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Medication nightmare

Discussion in 'Parents of Children with Type 1' started by Kaileen, Sep 20, 2008.

  1. Kaileen

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    I am seriously questioning our endo at this point. Our daughter is slightly overweight, so he has given her some medications that are supposed to help her lose weight.

    What concerns me is he's put her on Metformin. I read the insert, and it said that Metformin is not recommended for children 10 and under. When I called the pharmacist, he said that studies had not been done on the medication for children, and that is the doctor has experience with the medication, it should be fine.

    I had to work, so I could not go to the endo appointment with them. James asked the endo how safe it was, and he said he hadn't seen any problems with it. The only problems he had seen were some children who started throwing up after having their dosage increased to two pills at a time.

    He has her on one pill twice daily, and he has also put her on acerbose three times daily. Both are supposed to help her lose weight. He has also put her on an exercise regimen, which today has left her extremely sore. I am skeptical, to say the least. Has anyone else had any experience with this, and was it positive or negative? I'm scared. I'm scared for her.
     
  2. moco89

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    Acarbose blocks carbohydrate absorption in the small intestines. I could see the possible benefits for a type 2 diabetic and possibly very carefully with an adult with type 1.

    However, considering that you dose for insulin based on carbohydrate consumption, acarbose/glucobay is not a good idea.

    Also, the efficiency of acarbose is based exclusively on the rate in which the stomach empties medicine out in to the small intestines, which can vary a lot. This determines how, or whether or not the carbs are going to get absorbed. This adds another variable, which could really wreak havoc on blood sugars, leading to wide fluctuations of highs and lows-all because of carbohydrate absorption issues.

    So, maybe you should consider getting a second opinion, if you do not like your child's doctor's decisions.
     
  3. Mody_Jess_Pony

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    I would question him it seems like he has set her on a regiemn I would expect an adult not a child would be put on.
    Her excersize regiemn should be CHILD apropriate and fun not a forced thing causes PAIN!
    Do you guys have acess to a Dance Dance Revolution game? You have a dance pad and it hooks up to a PS2 console. Hours of fun and you can track weight and calories burned. Or a game like the WI fit?
    I know when I had to lose weight swiming and horse back rding all activities I found fun worked.
    I would also question the Metformien I do not think it should be used on children IMHO
     
  4. danismom79

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    I know metformin is used to treat type 2s who are overweight, but I've never heard of it being used specifically to address weight.

    And if he's added exercise in there too, I think I would probably test her more often. Increased exercise, insulin, and metformin could cause some lows.

    ETA: Had he suggested an exercise and/or nutrition plan before, or was medication his first step?
     
    Last edited: Sep 20, 2008
  5. Kaileen

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    Thanks. I appreciate that. This is something I would love to do, and something I've been needing to do for a long time. I may have to call around and see if there's a regular endo around here that will see her. This pediatric endo is the only one we have. :( I have tried one that was highly recommended to me by several co-workers, but we will not take children.

    Her muscles are hurting bad. I'm strongly considering taking her off this crap and trying something else. She just started it today. He's been on her about her weight since we started seeing him. At the time we started, she was only 5 pounds over what he said she should be. Now she's 30 pounds over and both children now have complexes about it.
     
  6. s0ccerfreak

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    I would look for a second opinion.
    I'm on metformin, a mm pump, and lantus, but havent seen much of a change in bg's or weight with the metformin. The idea was it would make me more sensitive to insulin so I wouldn't need so much. If I wasn't taking as much insulin, I would lose weight.
     
  7. Kaileen

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    Jess, I love having you on here. Your perspective is fantastic. :) We don't have any of that, but it may be an investment we need to make. She loves going for walks, so we'll have to do that more.
     
  8. Kaileen

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    Will do on the testing more. I get worried about her going too low. He has not suggested anything else before the medication.

    I just found out he had her do 150 sit-ups, 150 jumping jacks, and 150 toe touches yesterday. No wonder she's sore.
     
  9. danismom79

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    That right there would be reason enough for me to start looking for someone more supportive.

    Tonight she could probably use a nice hot soak in the tub and a massage with some rubbing alcohol. Try to get her to stretch a little too.

    How about sports? I was a heavy child, and there was nothing I hated more than having to exercise. Fun activities that got me moving were just fine though, since it wasn't "exercise" to me.
     
  10. Kaileen

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    Thank you so much. Deirdre will be on a pump soon, so this helps a lot. I didn't know that metformin was supposed to react like that.
     
  11. s0ccerfreak

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    I don't know if that is how it is suppose to react- that is just what my endo said at the time
     
  12. danismom79

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    Oh hell no. My daughter used to have to do sit ups in tae kwon do, but nowhere near that many, and she'd be sore for a couple of days. I would have her lie on her back, and stretch her hands over her head, while reaching her toes in the opposite direction.

    And that's just not how you start someone, especially a child, on a workout plan. I agree with the above suggestion of dance dance revolution or WII if you have access to it. I hate to workout and I could play DDR for an hour without realizing it. Same with WII.
     
  13. Lisa P.

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    What is your feeling about her weight? I think you're the mom and whether you switch endos or not, if you don't want to take this approach you should not. And if you think the doctor is doing more harm than good with his opinions about her weight, I would think it is entirely within your rights to ask him not to discuss weight issues in front of her. I don't think health care professionals really know what they think they know about weight gain and loss, and while there may be something specific about the situation that warrants his approach, I am extremely leery of doctors who prescribe medication for things that aren't diseases.
     
  14. tiffanie1717

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    OKay, this just seems weird to me. Maybe I am out of touch, but she is only 9 years old. Isn't this a rather strict exercise/medication path for someone so young? Personally, unless it was really hurting her health, I would not use medication for weight loss at her age. Getting her involved in a sport or some of the things Jess said would be the age-appropriate thing to do. Encouraging her to do exercise - walking, swimming, playing, running - instead of tv or computer would be appropriate. 150 sits up, etc. right off the bat? Not appropriate at all in my book.

    I think it's good to be aware of weight in our children (and ourselves as I sit here more than 30 pounds overweight!), but making it such a big issue at such a young age is just going to lead to other problems down the road.

    I'd be looking elsewhere for sure. I don't want someone else's opinions of my children shaping their emotional growth.
     
  15. Mama Belle

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    Please seek another opinion. I personally would be very uncomfortable with his recommendations. The intense exercise program in itself would really worry me. You want her to grow up feeling good about making healthy choices; this regimen only puts her at odds with a healthy lifestyle. I think Jess's suggestions in this regard were very good. What are her I:C ratios like?
     
  16. speakup4kids

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    My first thought was really to wonder if maybe the increased weight gain wasn't in fact caused BY the doctor. I have seen it numerous times in children around this age... the focus on weight tends to cause a problem that previously was minimal or non-existant. At nine girls are going through a natural transition through puberty and will have body changes. Any focus on food restrictions will make them want more...forcing exercise tends to make them hate it. The other possibility is that they do become very worried about how they look and head into the world of eating disorders. I was only about ten or eleven when I started fixating on weight and by sixteen was a full fledged anorexic. By eighteen, in congestive heart failure. I started underweight but one comment by my sister set something off inside my head that is still part of my daily battle. As a nine year old child that could eat anything and not gain a thing, I had a healthy appetite. I was told one day to "watch what I eat because one day it will all catch up to me" that's all it took. I am not writing this for any reason other than to beg you to please get a second opinion and see another doctor. Teaching your daughter to love healthy foods and eat whenever she is hungry will help her so much more than medicine and diets and fear tactics by doctors. Kids this age can have so much fun weeding a garden or playing four square outside, the important part is not focusing on muscle groups like situps do but learning to enjoy physical activity. Sorry for the lecture..:) I am a bit impassioned about things like this!!:eek:
     
  17. bgallini

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    I don't know about the medication.

    But I do know that having a 9 yo do 150 sit ups, jumping jacks and toe touches is absurd! She is not going to enjoy that! She is going to hate that. Then she will want to exercise less.

    I would talk to her regular pediatrician about the metiform and about her weight in general.

    Maybe her insulin regime needs to be changed.

    As far as losing weight. You mentioned she likes walks....do that....walks in the neighborhood often. Walks at local parks at least weekly. Hikes in nature areas when you can. Also you can look into letterboxing (www.letterboxing.org) or find other activities that will encourage walking and moving.

    Bike riding can also be fun to do as a family.

    The Dance, Dance Revolution and/or Wii games might be worth investing in.

    Maybe she'd like a sport...tae kwon do, soccer, softball, dance, gymnastics, swimming....Or if she's not sure, see if your county/city has a recreation program with different sports lessons...then she can try things out w/o as much commitment or $$.

    And of course, you can make some changes to her diet....but just make small changes. You may be able to simply change how you cook some foods in order to make them healthier rather than totally eliminating some foods she loves (but aren't healthy).

    I know how you feel about having only one pediatric endo practice in the area. But I found out as Alex was turning 18 that there really was another peds endo in town. And maybe there's another endo at your ped's practice that will be easier to work with.
     
    Last edited: Sep 20, 2008
  18. Treysmom

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    I'm sorry I just don't agree with the exercise program. The endo sounds like a quack. I would try to switch to another endo if poss. If she's just a little overweight, what is the big concern.

    We bought a Wii. The Wii fit is great. My dd Sarah loves it, she was slightly over weight. She has lost some of that since trying the Wii fit. The biggest reason my dd was slightly over weight, is lack of exercise. Turing into a young woman will cause weight gain in some girls.

    I believe children should get their exercise outside riding bikes, running, playing.

    Good Luck in whatever decision you make. Make it fun!!
     
  19. Judith

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    Metformin is sometimes used in type 1 children/teens who are insulin resistant. Adding Acarbose at the same time certainly confuses the picture...as if it wasn't already complex enough using 3 insulins. If indeed she did all that exercise you mentioned it's not surprising that she has sore muscles. HOWEVER be advised that a serious side effect/complication of meformin is lactic acidosis, which presents as muscle pain. I think it would be very wise to check with the doctor immediately, before giving her any more doses of metformin. There are many advantages to having a ped endo versus an adult endo for the management of a child's diabetes, but in this case I do think a second opinion is warranted and if an adult endo is your only choice ........
     
  20. coni

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    I don't know anything about the use of the meds your doc wants your child to take in order to lose weight, so I can not comment on it other than to say I do not like my children on any medication without a sound rationale that can be thoroughly explained to my satisfaction...

    My first concern would be that the insulin regime my child is on is not causing weight gain. Are the doses correct? Am I feeding the insulin?

    Assuming the insulin regime was not the cause, my second concern would be to address the weight issues through healthy eating habits and adequate physical activity (notice I did not say exercise, since that makes it a chore in my mind!).

    I would be cautious about how much emphasis on weight I would place on my child at this age. One, it could cause eating issues, and two, many kids "chunk up" pre-puberty to prepare for a rapid growth phase. You know your child's medical treatment, family environment and genes. What do you think is going on?

    Also, be cautious about a doctor who may actually be the cause of the problem with their practices.

    I agree that a second opinion would be useful.
     

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