Health News from Pediatric Experts at THE Children’s hospital of michigan
Trampolines: Fun or Foolish? page 2
Beyond the Norm: Atypical Diabetes page 3
The Dangers of Food Dyes page 4
FALL 2010
Trampolines: Fun or Foolish?
D
uring early fall, when the heat of late summer passes and children are playing outside more, they crave play equipment that lets them burn off the extra energy suppressed during a long day at school. Often, one of their requests is for a trampoline. While jumping on a trampoline seems like a fun activity, it can be quite dangerous. A Range of Injuries During the months when outdoor play is the norm, hospitals have an increased number of trampoline injuries. These injuries range from sprains and fractures, to occasional concussions or more serious injuries. In a study conducted by the Department of Orthopedics at Children’s Hospital of Michigan, an alarming 74 percent of trampoline injuries were fractures. It’s easy to assume that these fractures were the result of neglecting safety precautions such as protective netting or padding. However, in a survey given to some parents of patients with trampoline injuries, 56 percent said that precautionary measures had been taken. Of that 56 percent, all claimed that the trampoline had protective netting. Most of the tram-
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poline related injuries actually occurred be administered,”adds Richard Reynolds, off of the equipment, while 22 percent M.D., Surgeon-in Chief and Chief of of the injuries happened while on the Orthopedic Surgery at Children’s Hospital trampoline. That number does not include of Michigan. ■ the 7.2 percent of injuries that happened because of collisions and 3.7 percent that were the result of incorrect landing on Richard A. Reynolds, M.D. the trampoline. Safety Measures Of course the best safety insurance is to keep your child away from trampolines. But parents also need to anticipate the unexpected friend or neighbor who might have a trampoline that your child is tempted to use. The following safety measures are supported by the Foundation for Spinal Cord Injury and Prevention, Care and Cure as well as the Department of Orthopedics at the Children’s Hospital of Michigan. 1. Make sure there is some form of trampoline protection, such as protective netting. This will help protect from falls off the trampoline. 2. Allow only one person to jump on the trampoline at a time. This will avoid collision injuries. 3. Have adult supervision at all times. “Although precautions do not guarantee that your child will not be injured, having adult supervision will prevent injuries resulting from imaginative use of trampolines, such as one case where a child jumped from a roof onto a trampoline,” says Julie Legakis, Ph.D., Senior Research Associate, Department of Orthopedics at Children’s Hospital of Michigan. “Luckily, the child was not seriously injured.” “Adult supervision also assures appropriate and rapid response in case of an injury, allowing for proper treatment to
America’s best ER doctors are waiting to see you. Our philosophy is, patients should not wait to see an emergency physician. The DMC hospitals are the only ones who will provide real-time ER Wait Times. Just go to www.dmc.org/ERwait or get the ER wait iTunes app by going to http://itunes.apple.com/us/ app/detroit-medical-center-er/ id374011138?mt=8 to get a wait time app on your iPhone or iTouch, for the most current DMC ER wait times at your fingertips, as well as a special mapping function to show you how to get to any DMC hospital, including the Children’s Hospital of Michigan, from any location. Is texting more your style? Text “ER” to 42660 to get the current ER wait times by a quick reply text. Save the number to your address book for when you need it most. (Texting charges may apply.)
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Beyond the Norm: Atypical Diabetes
M
ost people are familiar with two types of diabetes: type 1 and type 2. But few may be aware of another type, atypical diabetes mellitus, or ADM, which doesn’t fit the mold. What ADM Is Not To understand ADM, it’s helpful to know the basics of the more common forms of diabetes. Type 1 diabetes typically Kathleen Moltz, M.D. develops in children and teens. People with type 1 diabetes must take insulin each day to survive. The primary problem in type 1 diabetes is insulin deficiency and the cause is thought to be both genetic and autoimmune-related. Type 2 diabetes typically develops in adulthood. People with type 2 diabetes may be able to control their blood sugar with exercise, healthy eating, and weight loss; most need oral medication and many still require insulin. The primary problem in type 2 diabetes is insulin resistance (insulin that doesn’t work correctly). The cause is thought to be genetic and environmental/obesityrelated. Kathleen Moltz, M.D., a pediatric endocrinologist at DMC Children’s Hospital of Michigan and manager of the diabetes team, reports, “Twenty percent of all children with new diabetes are now found to have type 2 diabetes. This number is lower in some groups (people of Finnish heritage) and higher in other groups (descendants of some Native American groups). Often the type of diabetes is not clearly identifiable at diagnosis. This is particularly true in patients who have atypical diabetes.” Not Quite Type 1 or Type 2 People with ADM do not have typical type 1 or type 2 diabetes. ADM was first reported in young African-Americans
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who had symptoms of both type 1 and type 2 diabetes. ADM also tends to affect Native Americans and Hispanics. People with ADM often develop high blood sugar quickly and often present at diagnosis with high levels of certain acids in their blood much like type 1 diabetes. But as their disease progresses the need for insulin decreases and in many ways health issues look more like type 2 diabetes. People with ADM need to take insulin initially but after 10 to 12 weeks their blood sugar may return to normal. So unlike people with type 1 diabetes, they may not need lifelong insulin treatment. These people don’t become seriously ill immediately when they fail to take insulin but may still develop the long-term complications associated with high blood sugars and out-of-control diabetes. And similar to type 2 diabetes, the need for insulin increases with duration of diabetes, so that many people with ADM return to use of insulin after some time off this medication. Too Much Weight May Be a Factor What causes ADM is currently a mystery. Genes may play a role. Many people with ADM have a strong family history of diabetes. Some researchers think extra pounds also may be an issue. Weight gain may speed up the onset of insulintreated diabetes and contribute to the development of ADM. Generally, young people with type 1 diabetes are not overweight, but that may be changing. A study in the journal Diabetes Care found that the prevalence of being overweight at the onset of insulindependent diabetes has tripled in children and teens since the 1980s. At this point, ADM is not wellunderstood. The causes of type 1 and type 2 diabetes have not been fully identified. And there is no cure for diabetes. Doctors advise those
without diabetes to take steps that may lower the risk of developing diabetes, including staying active and eating a healthy, balanced diet high in fiber and low in processed foods. According to Dr. Moltz, “In the end, we know much more about how to treat diabetes mellitus than how to prevent diabetes. Diabetes in 2010 is a life-changing diagnosis, but one that can be managed and fit into the lives of most people. The key to success is good communication with a knowledgeable team of diabetes experts who are interested in tailoring a treatment plan specifically for each patient.” ■
Participants in the ADA’s Step Out: Walk to Fight Diabetes.
The 2010 American Diabetes Association walk, Step Out: Walk to Fight Diabetes, will take place October 2 at the Detroit Zoo. Registration for walkers will start at 7:30 a.m. and the walk start time is 8:15 a.m. Herman B. Gray, M.D., MBA, President of the Children’s Hospital of Michigan and this year’s corporate recruitment chair for the walk, encourages everyone to come out, register to walk, have some fun and lend your support for the ADA’s Cure – Care – Commitment. For more information, go to: www.childrensdmc.org
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Consumer Group Warns About Food Dyes
T
he Center for Science in the Public Interest (CSPI), a consumer advocacy group, has challenged the Food and Drug Administration to ban the three most widely used food dyes—Red 40, Yellow 5, and Yellow 6—because they say the dyes are contaminated with carcinogens, something that the Food and Drug Administration has acknowledged for years. “These synthetic chemicals do absolutely nothing to improve the nutritional quality or safety of foods, but trigger behavior problems in children and, possibly, cancer in anybody,” says CSPI Executive Director Michael F. Jacobson, co-author of the 58-page report, “Food Dyes: A Rainbow of Risks.” “The Food and Drug Administration should ban dyes, which would force industry to color foods with real food ingredients, not toxic petrochemicals.”
DMC Children’s Hospital of Michigan ranks among the nation’s top 30 hospitals in the U.S.News & World Report 2010–11 edition of Best Children’s Hospitals. As a major referral center for all aspects of pediatric cardiology and having performed more pediatric heart transplants than any other hospital in the state, the Children’s Hospital of Michigan has been recognized among the best for heart and heart surgery.
“Food dyes—used in everything from M&Ms to Manischewitz Matzo Balls to Kraft salad dressings—pose risks of cancer, hyperactivity in children, and allergies, and should be banned,” says CSPI’s report. Fortunately, says CSPI, many natural colorings are available to replace dyes. Beet juice, beta-carotene, blueberry juice concentrate, carrot juice, grape skin extract, paprika, purple sweet potato or corn, red cabbage, and turmeric are some of the substances that provide a vivid spectrum of colors. However, CSPI warns that “natural” does not always mean safe. Some natural dyes have been known to cause allergic reactions. “While severe allergies to dyes are rare, parents should always do what is best for their children. A varied diet that includes plenty of fresh fruits and vegetables would be ideal,” says Keenan Bora, M.D., Children’s Hospital of Michigan Poison Center. “This is easiest to do by demonstrating good eating choices ourselves and with our children when they first start eating solid foods.” ■ Photo: Horia Varlan
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safe sound Herman Gray, M.D., President Children’s Hospital of Michigan Vickie Dahlman-Anger, Editor To ask a health question, dial 313-745-5437. For story suggestions, call 313-745-5340 or e-mail
[email protected]. Safe & Sound provides general health information and is not intended to provide personal medical advice, which should be sought from a physician. © 2010. Printed in U.S.A. Printed on Recyclable Paper
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Children’s Hospital of Michigan After-Hours Pediatric Urgent Care at the Stilson Specialty Center 19 Mile Rd. 18 Mile Rd.
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