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Type 2 Diabetes in Children

  • Learning About Type 2 Diabetes

    Image for kids with type2 diabetes article Glucose is a type of sugar. Under normal conditions, rising glucose levels in the blood cause the pancreas to produce a hormone known as insulin. Insulin allows the glucose in the blood to enter the cells of the body and be converted into energy. Type 2 diabetes develops when the body loses its ability to respond properly to insulin.
    In type 2 diabetes, the body’s cells become less sensitive to insulin. As a result, large amounts are required for glucose control. Unfortunately, the pancreas cannot maintain this high level of insulin production indefinitely, and eventually the body loses the ability to produce all the insulin it needs. At this point, blood sugar levels rise. Despite these high blood sugar levels, symptoms of diabetes may either be absent or mild.
    In contrast, type 1 diabetes occurs only after the pancreas is severely damaged by the body’s immune system. The damaged pancreas can no longer produce enough insulin. Instead of the high levels of insulin and insulin resistance seen in type 2 diabetes, very low levels of insulin occur in type 1 diabetes. As a result, sudden serious illness requiring emergency insulin treatment is common in type 1 diabetes.
  • Finding the Causes and Risk Factors

    Obesity is the major cause of most type 2 diabetes. The tissue of overweight people often becomes resistant to insulin. Since physical activity improves tissue sensitivity to insulin, physically inactive people may also have tissues that are more insulin resistant.
    The short-term effects of type 2 diabetes include:
    • Frequent urination
    • Increased thirst
    • Fatigue
    Possible long-term effects of type 2 diabetes include:
    • Eye disease and vision problems
    • Kidney disease
    • Heart disease and circulatory problems, including stroke
    • Nerve damage, neuropathy
    • Problems with wound healing
    • Reduced life expectancy
  • Screening and Diagnosing

    According to the American Diabetes Association (ADA), doctors should begin to screen children for diabetes at age 10 or puberty if they are overweight and have at least two other risk factors for diabetes. Screening should be repeated every 3 years. In addition to obesity, other risk factors for type 2 diabetes include:
    The risk of type 2 diabetes is higher in children of African American, Asian American, Native American, and Pacific Islander descent.
    A blood test is done for screening and diagnosis. The most commonly used test is the fasting plasma glucose, a blood test done after a person has fasted for eight hours. A fasting plasma glucose (blood sugar) level of 126 milligrams per deciliter or greater on two separate occasions is diagnostic of diabetes. Other tests, like a hemoglobin A1c (HbA1c) test or a two-hour glucose tolerance test, can also be done to diagnose diabetes.
  • Making Lifestyle Changes

    Managing blood sugar levels requires major lifestyle changes for children. To succeed, children need adult supervision and support. The entire family should work with a diabetes team (doctor, nurse, social worker, dietitian, and exercise counselor) to develop a healthy lifestyle.
    Children living with type 2 diabetes need daily strategies to maintain normal blood sugar levels. These include:
    • Planning healthy meals
      • Eliminate regular sodas, limit carbohydrates and sugar-sweetened fruit juice, and have your child eat whole grains and vegetables.
      • Count grams of carbohydrates and read food labels.
    • Increasing physical activity
      • Encourage your child to get plenty of active play time every day.
      • Plan for periods of low blood sugar caused by activity. Carry short-acting glucose or carbohydrates.
    • Monitoring and taking medications
      • Check your child's blood sugar levels throughout the day if directed. There are different ways to check blood sugar levels. Some methods involve pricking the finger or arm and applying a drop of blood to a meter with a glucose-sensitive strip.
      • Schedule regular eye and foot exams to detect and treat early vision and circulatory problems.
      • Have your child's blood pressure and cholesterol levels monitored.
      • To control blood sugar, have your child take medications and/or insulin injections as prescribed.
  • Preventing Type 2 Diabetes in Children

    The primary preventive measures for type 2 diabetes are maintaining a healthy weight and getting regular exercise. A diet with age appropriate calorie intake and plenty of fruits and vegetables is ideal for diabetes prevention. Active daily play should also be encouraged in school and at home. Children should have fun exercising instead of spending a lot of time online, watching TV, or playing video games.
  • RESOURCES

    American Diabetes Association http://www.diabetes.org

    HealthyChildren.org—American Academy of Pediatrics http://www.healthychildren.org

    CANADIAN RESOURCES

    Canadian Diabetes Association http://www.diabetes.ca

    Health Canada http://www.hc-sc.gc.ca

    References

    Am I at risk for type 2 diabetes? National Diabetes Information Clearinghouse website. Available at: http://diabetes.niddk.nih.gov/dm/pubs/riskfortype2/#7. Updated July 23, 2012. Accessed January 30, 2014.

    American Diabetes Association. Standards of medical care in diabetes—2012. Diabetes Care. 2012;35(suppl 1:S11–63).

    Diabetes mellitus type 2. EBSCO DynaMed website. Available at: http://www.ebscohost.com/dynamed. Updated January 29, 2014. Accessed January 30, 2014.

    Diabetes mellitus type 2 screening. EBSCO DynaMed website. Available at: http://www.ebscohost.com/dynamed. Updated January 22, 2014. Accessed January 30, 2014.

    Diabetes Public Health Resource. Centers for Disease Control and Prevention website. Available at: http://www.cdc.gov/diabetes/. Updated January 6, 2014. Accessed January 30, 2014.

    Diet and exercise delay diabetes and normalize blood glucose. National Institute of Diabetes and Digestive and Kidney Diseases website. Available at: http://www.nih.gov/news/pr/feb2002/hhs-06.htm. Published February 6, 2002. Accessed January 30, 2014.

    Facts about type 2. American Diabetes Association website. Available at: http://www.diabetes.org/diabetes-basics/type-2/facts-about-type-2.html. Updated January 23, 2014. Accessed January 30, 2014.

    Hopkin K. Confronting diabetes from all angles. Howard Hughes Medical Institute Bulletin. 2001:16-21.

    Mansfield J. Pediatric and Adolescent Endocrinology, Joslin Diabetes Center. Personal communications. May 27, 2003 and June 5, 2003.

    McLean M, Chipps D, Cheung NW. Mother to child transmission of diabetes mellitus: does gestational diabetes program type 2 diabetes in the next generation? Diabet Med. 2006;23(11):1213-1215.

    Morrison JA, Friedman LA, Wang P, Glueck CJ. Metabolic syndrome in childhood predicts adult metabolic syndrome and type 2 diabetes mellitus 25 to 30 years later. J Pediatr. 2008;152(2):201-206.

    What you need to know about type 2 diabetes in children. Children With Diabetes website. Available at: http://www.childrenwithdiabetes.com/d%5F0n%5Fd00.htm. Updated October 19, 2005. Accessed January 30, 2014.

    2/15/2010 DynaMed's Systematic Literature Surveillance http://www.ebscohost.com/dynamed: American Diabetes Association. Standards of medical care in diabetes—2010. Diabetes Care. 2010;33(suppl 1:S11-61).

    2/15/2010 DynaMed's Systematic Literature Surveillance http://www.ebscohost.com/dynamed: American Diabetes Association. Diagnosis and classification of diabetes mellitus. Diabetes Care. 2010;33(suppl 1:S62-69).

    8/27/2010 DynaMed's Systematic Literature Surveillance http://www.ebscohost.com/dynamed: Lobelo F, Liese AD, Liu J, et al. Physical activity and electronic media use in the SEARCH for diabetes in youth case-control study. Pediatrics. 2010;125(6):e1364-71. Epub 2010 May 10.

    4/14/2014 DynaMed's Systematic Literature Surveillance http://www.ebscohost.com/dynamed: Xi B, Li S, et al. Intake of fruit juice and incidence of type 2 diabetes: a systematic review and meta-analysis. PLoS One. 2014;9(3):e93471.

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