Description

Type 2 diabetes in children is a chronic disease that affects the way your child's body processes sugar (glucose) for fuel. Without treatment, the disorder causes sugar to build up in the bloodstream, which can lead to serious long-term consequences.

Type 2 diabetes is more common in adults. In fact, it used to be called adult-onset diabetes. But the increasing number of children with obesity has led to more cases of type 2 diabetes in younger people.

There are many things that you can do to help prevent or control type 2 diabetes in their child. Encourage your child to eat healthy foods, get plenty of physical activity and maintaining a healthy weight. If healthy eating and exercise are not enough to control type 2 diabetes, oral medications or insulin treatment may be needed.

Symptoms

Type 2 diabetes in children can develop so gradually that there is no noticeable symptoms. Sometimes, the disorder is diagnosed during a routine checkup.

Some children may experience these signs and symptoms as a result of an excess of sugar in your bloodstream:

  • Increased thirst
  • Frequent need to urinate
  • Increased hunger
  • Fatigue
  • Blurred vision
  • Dark background of the skin, most often around the neck or in the armpits and in the groin
  • Unintentional weight loss, although this is less common in children with type 2 diabetes than in children with type 1 diabetes
  • Frequent infections

When to see a doctor

See your health care provider 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 have started puberty or at least 10 years of age who are overweight or obese, and who have at least one other risk factor for type 2 diabetes.

Causes

The exact cause of type 2 diabetes is unknown. But the family history, and genetics seems to play an important role. What is clear is that children with type 2 diabetes can't process sugar (glucose) properly.

The majority of sugars in the body comes from the food. When food is digested, the sugar enters the bloodstream. Insulin allows sugar to enter cells and decreases the amount of sugar in the blood.

Insulin is produced by a gland located behind the stomach called the pancreas. The pancreas releases insulin into the blood when the food is eaten. When the blood sugar level starts to drop, the pancreas inhibits the secretion of insulin in the blood.

When your child has type 2 diabetes, this process doesn't work as well. As a result, instead of feeding the cells, sugar builds up in the bloodstream of the child. This can occur because:

  • The pancreas can not produce enough insulin
  • The cells become resistant to insulin and does not allow the same amount of sugar

Risk factors

The researchers do not fully understand why some children develop type 2 diabetes and others don't, even if they have similar risk factors. However, it is clear that certain factors increase the risk, including:

  • Weight. Being overweight is a risk factor for type 2 diabetes in children. The more adipose tissue that children have — especially in the interior, and between the muscle and skin around the abdomen — the most resistant of your bodies cells become to insulin.
  • The inactivity. The less active children are, the greater your risk of type 2 diabetes.
  • Of the diet. The consumption of red meat and processed meat and drink sugar-sweetened beverages is associated with an increased risk of type 2 diabetes.
  • The history of the family. The children's risk of type 2 diabetes increases if you have a parent or sibling with the disease.
  • Race or ethnic origin. Although it is not clear why some people — including Blacks, Hispanics, American Indians and Asian Americans, people are more likely to develop type 2 diabetes.
  • The age and the sex. Many children develop type 2 diabetes in their early teenage years, but can occur at any age. Adolescents are more likely to develop type 2 diabetes than are adolescent boys.
  • Maternal gestational diabetes. Children born to women who have had gestational diabetes during pregnancy have a higher risk of developing type 2 diabetes.
  • Low birth weight or premature birth. Have a low birth weight is associated with an increased risk of developing type 2 diabetes. Babies who are born prematurely, before the 39 to 42 weeks of gestation have an increased risk of type 2 diabetes.

Type 2 diabetes in children is often associated with the metabolic syndrome and polycystic ovary syndrome.

The metabolic syndrome

When certain conditions occur with obesity, which are associated with insulin resistance and may increase the risk of diabetes and heart disease and stroke. A combination of the following conditions is often called metabolic syndrome:

  • High blood pressure
  • Low levels of high-density lipoprotein (HDL) cholesterol, the "good" cholesterol
  • High triglycerides
  • High levels of sugar in the blood
  • Great waist size

Polycystic ovary syndrome

Polycystic ovary syndrome (PCOS) affects young women after puberty. PCOS is caused by an imbalance of hormones, which results in signs such as weight gain, irregular menstrual periods, and the excess of the face and hair of the body. People with this syndrome often have problems with metabolism, which can result in insulin resistance and type 2 diabetes.

Complications

Type 2 diabetes can affect almost any organ in the body of his son, including the blood vessels, nerves, eyes and kidneys. The long-term complications of type 2 diabetes develop gradually over many years. Finally, the complications of diabetes can be serious or even life-threatening.

The complications of type 2 diabetes are related to high sugar in the blood, and they are:

  • High cholesterol
  • Heart and blood vessels
  • Stroke
  • Damage to the nerves
  • Kidney disease
  • Disease of the eyes, including blindness

Keep your child's blood sugar level close to the standard range of the majority of the time can dramatically reduce the risk of these complications. You can help your child to avoid the complications of diabetes by:

  • Work with your child to keep a good control of blood sugar as much as possible
  • Teach your child the importance of healthy diet and participation in regular physical activity
  • Scheduling regular visits with your child's diabetes treatment team

Prevention

-A healthy life style choices can help to prevent type 2 diabetes in children. Encourage your child to:

  • Eat healthy foods. Offer your child foods that are low in fat and calories. Focus on fruits, vegetables and whole grains. Strive for variety to prevent boredom.
  • Get more physical activity. Encourage your child to become active. Enroll your child for a sports team or dance classes.

Better yet, make it a family affair. The lifestyle choices that can help prevent type 2 diabetes in children can do the same for the adults.

Diagnosis

If diabetes is suspected, the doctor will probably recommend a screening test. There are several blood tests to diagnose type 2 diabetes in children.

  • Random blood sugar. A blood sample is taken at a random time, regardless of when your child last ate. A random blood sugar level of 200 milligrams per deciliter (mg/dL), or 11.1 millimoles per liter (mmol/L) or higher suggests diabetes.
  • The fasting blood sugar test. A blood sample is taken after his son had nothing to eat or drink, but water for at least eight hours or overnight in the morning (on an empty stomach). A level of blood sugar fasting glucose of 126 mg/dL (7.0 mmol/L ) or higher suggests diabetes.
  • The glycosylated hemoglobin (A1C) test. This test shows that your child's average blood sugar level over the past 3 months. An A1C level of 6.5% or higher indicates diabetes.
  • Oral glucose tolerance test. Your child will need to fast overnight and then drink a sugary liquid in the doctor's office or in a test lab. Blood sugar levels are tested periodically for the next two hours. A blood sugar level of 200 mg/dL (11.1 mmol/L ) or more generally means that your child has diabetes.

Additional tests

Your health care provider may recommend additional tests to distinguish between type 1 diabetes and type 2 diabetes, because the treatment strategies for each different type.

Treatment

The treatment for type 2 diabetes is for life, and can include:

  • Healthy eating
  • Regular physical activity
  • Insulin or other medicines
  • Glucose monitoring
  • Weight loss surgery in some cases

You are going to work closely with your child's diabetes treatment team, including a health care provider, certified diabetes care and education specialist, registered dietitian, and other specialists as needed. The goal of treatment is to keep your child's blood sugar within a certain range. This target range helps to keep your child's blood sugar level as close to the standard range as possible.

Your child's health care provider will let you know what your child's blood sugar target range is, and you can also set an A1C target. These numbers may change as your child grows and changes and so will your child's diabetes treatment plan.

Healthy eating

The food is an important part of any treatment plan for your diabetes, but that doesn't mean your child has to follow a strict "diabetes diet." Your health care provider may recommend weight loss to achieve and maintain a healthy weight. Blood sugar levels can improve with weight loss.

Your child's dietitian is likely to suggest that his son — and the rest of the family — eating foods that are high in nutritional value and low in fat and calories.

A healthy diet includes a diet high in fruits, vegetables, nuts, whole grains, and olive oil. Choose foods that are low in fat and calories and high in fiber. Eat a variety of foods to help achieve the goals of your child, without compromising on taste and nutrition.

Your child's dietitian can help you create a meal plan that fits your child's food preferences and health goals, as well as help you plan to occasional treats. Your dietitian will also likely recommend that your child:

  • Reduce the size of the portions and you don't feel the need to finish everything on the plate
  • Substitute a fruit or vegetable to a carbohydrate-rich food
  • Replace high-calorie beverages, such as soft drinks or fruit juices with water
  • Eat at home more often instead of eating in restaurants or in obtaining food for take out restaurant
  • Help make meal
  • Eat at the dinner table instead of in front of the TV

Physical activity

Everyone needs regular aerobic exercise, and the children who have type 2 diabetes are no exception. Physical activity helps children to control their weight, it uses the sugar for energy, and causes the body to use insulin more effectively. This can reduce the sugar in the blood.

Make physical activity part of your child's daily routine. Time of the activity does not have to be all at once — it is good to break into smaller chunks of time. Encourage your child to get at least 60 minutes of physical activity daily, or, better yet, exercise with your child.

Medicine

There are three medications that have been approved by the Food and Drug Administration (FDA) for the treatment of type 2 diabetes in children.

  • Metformin (Glumetza, others). This pill reduces the amount of sugar a child's liver releases into the bloodstream between meals and will help the cells of the body use insulin more effectively.
  • Liraglutide (Victoza). This medicine is taken by injection. Liraglutide helps the body release more insulin from the pancreas after a meal, when blood sugar levels are higher. This medication can have the digestive system of the side effects, such as nausea or diarrhea.
  • Insulin.Sometimes, the insulin may be needed if your child's blood sugar levels are very high. Insulin allows the sugar into cells for energy, the reduction of the amount of sugar in the bloodstream. There are a number of different amounts of insulin, but the long-acting insulin once a day, along with a short-or rapid-acting insulin with meals, often used for type 2 diabetes in children. Insulin is typically delivered through a syringe or an insulin pen. With lifestyle changes, medicines, and other medicines, your child may be able to be weaned off insulin.

Insulin. Sometimes, the insulin may be needed if your child's blood sugar levels are very high. Insulin allows the sugar into cells for energy, the reduction of the amount of sugar in the bloodstream.

There are a number of different amounts of insulin, but the long-acting insulin once a day, along with a short-or rapid-acting insulin with meals, often used for type 2 diabetes in children. Insulin is typically delivered through a syringe or an insulin pen.

With lifestyle changes, medicines, and other medicines, your child may be able to be weaned off insulin.

Glucose monitoring

Your health care provider will let you know how often you or your child need to check and record your child's blood sugar. Children who take insulin, usually, need to test more frequently, possibly four or more times a day.

Depending on the needs of treatment, continuous glucose monitoring may be an option. Frequent testing is the only way to make sure that your child's blood sugar level is maintained within the target range.

Weight loss surgery

These procedures are not an option for everyone. But for teenagers who are significantly obese patients with a body mass index (BMI) equal to or higher than 35 — view the weight-loss surgery can lead to the improvement of the management of type 2 diabetes.

Ongoing medical care

Your child will need regular appointments to ensure the good management of diabetes. Visits with your child's health care provider may include a review of your child's blood sugar patterns, typical of the eating habits, physical activity, weight, and medications if they are taken. Healthy-lifestyle changes can reduce the need for medications.

Your health care provider may check your child's A1C levels. The American Diabetes Association recommends an A1C of 7% or less for all children and adolescents with diabetes.

Your health care provider also periodically review your child:

  • The growth of the
  • Blood pressure
  • Cholesterol levels
  • Kidney and liver function
  • Eyes — usually annually
  • Feet
  • Risk of polycystic ovary syndrome and obstructive sleep apnea

Your doctor will probably recommend a flu vaccine for their child each year, and may recommend the vaccine against pneumonia and COVID-19 vaccine if your child is 5 years of age or older.

Signs of problems

Despite their best efforts, sometimes problems arise. Certain short-term complications of type 2 diabetes — such as low blood sugar, high blood sugar, diabetic ketoacidosis and the hyperosmolar hyperglycemic state require immediate attention.

Low blood sugar (hypoglycemia)

Hypoglycemia is a blood sugar level below your child's target range. Blood sugar levels can drop for many reasons, including skipping a meal, eating less carbs than expected, do more physical activity than typical or inject too much insulin. Children with type 2 diabetes have less risk of having low levels of sugar in their blood than children with type 1 diabetes.

The signs and symptoms of low blood sugar include:

  • Pallor
  • Tremors
  • The hunger
  • Sweating
  • Irritability and mood swings
  • Difficulty concentrating or confusion
  • Dizziness or lightheadedness
  • Loss of coordination
  • Speech difficulty
  • Loss of consciousness
  • Seizures

Teach your child the symptoms of low blood sugar. In case of doubt, the child should always do a blood sugar test. If a blood glucose meter is not readily available and your child has symptoms of a low level of sugar in the blood, the treatment for low blood sugar, and then the test as soon as possible.

If your child has a low level of sugar in the blood of the reading:

  • Giving a fast-acting carbohydrate. Has your child consumes 15 to 20 grams of fast-acting carbohydrate, such as fruit juice, glucose tablets, hard candy, regular (not diet) soda or other source of sugar. Foods with added fat, such as chocolate or ice cream, do not raise the blood sugar quickly, because the fat slows down the absorption of sugar.
  • Repeat the test for sugar in your blood. Repeat the test your child's blood sugar in about 15 minutes to make sure that it is back in the target range. If not, repeat giving a fast-acting carbohydrate and tests in 15 minutes as needed until you get a reading in your child's target range.

High blood sugar (hyperglycemia)

Hyperglycemia is a blood sugar level above your child's target range. Blood sugar levels can increase for many reasons, including disease, eating too much, eating certain types of food, and not taking enough medication for diabetes or insulin.

The signs and symptoms of high blood sugar include:

  • Frequent need to urinate
  • Increased thirst or dry mouth
  • Blurred vision
  • Fatigue
  • Nausea

If you suspect that the hyperglycemia, check your child's blood sugar. You may need to adjust your child's meal plan or medications. Contact your pediatrician if your child's blood sugar regularly above its target range.

Diabetic ketoacidosis

A severe lack of insulin causes the body of his son to the production of certain toxic acids (ketones). If the excess ketones build up, your child may develop a life-threatening condition known as diabetic ketoacidosis (dka). The CAD is more common in children with type 1 diabetes, but can sometimes occur in children with type 2 diabetes.

The signs and symptoms of CAD include:

  • The thirst or a very dry mouth
  • Increased urination
  • Dry or redness of the skin
  • Nausea, vomiting, or abdominal pain.
  • A sweet, fruity smell of your child in the breathing
  • The confusion

If you suspect DKA , check your child's urine for excess ketones using an over-the-counter ketone test kit. If ketone levels are high, call your doctor or seek emergency care.

Hyperosmolar hyperglycemic state

Hyperosmolar hyperglycemic state (HHS) can develop over a period of a couple of days in children with type 2 diabetes. The very high level of sugar in blood HHS — 600 mg/dL or higher — can develop serious infections, disease, or other medical conditions. The attempt of the body to get rid of the high level of sugar by passing it into the urine resulting in severe dehydration.

The signs and symptoms of HHS include:

  • No or minimal amount of ketones in the urine
  • Increased urination
  • Increased thirst
  • Your mouth is dry and warm, dry skin
  • The confusion or combativeness
  • Seizures
  • Comma

HHS can be life-threatening and requires emergency care.

Lifestyle and home remedies

Helping your child follow the plan of treatment of diabetes takes round-the-clock commitment. But be careful with the management of type 2 diabetes can reduce the risk of your child from serious complications.

As your child grows:

  • Encourage your child to take an increasingly active role in the management of diabetes
  • To emphasize the importance of life diabetes care
  • Teach your child how to test blood sugar levels and the use of medication and injected the insulin if it is necessary to
  • Help your child to make healthy food choices
  • Encourage your child to be physically active and limit electronic screen-time
  • Foster a relationship between your child and the treatment of the diabetes team
  • Make sure that your child wears a medical identification tag

The school and the diabetes

You will need to work with the school nurse and teachers to ensure that they know the symptoms of high and low blood sugar levels. The school nurse may need to administer insulin, or check your child's blood sugar.

The Federal law protects children with diabetes, and schools must make reasonable accommodations to ensure that all children receive a suitable education.

When to contact your care team diabetes

Please contact your physician, certified diabetes care and education specialist, or registered dietitian between appointments if your child's blood sugar is constantly out of the target range your doctor. Also in contact with the health care team if you are not sure of what to do in a given situation.

Coping and support

Living with type 2 diabetes is not easy for you or for your child. Good management of diabetes requires a lot of changes, especially in the beginning. That is why some specialists in diabetes, regularly include a social worker or a psychologist as part of their diabetes care teams. Don't forget that you're not alone and your diabetes treatment team can help.

If you notice that your child or teen is persistently sad or pessimistic, or experiences dramatic changes in sleeping habits, friends, or school performance, have your child assessed for depression.

The rebellion can also be a problem, especially for teenagers. A child who has been very good in order to comply with the plan of treatment of diabetes may rebel, in adolescence, in disregard of diabetes care. In addition, experimentation with drugs, alcohol and smoking can be even more dangerous for people with diabetes.

Speak with a counselor or therapist can help your child cope with the dramatic lifestyle changes that come with a diagnosis of type 2 diabetes. Websites that offer support services, which include the American Diabetes Association (ADA).

Preparing for your appointment

Your child's family doctor or pediatrician will probably make the initial diagnosis of diabetes. However, it is likely that after being referred to a specialist in metabolic disorders in children (pediatric endocrinologist).

Your child's health care team in general also includes a certified diabetes care and education specialist and a registered dietitian.

Here's some information to help you prepare for your appointment.

What you can do

Prior to her appointment, take these steps:

  • Ask about any pre-appointment restrictions. If the health care provider is going to control your blood sugar, your child might need to fast for eight hours, depending on the type of test.
  • Make a list of the symptoms your child is experiencing, including any that may seem unrelated to the reason for your appointment.
  • Ask a family member or a friend to join you, if possible. The management of diabetes requires you to remember a large amount of information. Someone who accompanies you may remember something that you missed or forgot.
  • Make a list of questions to ask your health care provider.

Some basic questions to ask your doctor include:

  • How often do you need to monitor my child's blood sugar?
  • What should I tell my child's blood sugar levels during the day and before going to bed?
  • What changes need to be made in your family's diet?
  • How much exercise should my child receive each day?
  • Does my child need to take medication? If so, what kind and how much?
  • What are the signs and symptoms of complications should I look for?
  • My son has another health problem. How can we best manage them together?
  • How often does my child need to be monitored for diabetes care? What specialists do we see?

Don't hesitate to ask additional questions during the appointment.

What to expect from your doctor

Your doctor may ask you a series of questions, such as:

  • How comfortable are you with the management of your child's diabetes?
  • What is a typical day of eating like for your child?
  • Is your child to exercise? If so, how often?
  • How do you feel that your child is doing in front of diabetes and its treatment?
Symptoms and treatment of Type 2 diabetes in children