Author: Children’s Hospital Boston staff

One patient’s story: my Type 2 diabetes

Mirna “Minnie” Ortiz is a lot like most 16-year-olds. She likes hanging out with her friends, watching television and has dreams for her future. Unlike other teens her age, Minnie is the only person she knows that has Type 2 diabetes. Minnie recently shared her story with PBS in an online video series. Here is Minnie’s introductory video in the series, and below she shares her story about being diagnosed with Type 2 and how it’s changed her life.

Minnie’s story

I was getting really sick towards the end of August 2005. I was throwing up, really thirsty all of the time and felt like I could sleep all day. I was constantly asking for sugary drinks and foods. That’s what my mom would give me. She had no idea at the time that I had diabetes.

On my first day of 6^th grade, I was sitting on the couch at home and then out of nowhere I fell into a diabetic coma. My family took me to the hospital and the doctors told my mom I had ketones and that my sugar level was 1,200, which is incredibly high and potentially dangerous.

I was in a diabetic coma for week. I was fed through IVs because I wasn’t allowed to eat. When I finally woke up, I was really disoriented because I didn’t remember anything that had happened to me. I thought, Why am I in the hospital?

The doctors told me that I have diabetes. Before that moment, I had never even heard the word diabetes before. I had no idea what it was. While the doctors were explaining it to me, all I heard was that there would be needles and a lot of tests. I was going to have to stay in the hospital longer for them to figure everything out. I was only 12 at the time and didn’t really understand it all.

My life has changed a lot since then. I never had to worry about my blood sugar. Now I take medicine twice a day to help control it and I have to keep track of my sugar levels in a log book three times a day.

The doctors talked to me about my diet and said I couldn’t eat candy anymore. I used to love candy. Twizzlers were my favorite. But sugar is bad for me now, so I don’t eat them anymore, except maybe on Halloween. I’ll eat one Twizzler. I used to drink a lot of Pepsi and Sierra Mist, but now if I drink soda it has to be diet. I mostly drink juice or flavored water like Crystal Light. I used to not pay attention to what I ate, but I have to be responsible for myself now.

I was also told that I had to lose weight. If I didn’t, my diabetes would get worse. I hate to exercise, but know that it’s important that I do. I get most of my exercise in gym class and I actually like to play basketball and walk around the track. I have lost some weight thanks to exercise and a change in my diet. I eat smaller portions, three meals a day and always have fruits and vegetables.

Life with Type 2 can be hard, especially since I don’t know anyone else my age who has it. So, I just write in my journal when I need to vent. It’s been really helpful.

My family is the real reason I have survived this. They motivate me, and if it wasn’t for them, I wouldn’t feel pushed to control my diabetes. They’ve even started eating healthier too.

I want other kids with Type 2 to know that they’re not alone. That’s why I did the project with PBS. I know how it feels when you first find out you have diabetes. You feel shut out and really confused. I hope that when people see my video diaries they see someone they can look up to. I want other kids with diabetes to be more open about expressing themselves and to not get stressed out about it. I just don’t want anyone to feel like they’re alone.

Here’s another interesting story about how diabetic kids may focus too much on carb counting.

Are you dealing with diabetes in your home? What’s the hardest part about it? What have you learned about yourself as a result?

December 18, 2009
Healthful eating during the holiday season
by Jenny Kinne MS, RD, LDN, CLC, clinical nutrition specialist in Gastroenterology/Nutrition.

It’s beginning to look and feel a lot like the holiday season! With celebrations of all sorts just around the corner many people find themselves asking, how do you balance healthful eating with all the tempting treats and fun foods? Here are some tips to keep up healthful habits but also enjoy your holiday favorites.
- Add color to your holiday spread by incorporating fruits and vegetables that are in season. Examples include: sweet potatoes, winter squash, broccoli, cranberries, pear, pomegranates and clementines/oranges. Try adding these in a salad, main entrée or dessert.
- Choose lean protein sources, such as turkey or chicken breast, fish, beans or legumes as your main entrée and pair with steamed vegetables.
- Try calorie free beverages such as sparkling water or water with a fruit garnish instead of juice and soda.
- Make some traditional holiday recipes healthier by changing some ingredients. Make adjustments slowly to favorite recipes, substitute one ingredient at a time so you can make sure the recipe works. If you can’t alter the recipe to be healthier, enjoy the classic but try to be mindful of the portions. Common substitutions include:
  - egg substitutes or two egg whites used in place of a whole egg
  - applesauce in place of oil in baked goods
  - for dips, sauces and toppings choose non-fat or low fat dairy products
  - try adding raisins or nuts to bread or cookie recipes.
- Keep in mind food safety! Don’t keep dishes out of the fridge for more than two hours.
- Try to have a small snack before heading out to a holiday party to avoid over-doing it.
- Stick to a normal eating schedule, include breakfast and lunch on days where there is a main holiday meal, and be sure to include fruits, vegetables and whole grains! Skipping meals can lead to over eating. This will allow you to enjoy your holiday meal in moderation.
- Eat slowly. It’s important to enjoy the foods you’re consuming. Many of our favorite holiday dishes are family favorites that you may not have on a daily basis. If you eat slowly you’re more likely to sense when you’re full; if you eat too fast you can miss your body’s cues and over eat.
- Move the conversation away from the food area to avoid grazing.
- Children and adults tend to eat more when watching TV. Enjoy the holiday meal with the TV turned off.
- Moderation is key. It’s okay to try all foods, just watch the portion sizes.
- Offer to prepare a healthful dish or appetizer if you’re attending a holiday party. Some simple dishes like a vegetable platter with low fat dip or whole grain crackers and cheese are always a great choice.
- Try to be active during the day. When possible, outdoor family activities, like taking a walk, sledding or ice skating are always fun!
The holidays are such a wonderful time for celebration and enjoying time with friends and family. With a little preparation and thought you can enjoy the season even more by choosing healthier options with a balance of traditional holiday foods.

Do you know how many calories you consume during a holiday meal? Health Castle has a list of how many calories are in the most popular holiday foods and gives tips on how to trim some of the calories off.

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December 16, 2009
Keep the holidays from being ho-ho-hazardous to kids
By Lois Lee, MD, MPH, from Children’s Hospital Boston’s Emergency Department Injury Prevention Program

Many parents know that kids like to put things in their mouth, nose and ears—even if they know those things don’t belong there. Holiday decorations are no exception. Every year in the Emergency Department (ED), we see children who get injuries from holiday decorations—usually from trying to eat them. But children can sustain other injuries as well—and usually in ways that an adult would never think about.

My colleagues and I have just published a study in the journal Pediatric Emergency Care about holiday-ornament related injuries in children. We saw an average of five children a year who came to the ED for injuries from a holiday ornament. Most of the injuries were from glass ornaments, but some were related to the light bulb part of the decoration. Almost half of the children came to the ED because they tried to eat the ornament. Twelve of these children had bleeding from their mouth or gastrointestinal tract (stomach and intestines). Others had cuts on their skin by glass in the ornament or light bulb. Two children suffered minor electrocution when they put the ornament in the electrical socket. Another child placed part of an ornament fragment in his ear canal.

The majority of these children had an X-ray as part of their evaluation. Two children had to go to the operating room (OR) for further exploration of the ornament foreign bodies in the mouth or airway. Six children were admitted to the hospital for observation.

In addition to holiday ornament injuries, there are other types of injuries that we see around the holidays. The Christmas tree can fall on children if they pull on an ornament and the tree is not well secured. Stocking holders, which can be placed on a mantle, are very popular, but can cause head injury if the child pulls on the stocking and pulls the holder (which is often heavy) onto their heads. Candles can cause burns to children or fires in the home if not well monitored.

So here are a few tips to keep your children safe this holiday season:
- Consider placing ornaments on higher branches of the Christmas tree to keep them out of reach of curious toddlers.
- Cover electrical outlets so children can not put an ornament or wire in them.
- Candles should only be lit in rooms where people are present.
- Take care in using stocking holders if the stockings hang low enough for children to reach.
- Take care in placing garlands that hang from windows or other surfaces, as they can be a strangulation hazard if a small child gets caught in them.
- Make sure the Christmas tree has a secure base to prevent it from falling on a child.
And as always, close supervision of young children is the best way to keep them safe this holiday season—and all year round.

Read this LA Times article highlighting Children’s research on the perils posed by holiday ornaments.

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December 15, 2009
This week on Thrive: Dec. 7 – 11
Here’s a quick look at what Thrive was up to last week.

Why are suicide clusters more common in teens? Children’s Global Fellow Stephen Sullivan, MD, MPH, addresses the global burden of surgical diseases. KABC in Los Angeles interviewed Children’s Hanno Steen, PhD, about a urine test that quickly identifies cases of appendicitis. Children’s Center for Young Women’s Health youth advisor, Erica, writes a compelling review of the movie, Precious. The HealthMap team gives us our final H1N1 update. David Ludwig, MD, PhD, director of Children’s Optimal Weight for Life Program, just published a commentary in JAMA expressing concern about the widespread use of artificial sweeteners in soft drinks. Our Mediatrician talks about how negative portrayals of black women in movies affects teens. We give a roundup on all of the news this week on the fight for what our children should be eating and drinking.

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December 13, 2009
Health headlines: Mozart helps preemies, children’s allergies and teen brains really are different
Other stories we’ve been reading:

Psychologist wins $1 million for showing that teen brains really are different. Researchers are able to show that remedial reading classes for weak readers really can change young brains. A history of juvenile delinquency is linked to early death in men.

If your children have cavities, it’s much more likely they’ll become adults with cavities. An Israeli study found that premature babies listening to Mozart were able to grow faster. Children born to mothers exposed to microbes during pregnancy may be less likely to develop allergies.

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December 12, 2009
Do negative portrayals of Black women in movies affect how teens view them?
Media expert Michael Rich, MD, MPH, director of the Center on Media and Child Health at Children’s Hospital Boston, answers your questions about media use. Last week, he discussed Guitar Hero and age appropriate song lyrics.

Here’s this week’s question:

Q: I was made to feel ugly and repulsive (because I am a Black) when I was in middle school up to high school. I was treated like this by people of all races, including other Blacks. I want to know–do the negative portrayals of Black women in movies affects how teens view Black girls and women?
-Miss Represented, Addis Ababa, Ethiopia

A: Dear Miss Represented,

In short, the answer to your question is yes: Media portrayals of Black women—or any other group of people, for that matter—affect how teens view them, regardless of whether the teens are themselves part of that group. For example, for a Black woman, media affect both how other people see her and how she sees herself.

Research suggests that when we are exposed to images repeatedly and over a long period of time, we internalize these images and measure ourselves and others against them. Therefore, when people are exposed to media that consistently portray people of color as less successful, less beautiful, and less worthwhile than White people, they tend to internalize those ideas.

Fortunately, there are conscious efforts underway by filmmakers to bring more diversity into media images and to portray people of many races and ethnicities in positive, healthful ways. And while there’s no way to undo the humiliation you were made to feel as a teen, you can help the young people in your own life by guiding them toward media choices that represent members of all races in a positive light and by helping them think critically about the media they consume.

Enjoy your media and use them wisely,
The Mediatrician

Do you have a question about your child’s media use? Ask it today!

This is a must-see list for the 10 video games to cross off your child’s gift list.

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December 11, 2009