More children are being diagnosed with this blood sugar condition. Learn how to help manage or prevent this chronic disease in your child.
Type 2 diabetes in children is a chronic disease that affects the way your child's body processes sugar (glucose). Without treatment, the disorder causes sugar to build up in the blood, which can lead to serious long-term consequences.
Type 2 diabetes occurs more commonly in adults. In fact, it used to be called adult-onset diabetes. But type 2 diabetes in children is on the rise, fueled by the obesity epidemic.
There's plenty you can do to help manage or prevent type 2 diabetes in children. Encourage your child to eat healthy foods, get plenty of physical activity and maintain a healthy weight. If diet and exercise aren't enough to control type 2 diabetes in children, oral medication or insulin treatment may be needed.
Type 2 diabetes in children may develop so gradually that there are no noticeable symptoms. Sometimes, the disorder is diagnosed during a routine check-up.
Other children might experience:
See your child's doctor if you notice any of the signs or symptoms of type 2 diabetes. Undiagnosed, the disease can cause serious damage.
Diabetes screening is recommended for children who are overweight or obese who have started puberty or are at least 10 years old and have at least one other risk factor for type 2 diabetes. Other risk factors include having a family history of diabetes, being a nonwhite race or having signs of insulin resistance, such as darkened skin patches on the neck or armpits.
The exact cause of type 2 diabetes is unknown. But family history and genetics appear to play an important role. Inactivity and excess fat — especially fat around the belly — also seem to be important factors.
What is clear is that people with type 2 diabetes can't process glucose properly. As a result, sugar builds up in the bloodstream instead of doing its normal job of fueling the cells that make up muscles and other tissues.
Most of the sugar in people's bodies comes from the food they eat. When food is digested, sugar enters the bloodstream. Moving sugar from the bloodstream to the body's cells requires the hormone insulin.
Insulin comes from a gland located behind the stomach called the pancreas. The pancreas releases insulin into the blood after a person eats.
As insulin circulates, it allows sugar to enter the cells — lowering the amount of sugar in the bloodstream. As the blood sugar level drops, so does the secretion of insulin from the pancreas.
Type 2 diabetes develops when the body becomes resistant to insulin or when the pancreas stops making enough insulin. The resulting buildup of sugar in the bloodstream can cause symptoms of high blood sugar.
Researchers don't fully understand why some children develop type 2 diabetes and others don't, even if they have similar risk factors. However, it's clear that certain factors increase the risk, including:
Type 2 diabetes can affect nearly every major organ in your child's body, including the blood vessels, nerves, eyes and kidneys. The long-term complications of type 2 diabetes develop gradually over many years. Eventually, diabetes complications may be disabling or even life-threatening.
Complications of type 2 diabetes include:
Keeping your child's blood sugar level close to normal most of the time can dramatically reduce the risk of these complications.
Healthy lifestyle choices can help prevent type 2 diabetes in children. If your child already has type 2 diabetes, lifestyle changes can reduce the need for medications and the risk of complications. Encourage your child to:
Better yet, make it a family affair. The same lifestyle choices that can help prevent type 2 diabetes in children can do the same for adults. The best diet for a child with diabetes is also the best diet for the whole family.
If diabetes is suspected, your child's doctor will likely recommend a screening test. A diagnosis of type 2 diabetes in children generally requires abnormal results from two tests taken on different days. There are several blood tests for diabetes.
Your doctor will likely recommend additional tests to distinguish between type 1 diabetes and type 2 diabetes, because treatment strategies for each type differ.
Your child will need regular follow-up appointments to check his or her A1C levels and ensure good diabetes management. Your doctor will also periodically check your child's:
Your child will also need annual eye examinations.
Treatment for type 2 diabetes is lifelong and includes:
As your child grows and changes, so will his or her diabetes treatment plan. You'll work closely with your child's diabetes treatment team — doctor, certified diabetes educator and dietitian — to keep your child's blood sugar level as close to normal as possible in order to prevent complications later.
Your doctor will let you know how often you need to check and record your child's blood sugar. Children who take insulin usually need to test more frequently, possibly three times a day or more. Checking your blood sugar usually requires finger sticks, although some blood glucose meters allow for testing at other sites. Testing is the only way to make sure that your child's blood sugar level remains within his or her target range — which may change as your child grows.
Because kids are still growing, the focus is on slowing down weight gain instead of losing weight. Your child's dietitian will likely suggest that your child — and the rest of the family — consume fewer animal products and sweets.
Your dietitian is also likely to recommend that you:
Physical activity lowers blood sugar. Encourage your child to get regular aerobic physical activity for at least an hour a day and, better yet, exercise with your child. Activity time doesn't have to be all at once — you can break it down into smaller chunks of time.
There are three medications that have been approved by the Food and Drug Administration for treating type 2 diabetes in children — metformin (Glumetza, others), liraglutide (Victoza) and insulin. Metformin is a pill and liraglutide and insulin are taken by injection.
Metformin reduces the amount of sugar a child's liver releases into the bloodstream between meals and helps the body's cells use insulin more effectively. Liraglutide helps the body release more insulin from the pancreas after meals, when blood sugar levels are higher. Both drugs may have digestive system side effects, such as nausea or diarrhea.
Sometimes, insulin may also be needed if your child's blood sugar levels are very high. With lifestyle changes and other medications, your child may be able to be weaned off insulin.
There are a number of different insulins, but a long-acting insulin, such as insulin glargine (Lantus), is often used for type 2 diabetes in children. Insulin is typically delivered via a syringe or an insulin pen. An insulin pump programmed to dispense specific amounts of insulin might also be an option for children who need to take insulin more frequently.
These procedures are not an option for everyone. But, for teens who are significantly obese — a BMI above 35 — having weight loss surgery may lead to a remission in type 2 diabetes.
Despite your best efforts, sometimes problems will arise. Certain short-term complications of type 2 diabetes — such as low blood sugar, high blood sugar and ketoacidosis — require immediate care.
Hypoglycemia (sometimes called an "insulin reaction") is a blood sugar level below your child's target range. Blood sugar can drop for many reasons, including skipping a meal, eating fewer carbohydrates than you planned to, getting more physical activity than normal or injecting too much insulin. Children with type 2 diabetes have less risk of low blood sugar than do kids with type 1 diabetes.
Signs and symptoms of low blood sugar include:
If your child has a low blood sugar reading:
Hyperglycemia is a blood sugar level above your child's target range. Blood sugar levels can rise for many reasons, including illness, eating too much, eating the wrong types of foods, and not taking enough diabetes medication or insulin.
Signs and symptoms of high blood sugar include:
If you suspect hyperglycemia, check your child's blood sugar. You might need to adjust your child's meal plan or medications. If your child's blood sugar is persistently above his or her target range, call your child's doctor or seek emergency care.
A severe lack of insulin causes your child's body to produce certain toxic acids (ketones). If excess ketones build up, your child may develop a potentially life-threatening condition known as diabetic ketoacidosis (DKA). DKA is more common in children with type 1 diabetes, but can sometimes occur in children with type 2 diabetes.
Signs and symptoms of DKA include:
If you suspect DKA, check your child's urine for excess ketones using over-the-counter ketone strips. If the ketone levels are high, call your child's doctor or seek emergency care.
Helping your child follow his or her diabetes treatment plan takes round-the-clock commitment. But careful management of type 2 diabetes can reduce your child's risk of serious complications.
As your child gets older:
You'll need to work with your child's school nurse and teachers to make sure they know the symptoms of high and low blood sugar levels. Federal law protects children with diabetes, and schools must make reasonable accommodations to ensure that all children get a proper education.
Although many alternative therapies have been touted as possible ways to treat or prevent type 2 diabetes, there's no definitive evidence that any of these alternative therapies are effective.
Some supplements or alternative therapies might be harmful if combined with certain prescription medications. Talk with your child's doctor about the pros and cons of specific alternative therapies you might be considering.
Living with type 2 diabetes isn't easy — for you or for your child. Good diabetes management requires a lot of changes, especially in the beginning. If you notice that your child or adolescent is persistently sad or pessimistic, or experiences dramatic changes in sleeping habits, friends or school performance, have your child assessed for depression.
Your child may find encouragement and understanding in a type 2 diabetes support group for children. Support groups for parents also are available. Websites that offer support include the American Diabetes Association (ADA).
Your child's family doctor or pediatrician will probably make the initial diagnosis of diabetes. However, you'll likely then be referred to a doctor who specializes in metabolic disorders in children (pediatric endocrinologist).
Your child's health care team will also generally include a dietitian, a diabetes educator and a doctor who specializes in eye care (ophthalmologist).
Here's some information to help you get ready for your appointment.
Before your appointment take these steps:
Some basic questions to ask your child's doctor include:
In addition to the questions that you've prepared to ask your doctor, don't hesitate to ask additional questions that may come up during the appointment.
Your doctor is likely to ask you a number of questions, such as:
Contact your child's doctor or diabetes educator between appointments if your child's blood sugar isn't well controlled, or if you're not sure what to do in a certain situation.
December 24th, 2020