Along the way, there were daily sit-ups — up to 100 per day — and 45-minute daily stationary bike sessions; a whole new way of eating (goodbye Mom’s grease-fried chicken); and a brief experience with insulin injections that are now in the rearview mirror. Plus, there was a lot of encouragement and cajoling by his mother, Michelle Stewart, a 50-year-old paralegal whose determination to turn around her son’s health was crucial to his transformation. But Tayé was deeply invested in his own success. “When I was first diagnosed, I understood that I would deal with it for rest of my life. I worried about how life would change, but I focused on getting better. It motivated me to lose weight,” says the teen. RELATED: Diabetes Is Increasing in Children and Teens, Especially BIPOC Youth “It is not very often that we are able to reverse diabetes one hundred percent,” says Zeina Nabhan, MD, a pediatric endocrinologist at Riley Hospital for Children in Indianapolis who treats Tayé. “It requires a lot of discipline and a lot of hard work on the part of the kids, and it requires a lot of weight loss. Tayé was one of those kids who was committed to a lifelong journey of healthier habits. He wanted to take ownership of his life, and I’m so proud of him.”
A Surprise Type 2 Diabetes Diagnosis for the Teen
Type 2 diabetes happens when the body’s ability to use insulin for converting blood glucose (sugar) into fuel is impaired, leading blood sugar to rise too high, as the ADA explains. It is different from type 1 diabetes, which is an autoimmune disease that destroys the body’s ability to make insulin in the first place. Just under 6,000 children and teens are diagnosed with type 2 diabetes in the United States each year, according to the Centers for Disease Control and Prevention (CDC), with a nearly 5 percent rise per year between 2002 and 2015. The increases for Asian and Pacific Islander, Hispanic, and Black youth all exceeded 6 percent per year, the agency has reported. The health crisis that set Tayé on that journey began with a hospital visit for diabetic ketoacidosis, a dangerous condition that results when your body can’t produce enough insulin to handle your body’s need for glucose, leading it to burn fat instead for fuel and produce chemicals called ketones. As the ketones build up, your blood becomes more acidic, which can lead to diabetic coma or even death, according to the ADA. Although DKA is more common in youth and adults with type 1 diabetes, the condition is present in 6 percent of children overall who are newly diagnosed with type 2 diabetes, according to a previous analysis. It is even higher in youth who are Black, like Tayé, and those who are Hispanic. “When we took him to the doctor I was asked if he had ever been tested for sugar, for diabetes. I thought, Why would we do that? He’s 15,” explains Stewart. “But I saw the look on the nurse’s face, and I could see that she was worried.” The nurse told them rush to Riley Hospital for Children in Indianapolis. The boy was in such pain that he was no longer able to walk, so hospital workers had to wheel him in. Once there his blood glucose level was measured at a stratospheric 694 milligrams per deciliter (mg/dL) (a normal reading is below 200 mg/dL, per the CDC). “They said we’re keeping him because he has DKA and I said, ‘What is that?’ I never thought in a million years they would say my son has DKA and diabetes, and will rely on insulin for the rest of his life,” says Stewart. Upon his release from the hospital, Tayé was put on three to four shots of short-acting insulin with meals, one shot of long-acting insulin at bedtime, and twice-daily oral doses of metformin. “Riley sent me to classes to learn what to do,” says Stewart. “I was so terrified I could not do what was needed. I lay there and prayed about it, asking God to give me the knowledge, patience, and strength.” Worried that her son would face a future of diabetes complications such as limb amputations, as well as the high cost of insulin, Stewart was determined to wean him off insulin. “I remember after they got discharged from the hospital and meeting Michelle for the first time,” says his endocrinologist. “We talked about the options and what life with diabetes is going to look like. And she said, ‘Dr. Nabhan, we’re going to win this.’” RELATED: Is There a Cure for Diabetes?
A Diet and Lifestyle Makeover to Stabilize Blood Sugar
Seven weeks later and 20 pounds lighter, as a new lifestyle including exercise and a diabetes-friendly diet took hold, the insulin injections were history. That may seem like a brief time to be on insulin, but it is in keeping with best practices, says Mary Pat Gallagher, MD, the director of the Robert I. Grossman, MD, and Elisabeth J. Cohen, MD, Pediatric Diabetes Center at NYU Langone in New York City. Dr. Gallagher was not involved in Tayé’s care. “With type 2 diabetes, the goal is to get you off insulin within three months.” If weight loss, insulin, and metformin aren’t enough for a child or teen to reach their target blood sugar levels, adding liraglutide (also known as Victoza or Saxenda) is recommended. At first, getting more exercise seemed like a daunting challenge. Tayé enjoys video games — especially Mario & Sonic — and preferred staying inside even before the COVID-19 pandemic kept him homebound. Stewart decided to bring the exercise indoors, insisting on an hour of exercise per day: typically, 45 minutes on the treadmill and 50 sit-ups. Twice a month, Tayé gets a break from the treadmill — as long as he does 100 sit-ups. His newfound fitness is reaping dividends as life emerges from lockdown. Exercise helps the body use insulin more efficiently, helping lower A1C. A review published in March 2020 in Mayo Clinic Proceedings suggests that regular exercise may also help reduce reliance on type 2 diabetes medications. “Now I can play basketball with my friends,” says Tayé. “Before, I couldn’t play for more than five minutes, but now I can do it for a long time.” It’s easier to stick with activities you enjoy, he advises other young people. “Try to find something you are comfortable with and make fun out of it.” Exercise options abound. “There are multiple exercise videos that you can stream on your TV and do cardio in your house,” says Nabhan. “You can jump rope, you can dance, or if you have stairs in your home, go up and down the stairs. You really can be creative with what you do.” She advises that parents have their children ages 12 and older vaccinated against COVID-19 so they can exercise safely with other kids. Hand-in-hand with exercise were the changes Stewart made to how she prepared meals to keep her son on a low-carbohydrate, low-fat, portion-controlled diet. “I had the measuring cups and measured everything, even down to the condiments. I counted the carbs in every teaspoon of ketchup,” says Stewart. She also kept a food journal for Tayé and sent weekly reports to his healthcare team. Stewart furthermore found healthier ways to prepare Tayé’s favorite foods. She ditched grease frying, bought an air fryer, and relied more on oven baking. “He likes barbecue, so I would bake the chicken — use only 2 tablespoons of sauce and smear it on the chicken, then bake it in the oven instead.” Her tip for parents who are trying to help a child with type 2 diabetes lose weight and lower their blood sugar: “It’s important to eat and take meds and exercise on a schedule. Being consistent trains the stomach to be hungry at the same time each day, and that cuts down on snacking in between meals.” RELATED: How Exercise Helps Prevent and Manage Type 2 Diabetes
A Commitment to Stay on a Healthy Path
Now entering his final year of high school, Tayé looks forward to studying computer science and dreams of having his own company one day. With that new life ahead will come the responsibility to maintain a healthy weight and blood sugar level on his own. His mother has played a large role in his success thus far, observes Nabhan. Going forward, “My hope is that he has seen what diabetes can do to you, and what it means to be diabetes-free. I do think he will have the ability to be a little bit more flexible with his diet, but he cannot lose this focus and live free as if he doesn’t have diabetes. We know that diabetes can come back with a vengeance.” Once he makes the transition to college, it’s important for him to make his own schedule and stick to it, says Dr. Gallagher. College class and study schedules are more variable than those in high school, so it will fall to a college student with type 2 diabetes to create consistency on their own. “Make sure you get dressed and get out of your room, go to the gym or do whatever physical activity you like every single day.” She also advises reaching out to those who manage the campus meal plan to find out what diabetes-friendly options they provide. Meanwhile, Tayé encourages other young people do what he has done to take back his health. “Just motivate yourself,” he says. “Find a goal and set it for yourself, whatever inspires you to lose the weight.”
