School-based diabetes program stems normal childhood rise in blood sugar

San Antonio (Sept. 7, 2004) – A school-based program to instill healthy habits in low-income, Mexican-American children resulted in a dramatic drop in blood sugar levels of 1,200 fourth-graders, according to a randomized, controlled trial released Sept. 6 in Archives of Pediatric and Adolescent Medicine.

Students in 13 San Antonio elementary schools participated in the Bienestar Health Program over an eight-month period in 2001 and 2002. Bienestar means “well-being” in Spanish.

“All children ages 9 to 13 go through a prepubertal stage that includes a physiological increase in blood sugar, which mimics type 2 diabetes,” said lead investigator Roberto P. Treviño, M.D., of the Social and Health Research Center in San Antonio. “The Bienestar intervention of diet, exercise and education, on the other hand, lowered blood sugar by 2.24 miligrams per deciliter (mg/dl). It sounds like a small decrease, but the reason this is so exciting is that it is very difficult to drive down blood glucose during the prepubertal stage.”

Type 2 diabetes, a metabolic disease once seen almost exclusively in adults, has been linked to poor diet and lack of fitness in children with the disease. These factors are addressed in the Bienestar study, which was conducted in the San Antonio Independent School District (SAISD) and at the Texas Diabetes Institute by researchers from The University of Texas Health Science Center at San Antonio, The University of Texas at San Antonio and the Social and Health Research Center.

The Bienestar Health Program consists of a health class and physical education curriculum, a family program, a school cafeteria program and an after-school health club. The objectives are to lower dietary saturated fat intake, increase dietary fiber intake and boost physical activity.

Students in Bienestar intervention schools were compared with peers in 14 non-Bienestar schools to assess the program’s effect on several measures, including fasting capillary glucose.

In addition to lower blood sugars, Bienestar participants exhibited improved fitness scores and an increase in dietary fiber intake. Non-participants showed the reverse trend of increased blood sugar, lower fitness and diminished dietary fiber intake. Body fat percentage and dietary saturated fat intake did not differ significantly between the two groups.

Nearly 20 million Americans, including an estimated 125,000 in San Antonio, have diabetes. The cost to treat one person with type 2 diabetes may run as high as $13,000 a year, according to the American Diabetes Association. “The Bienestar intervention cost only $9 per student,” Dr. Treviño said. “That’s very low, considering that the 2.24 mg/dl decrease, if maintained for several years, might be enough to save a child from going blind.”

Daniel Hale, M.D., professor and chief of pediatric endocrinology and diabetes at the Health Science Center and co-author of the Bienestar paper, said: “It is becoming increasingly apparent that we need to control glucose levels in children as early as possible, especially those from families where diabetes is present. Diabetes and its complications are best prevented, rather than treated much later down the line when there is not as much we can do.”

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