Overview

Type 2 diabetes in children is a chronic disease that affects the way your child's body processes sugar (glucose). It's important to manage your child's diabetes because its long-term consequences can be disabling or even life-threatening.

Type 2 diabetes is more commonly associated with adults. In fact, it used to be called adult-onset diabetes. But type 2 diabetes in children is on the rise, fueled largely 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.

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Symptoms

Type 2 diabetes in children may develop gradually. About 40 percent of children who have type 2 diabetes have no signs or symptoms and are diagnosed during routine physical exams.

Other children might experience:

• Increased thirst and frequent urination. Excess sugar building up in your child's bloodstream pulls fluid from tissues. As a result your child might be thirsty — and drink and urinate more than usual.
• Weight loss. Without the energy that sugar supplies, muscle tissues and fat stores simply shrink. However, weight loss is less common in children with type 2 diabetes than in children with type 1 diabetes.
• Fatigue. Lack of sugar in your child's cells might make him or her tired and lethargic.
• Blurred vision. If your child's blood sugar is too high, fluid may be pulled from the lenses of your child's eyes. Your child might be unable to focus clearly.
• Slow-healing sores or frequent infections. Type 2 diabetes affects your child's ability to heal and resist infections.

When to see a doctor

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 all children and adolescents who are overweight and have at least two other risk factors for type 2 diabetes.

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Causes

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 abdominal fat — also seem to be important factors.

What is clear is that people with type 2 diabetes don't process glucose properly anymore. As a result, sugar accumulates in the bloodstream instead of doing its normal job of fueling the cells that make up muscles and other tissues.

Most of the glucose 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 a hormone (insulin).

Insulin comes from the pancreas, a gland located behind the stomach. The pancreas secretes insulin into the bloodstream after a person eats.

As insulin circulates, it allows sugar to enter the cells — and lowers 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 life-threatening complications.

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Diagnosis

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.

Fasting blood sugar test

A blood sample is taken after your child fasts for at least eight hours, or overnight. Blood sugar values are expressed in milligrams per deciliter (mg/dL) or millimoles per liter (mmol/L).

In general:

• A fasting blood sugar level below 100 mg/dL (5.6 mmol/L) is considered normal.
• A fasting blood sugar level from 100 to 125 mg/dL (5.6 to 7.0 mmol/L) is considered prediabetes — which indicates a high risk of developing type 2 diabetes.
• A fasting blood sugar level of 126 mg/dL (7.0 mmol/L) or higher indicates type 2 diabetes.

Glycated hemoglobin (A1C) test

Your doctor might recommend this test if your child's fasting blood sugar test results don't indicate diabetes but the doctor still suspects it.

The A1C test indicates your child's average blood sugar level for the past two to three months. Specifically, the test measures the percentage of blood sugar attached to the oxygen-carrying protein in red blood cells (hemoglobin). The higher your child's blood sugar levels, the more hemoglobin your child will have with sugar attached.

In general:

• An A1C level below 5.7 percent is considered normal.
• An A1C level between 5.7 and 6.4 percent is considered prediabetes.
• An A1C level of 6.5 percent or higher on two separate tests indicates type 2 diabetes.

Oral glucose tolerance test

A blood sample is taken after your child fasts for at least eight hours or overnight. Then your child drinks a sugary solution, and his or her blood sugar levels are measured periodically over the next few hours.

In general:

• A blood sugar level less than 140 mg/dL (7.8 mmol/L) is considered normal.
• A blood sugar level from 140 to 199 mg/dL (7.8 to 11.0 mmol/L) is considered prediabetes.
• A blood sugar level of 200 mg/dL (11.1 mmol/L) or higher indicates type 2 diabetes.

Random blood sugar test

A blood sample is taken at a random time. Regardless of when your child last ate, a random blood sugar level of 200 mg/dL (11.1 mmol/L) or higher suggests diabetes.

Additional tests

Your doctor will likely recommend additional tests to confirm the type of diabetes that your child has. It's important to distinguish between type 1 diabetes and type 2 diabetes because treatment strategies differ.

After the diagnosis

Your child will need regular follow-up appointments to ensure good diabetes management and to check his or her A1C levels. Your doctor will also periodically use blood and urine tests to check your child's:

• Cholesterol levels
• Thyroid function
• Kidney and liver function

In addition, your doctor will regularly assess your child's blood pressure and growth. Your child will also need regular eye examinations.

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Complications

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. But eventually, diabetes complications may be disabling or even life-threatening.

Complications of type 2 diabetes include:

• High blood pressure
• High cholesterol
• Heart and blood vessel disease
• Stroke
• Nonalcoholic fatty liver disease
• Kidney disease
• Blindness
• Amputation
• Certain skin conditions

Keeping your child's blood sugar level close to normal most of the time can dramatically reduce the risk of these complications.

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Prevention

Healthy lifestyle choices can help prevent type 2 diabetes in children and its complications. And if your child already has type 2 diabetes, lifestyle changes can reduce the need for medications. Encourage your child to:

• Eat healthy foods. Offer your child foods 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. Sign up for a sports team or dance lessons, or look for active things to do together.

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.

Alternative medicine

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.

Talk to your child's doctor about dietary supplements or other alternative therapies to treat or prevent type 2 diabetes. Some of these supplements or alternative therapies might be harmful if combined with certain prescription medications. Your child's doctor can help you weigh the pros and cons of specific alternative therapies.

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Lifestyle and home remedies

Type 2 diabetes is a serious disease. Helping your child follow his or her diabetes treatment plan takes round-the-clock commitment. But your efforts are worthwhile. Careful management of type 2 diabetes can reduce your child's risk of serious — even life-threatening — complications.

As your child gets older:

• Encourage him or her to take an increasingly active role in diabetes management
• Stress the importance of lifelong diabetes care
• Teach your child how to test his or her blood sugar and inject insulin if needed
• Help your child make wise food choices
• Encourage your child to remain physically active
• Foster a relationship between your child and his or her diabetes treatment team

Above all, stay positive. The habits you teach your child today will help him or her enjoy an active and healthy life with type 2 diabetes.

School and diabetes

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.

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Coping and support

Living with type 2 diabetes isn't easy — for you or for your child. Good diabetes management requires a lot of time and effort, especially in the beginning.

Diabetes can affect your child's emotions both directly and indirectly. Poorly controlled blood sugar can cause behavior changes, such as irritability. 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 are also available. Websites that offer support include the American Diabetes Association (ADA).

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Risk factors

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:

• Weight. Being overweight is a primary risk factor for type 2 diabetes. The more fatty tissue children have — especially inside and between the muscle and skin around the abdomen — the more resistant their bodies' cells become to insulin. The association between obesity and type 2 diabetes is even stronger in youth than in adults.
• Inactivity. The less active your child is, the greater his or her risk of type 2 diabetes. Physical activity helps your child control his or her weight, uses glucose as energy, and makes your child's cells more responsive to insulin.
• Family history. Children's risk of type 2 diabetes increases if they have a parent or sibling with the disease.
• Race. Although it's unclear why, people of certain races — including African-Americans, Hispanics, Native Americans, Asian-Americans and Pacific Islanders — are more likely to develop type 2 diabetes.
• Age and sex. Many children develop type 2 diabetes at the start of puberty. Adolescent girls are likelier to develop type 2 diabetes than are adolescent boys.
• Birth weight and gestational diabetes. Low birth weight and being born to a mother who had gestational diabetes during the pregnancy are both associated with a higher risk of developing type 2 diabetes.

Source: http://www.mayoclinic.com