Essay Example on Rising Diabetes: Preventing Comorbidities of Childhood Obesity

Introduction: Diabetes, Obesity, and the Need for Prevention in Children

There is an increase in cases of diabetes owing to the prevalence of obesity which is currently a global pandemic. Arenaza et al (2017) acknowledge in their article that pre-diabetes and type-2 diabetes have become a huge concern. Their main idea is to reduce the comorbidities associated with obesity through identification and prevention in children who have a high risk of developing type-2 diabetes. They suggest that a family-based intervention program that involves supervised exercise, dubbed PREKID project, could help prevent diabetes in overweight and obese children. The authors discuss a 22-week family-based intervention program, children with the risk of insulin resistance syndrome, microRNA in peripheral blood mononuclear cells and in circulating exosomes, and how exercise can be an effective intervention method.

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Study Design and Implementation of the Family-Based Intervention

The study involved a total of 84 children between the ages of 8 to 12 years that are at risk of developing type-2 diabetes. The children were randomly assigned to control and intervention groups with equal distribution. A family-based psycho-education and lifestyle education program was offered to the control group two days per month. The same programs were offered to the intervention group but with the addition of exercise program three days per month. Measurements for the cardiorespiratory fitness, microRNA expressions in peripheral blood mononuclear cells and circulating exosomes, glucose and hemoglobin A1c, fasting insulin, physical activity, and dietary habits were taken prior to the experiment.

The randomized clinical trial for the prevention of diabetes in kids was conducted for 22 weeks. Pediatricians from Pediatric Endocrinology of the University Hospital of Txagorritxu helped in the recruitment of the participants. A multidisciplinary team of health care professionals engaged the families, whose children were in the study, in a psycho-educational and lifestyle education program. All the families received the same programs with the anticipated outcome variable to be the additional exercise. At least one parent or caregiver was in attendance during the program sessions that involved children in the ages that meet the international criteria for the classification of the risk of type-2 diabetes. The exercise was a crucial part of the experiment for the purpose of diabetes prevention, and as such, the children in the control group were initiated into the exercise program after completion.

All of the families participated separately in the psycho-education and the healthy lifestyle education program for 90 minutes once every two weeks for 22 weeks. The 11 sessions involved promoting healthy dietary habits such as consumption of fruits and vegetables and avoiding foods with sugar. Good sleeping habits, hygiene, and activity levels were also encouraged. The psycho-educational program aimed to encourage positive lifestyle changes and so to improve psychological well-being and self-esteem.

A 3 days per week session for 90 minutes was scheduled for the exercise group for a period of 22 weeks. The program involved muscle strength exercises, cardiovascular endurance, intense aerobic workouts, stretching exercises, and gaming activities. The aim was to achieve a heart rate of over 75% and enjoyment. Heart rate monitors were placed on the participants to ensure accuracy. Enjoyment was necessary for motivation and to encourage participation.

Results and Findings: Exercise as a Key Intervention for Diabetes Prevention

The research findings show that physical exercise is an essential tool for the prevention of diabetes in children with a combination of psycho-education and healthy dietary habits. Insulin resistance syndrome and the risk of type-2 diabetes are characterized by low levels of insulin sensitivity, hypertension, excess adiposity, and dyslipidemia. Insulin resistance was the primary outcome of the experiment, with the cardiorespiratory fitness, visceral and abdominal adiposity, adipokines, hepatokines, inflammation markers and cardiovascular disease risk factors as the secondary outcome. A baseline for both the primary and secondary outcomes was taken before the experiment and after the 22-week intervention. Total, abdominal and visceral adiposity accumulation in children are responsible for the development of insulin resistance syndrome and the subsequent type-2 diabetes. It is such that 2.9% of insulin sensitivity decreases for every 1% of additional adiposity for children between 8 to 10 years. The visceral adiposity measured using the magnetic resonance imaging established that the family intervention program helps to reduce its levels and ultimately the risk of diabetes. The risk of insulin resistance and type-2 diabetes are increased by accumulated fat in the pancreas and liver. Measured by the magnetic resonance imaging, the pancreatic and hepatic fat reduced in both control groups, but more through physical exercise. Cardiorespiratory fitness assessed using the 20-m shuttle run test and direct cardiopulmonary exercise progressive incremental treadmill test found that it reduces the fat deposition on the pancreas and liver. It reduces cardiovascular disease risk factors associated with diabetes.

The pandemic of diabetes worldwide and increased prevalence of type-2 diabetes has made it a public health issue with considerable economic costs. The article addresses this issue and identifies exercise in children incorporated with psycho-education and lifestyle education as key intervention methods. Arenaza et al (2017) posit that evidence-based adiposity and insulin resistance syndrome treatments can reduce the risk of type-2 diabetes in children. A multidisciplinary team of health care professionals involved families in the education program consisting of physical, psychological, and lifestyle materials. It is not established why some children show metabolically healthy phenotype while others develop insulin resistance syndrome and type-2 diabetes (Arenaza et al., 2017). However, the research project helps to identify miRNAs that are associated with onset of insulin resistance syndrome onset in children, and the effect of exercise as an evidence-based intervention method.

References

Arenaza, L., Medrano, M.C., Amasene, M., Rodriguez-Vigil, B., Diez, I.A., Grana, M.,

Tobalina, I., Maiz, E., Arteche, E., Larrarte, E., Huybrechts, I., Davis, C.L., Ruiz, J.R., Ortega, F.B., Margareto, J., & Labayen, I. (2017). Prevention of diabetes in overweight/obese children through a family-based intervention program including supervised exercise (PREDIKID project): study protocol for a randomized controlled trial. Trials, 18: 372, doi: 10.1186/s13063-017-2117-y.