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Elizabeth Silva

Defying Diabetes

August 2004

by Natalie Gutierrez

A small prick, and a tiny drop of crimson blood spills onto a thin test strip. Elizabeth Silva meticulously places it into the monitor and then plays the waiting game. She counts down calmly in her head, "5 ... 4 ... 3 ... 2 ... 1," as she sits at the foot of her bed, waiting for the result of her blood glucose test to appear. And then it flashes across the digital display. The monitor reads 95. "Very good," she says with a sigh of relief and a smile on her face. "That was better than last time."

Silva is only 12 years old but already has an adult-sized responsibility - making sure she doesn’t develop type 2 diabetes. Silva comes from a long line of type 2 diabetics. Her late grandfather had it. Her aunt has it, as does her mother. "I’m not going to get it!’ she says, shaking her head emphatically. Elizabeth is determined not to become a statistic like many of her classmates. According to the National Institutes of Health (NIH), about 150,000 school-age children and adolescents nationwide have diabetes. Some clinics report that one-third to one-half of all new cases of childhood diabetes are now type 2. Mexican Americans are among those at highest risk for developing the disease.

But Silva is fighting back. She is enrolled in the Prevalence and Progression of Type 2 Diabetes in Mexican-American Youth study at the Health Science Center. The NIH funded the program for $250,000 for four years. Silva is one of more than 190 children enrolled from 34 elementary schools in San Antonio. The study, led by Principal Investigator Daniel Hale, M.D., professor of pediatrics, seeks to find what the specific risk factors are for Hispanic children ages 8 to 12 and how these factors change as the children age and develop.

FACT: "Every minute of every day, another American develops type 2 diabetes. Without intervention, one in
three children born in the year 2000 will develop diabetes in his or her lifetime. For some of us, the risk is even higher. If that child is Hispanic and female, she has a one in two chance of developing diabetes in her lifetime. We need to get the word out that type 2 diabetes prevention is proven, possible, and powerful."

– Dr. Saul Malozowski, National Institutes of Health

  According to national statistics, one of these children will develop type 2 diabetes in her lifetime.
According to national statistics, one of these children will develop type 2 diabetes in her lifetime.

"We are looking at how often abnormal test results occur, at what ages and whether or not pubertal development affects the way the children’s bodies regulate sugar," Dr. Hale said. "We hope our findings will lead to prevention programs and possibly medications to prevent diabetes at an early age."

As part of the study, more than 2,100 children underwent a free physical exam that included blood tests, a finger stick glucose test, and height, weight and body fat analysis. Children whose blood glucose measured above normal (higher than 110 mg/dl), were given an oral glucose tolerance test (oGTT). Children with abnormal test results were sent home with a glucometer (a device used to measure sugar levels in the blood). Silva and about 40 other children’s oGTT results showed they had high glucose levels.

"An abnormally high blood glucose test result alone doesn’t mean the child has diabetes, but it indicates that he or she should be tested further. It also means that child could be on the road to getting diabetes if low levels of activity and eating habits aren’t changed right away," Dr. Hale said. The children in the study will be monitored by researchers for four years. Families of the children are also provided with resources to help them begin diabetes prevention efforts at home. They are also referred to specialists such as nutritionists and offered training in meal planning and exercise programs.

The study is already making a difference for Silva and her mother, Yolanda Flores.

"She says to me, ‘no hamburgers, mom!’" Flores says with a smile. "And she encourages me to go walking every day. We do everything together now to keep ourselves healthy, including checking our sugar levels. It requires time, effort, discipline and accountability, but Elizabeth is on top of it. She takes charge," she said.

And taking charge is something Health Science Center researchers do every day, determined to find more clues to ending what’s becoming a frightening trend in Hispanic children.

"To prevent the debilitating consequences of diabetes, we have to start with children," Dr. Hale said. "And in doing so, we protect not only this generation, but future generations as well."

The study continues to seekparticipants ages 8 to 12. For more information, call (210) 358-7588.

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