he thinks about how close he came to losing his son
Mark Butts Jr. cries when he thinks about how close he came to losing his son.
Mark Butts III (left), 12, and his brother Christopher, 10, shoot hoops near their home. Mark is the youngest in his family to have Type2 diabetes. The family now makes an effort to exercise at least 30 minutes a day.
The Coppell father of four was rounding up the family Sept. 2 for a trip to Six Flags Over Texas. But a glassy look on the face of his eldest, 12-year-old Mark Butts III, brought back a terrifying memory.
“He looked just like my mom before she passed away,” Mr. Butts says, tearing up at the family’s kitchen table.
Remembering his mother, who died three years ago at age 61, he took Mark to the emergency room. The nurse tested Mark’s blood glucose level and found it was more than 700 milligrams per deciliter. A normal range is 80 to 130 mg/dL before meals and less than 180 after meals, according to the American Diabetes Association.
“I was scared, too,” Mark says softly, sitting beside his parents.
The doctors, who kept Mark at Children’s Medical Center Dallas for three days, said that if Mr. Butts had not brought him in promptly, his son might have gone into a coma and died. He has Type 2 diabetes, just as Mr. Butts’ mother did.
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Mark’s blood sugar log is periodically faxed to his doctor.
One reason the diagnosis took Mr. Butts by surprise is that Type 2 traditionally hits adults such as his mother, whose condition was diagnosed in her 40s, and his wife, Sandra, now 38, who developed gestational diabetes with her second pregnancy, only to find that it turned into Type 2 diabetes after the birth.
Seventy-three thousand Americans die of diabetes or its complications annually. Of affected children, 78 percent have Type 1, according to the ADA. With that, the pancreas doesn’t produce insulin to break down the sugar in food needed to nourish the body. Type 2 diabetes used to be called adult-onset diabetes because it hit heavy adults who produced insulin, but not enough for their weight.
But Type 2 diabetics are getting younger, says Dr. Jon Oden, a pediatric endocrinologist at Children’s Medical Center Dallas.
“Since our obesity clinic was initiated in April 2006, we are finding more and more kids diagnosed with Type 2 in our emergency room,” he says. “It’s still predominantly an adult problem. The peak incidence of Type 2 is 40 years of age. But we are finding 3 to 4 percent of obese kids with Type 2 diabetes and 15 to 20 percent with pre-diabetes. We saw 400 patients in the first year, and now we see 10 to 18 new patients every week. It’s very concerning.”
A recent study by the New York University School of Medicine bears out Dr. Oden’s observations. According to the study, the number of children with Type 2 diabetes increased 176 percent from 1997 to 2003, based on three samplings of 10,000 children taken over the course of six years.
In recognition of the growing problem, researchers are conducting a five-year national study called Treatment Options for Type 2 Diabetes in Adolescents and Youth that compares medicines and treatment strategies for Type 2 diabetes. The Web site is www.todaystudy.org.
Now, Mark says he feels much better, thanks to carefully monitoring the sugar in his blood, taking insulin and following a diet that he records in a log book every day.
He also does 30 minutes of exercise daily on a stationary bicycle or at the school park across the street, where he plays basketball with his father and younger brother. Christopher, 10, understands that a good diet and exercise could help prevent him from developing the disease.
“I eat less,” Christopher says. “I’m losing weight.”
And Mr. Butts is relieved to hear it. The truck driver lost his job after Mark’s hospital stay, and he is paying for interim insurance while waiting for coverage from a new employer to kick in. The family is trying to pay $2,000 of Mark’s hospital bill that insurance didn’t cover.
But “not getting the insulin, not getting the right food, is not an option,” Mr. Butts says, even though he has not quite figured out how to make it happen.
“Losing my mom about killed me,” Mr. Butts says. “But losing a child, that would kill me.”
The news about the health of American kids hasn’t been good.
Alarms have been sounding, from the recent results of the new statewide school Fitnessgram to the rise in Type 2 diabetes in children, which often is caused by obesity and lack of exercise.
That’s why it’s so heartening to see a child, with the help of a devoted family, buck the trend.
[Click image for a larger version] MONA REEDER/DMN
MONA REEDER/DMN
Mark Butts, 12, gets encouragement from sister Alexandra, 4, on his stationary bike. Mark has worked hard to control diabetes.
Every day when 12-year-old Mark Butts pedals determinedly on a stationary bike, he offers a glimmer of hope amid the dark statistics.
Last year, Mark weighed 317 pounds. His parents didn’t know he was in danger until Sept. 2, when they rounded up their four kids for a trip to Six Flags Over Texas. Mark Butts Jr., 36, and his wife, Sandra, 39, saw the glassy look on their oldest child’s face and realized that he needed to go to a hospital emergency room.
Fortunately, they got there quickly.
When Mark arrived at Children’s Medical Center Dallas, he was diagnosed with Type 2 diabetes and was suffering from ketoacidosis (key-toe-ass-i-DOE-sis), a condition involving dangerously high levels of ketones, acids that can poison the body when it doesn’t have enough insulin.
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“We resolved the ketoacidosis over the course of eight to 12 hours, and we put him on insulin injections,” says Dr. Bassil Kublaoui, an endocrinologist at Children’s and an assistant professor at UT Southwestern Medical Center. At that point, Mark’s case seemed sadly typical.
“When you get obese, you produce hormones that can make you insulin-resistant,” Dr. Kublaoui explains, adding that when he arrived at the hospital seven years ago he saw two children per year with Type 2 diabetes. Now, he sees 50 to 60 cases a year and predicts that the number will rise.
Mark and his family shared their story in a Nov. 6 Dallas Morning News article about children with Type 2 diabetes. They showed us how he draws blood several times a day to check his blood sugar. At the time, he also took four insulin shots each day.
Dr. Kublaoui and the hospital staff talked to Mark and his family about how weight loss and exercise can turn things around. But the doctor knew from experience that this was a tough prescription.
“The vast majority of patients I have with Type 2 diabetes continue to gain weight despite their best efforts,” the doctor says. “No more than 20 percent manage to get off insulin.”
Determination
But Mark was different. With his dad’s modest salary as a truck driver, there was no extra money for fitness programs. But the Butts family was determined to improve Mark’s health and to keep his younger siblings from developing the disease.
They banished the deep-fat fryer and started using an outdoor grill. They got rid of chips and packaged snacks and put a bowl of fruit in the center of the table. During my June interview with the family, Mark’s 7-year-old brother, Andrew, snacked on carrots. Later, his mother fixed him a can of water-packed tuna mashed with a little mayonnaise and mustard – no bread.
On Halloween, the kids gave away most of their trick-or-treat candy. On Thanksgiving, the family baked fewer pies and limited each person to one piece.
At Christmas, Mark received a 21-speed bicycle, a welcome addition to the stationary exercise bike and daily walks with the family.
Sharing
Among the treats the family misses are Mr. Butts’ aromatic peanut butter cookies.
But if they have less on their plates, they have more in their hearts from sharing. On Valentine’s Day, when Mark received a box of four chocolates, he kept one and gave the other three to his siblings.
Already a close family, the disease has brought them closer.
That, the doctor believes, is the difference that helped Mark improve enough to be taken off insulin injections on his April 24 visit. And at a checkup in late July, he was told he could check his blood sugar less frequently: just twice a day.
“He’s done really well,” Dr. Kublaoui says.
Mark, now 264 pounds, takes a pill called metformin, which treats high blood sugar by reducing the amount of glucose made by the liver.
He’s thrilled.
“I’m happy because I don’t have to take shots. That’s a relief. No pain in the arms. Everything is better.”
Still, he has a goal.
“I want to go under 200 pounds,” he says. If he does, Dr. Kublaoui says, he could stop taking metformin, too.
We’ll be rooting for Mark to do just that.
