many ways it keeps me honest on controlling the carbs.

I highly recommend the book Dr. Bernstein's Diabetic Solution. This is very different advice than you may get from your endocrinologist or diabetes educator. Many people are able to get off meds or greatly reduce their needs for them (Type I's will ALWAYS need insulin, but how much depends) and many really can prevent a lot of diabetic complications using his techniques.

I occasionally track and count using a mobile app just to be sure I'm staying on track. But most of the time I don't bother, because I tend to eat pretty much the same from week to week.

Another approach is to "eat to your meter"--you can track how your body responds to various food and combinations and adjust what you eat accordingly. It's intense at first, but after a while you get to know what foods are ok and what to eat sparingly, and you don't have to test as frequently.

[Catnapper]

Hi John, You are right about my big spending! Now that I have retired I try to remember the lack of income and the finite amount of savings.

Jan, I haven't read Bernstein's book cover to cover, so I guess I need to make a better effort there. (Another of my used book purchases, John!) I have the sense that he recommends low carb and small portions. Is that about it?

This thread has inspired me to return to my low-carb ways. What I have done in the past is eliminate grains, fruit (except a few berries occasionally), potatoes, and anything with sugar. Mostly I avoid prepared foods anyway. I have gone this route off and on again for years. I always feel better without the carbs, but I sure do love them. A piece of buttered toast with my egg tastes so good. I don't have any trouble missing the sweets and never did eat junk food.

As for eating to the meter, how do you get all those test strips? Those suckers are expensive, about $1 each! I get mine from Medicare but they act stingy with them and no wonder. Is there a cheaper version I don't know about? My doctor told me to check before meals rather than after.
I have no problem with sticking my fingers, but I can only use my left hand because I have to protect my right arm and hand from sticks and blood pressure taking to prevent lymphedema since I had lymph nodes removed as a part of breast cancer treatment.
Thanks for the tips.

Catnapper - Joanie

[Catnapper]

Could someone explain this to me? I had breakfast and then 4 hours later checked my blood sugar. I ate about 10 pecan halves and some steamed buttered cauliflower for lunch. An hour or so later my blood sugar was 15 points lower than before I ate. I have had this happen several times before where eating lowered the reading right after I ate, sometimes a lot of points.

Other times if my blood sugar tested low, about 60-65, I could not get it to go up even if I ate a candy bar. I really hate low blood sugar. I can't function at all when it gets like that. When that happened I had been taking glipizide. The doctor said it was the glipizide that kept the blood sugar low.

Catnapper - Joanie