Type 2 Diabetes in Children

What is type 2 diabetes in children?

Diabetes is a condition in which the body can't make enough insulin. Or can't use insulin normally. Type 2 diabetes is a metabolic disorder. Insulin is a hormone. It helps sugar (glucose) in the blood get into cells of the body to be used as fuel. When glucose can’t enter the cells, it builds up in the blood. This is called high blood sugar (hyperglycemia). High blood sugar can cause problems all over the body. It can damage blood vessels and nerves. It can harm the eyes, kidneys, and heart.

What causes type 2 diabetes in a child?

The cause of type 2 diabetes is unknown. But it can run in families. It often takes another factor, such as obesity, to bring on the condition.

Which children are at risk for type 2 diabetes?

A child is more at risk for type 2 diabetes if they have any of these risk factors:

• Family history of type 2 diabetes

• Being overweight

• Not exercising regularly

• Being African American, Hispanic American, Asian/Pacific Islander, or American Indian

• A low-level HDL cholesterol

• A high triglyceride level

• Being female

• Having slightly high blood sugar levels (prediabetes)

• Their mother had diabetes during pregnancy

• They had a low birth weight

What are the symptoms of type 2 diabetes in a child?

Type 2 diabetes often causes no symptoms. When symptoms occur, they can include:                                                                                                                                               

• Frequent bladder infections

• Skin infections and wounds that don’t heal easily

• Needing to urinate often

• Weight loss despite increased appetite  

• Excess thirst

• Blurred vision

• Weakness and severe tiredness (fatigue)

• Grouchiness (irritability) and mood changes

• Nausea and vomiting

• High levels of glucose in the blood and urine when tested

• Tingling or loss of feeling in the hands or feet

• Darkened areas of skin, especially around the neck or armpits

The symptoms of type 2 diabetes can seem like other health conditions. Make sure your child sees their healthcare provider for a diagnosis.

How is type 2 diabetes diagnosed in a child?

Children at higher risk of type 2 diabetes should be screened. Screening may include tests, such as:

• Glycated hemoglobin A1C. This test measures the amount of glucose in red blood cells. It shows the average blood glucose levels for the last 2 to 3 months.

• Fasting plasma glucose. The blood is tested after at least 8 hours of not eating.

• Oral glucose tolerance test. This test is done by measuring blood glucose levels 2 hours after drinking a glucose drink. If this test is used for screening, be sure your child has at least 5.25 ounces (150 grams) of carbohydrates per day for 3 days before the test.

Other urine and blood tests may be done to see if your child has type 2 diabetes. 

How is type 2 diabetes treated in a child?

Treatment will depend on your child’s symptoms, age, and general health. It will also depend on how severe the condition is. The goal of treatment is to keep blood glucose levels as close to normal as possible. Treatment will include:

• A healthy diet

• Weight loss, if needed

• Regular exercise

• Good hygiene

• Insulin replacement therapy (under the direction of your child's healthcare provider)

• Regular checking of blood sugar levels

• Medicines taken by mouth (oral), if needed

If your child has severe diabetes and is school-age, work with school personnel to educate them about your child's condition and to establish a plan of care.

What are possible complications of type 2 diabetes in a child?

Children with type 2 diabetes are at risk for problems, such as:

• High blood pressure

• High cholesterol

• Nonalcoholic fatty liver disease

• Depression

• Eating disorders

Other possible complications that may show up later in life include:

• Vascular disease

• Kidney damage

• Eye damage

• Heart disease

• Damage to the nervous system

What can I do to prevent type 2 diabetes in my child?

Lifestyle changes that may prevent or delay type 2 diabetes include: 

• A healthy diet

• Weight loss, if needed

• Regular exercise

How can I help my child live with type 2 diabetes?

Type 2 diabetes is a long-term (chronic) condition. It requires lifestyle changes to keep healthy blood glucose levels. It’s important to work closely with your child's healthcare team to create an ongoing plan that works for your child.

It helps if the whole family makes lifestyle changes together to develop healthy habits. For example:

• Eating at least 5 servings of fruits and vegetables each day

• Eating foods high in fiber and low in fat

• Eating smaller portion sizes off smaller plates

• Not having sugary drinks

• Doing regular physical activity each day, such as sports, bike riding, or walking

• Limiting screen time to no more than 1 to 2 hours a day, including TV, computer, and video games                                

• Keep all follow-up appointments. Ongoing monitoring is especially important for children with diabetes.

When should I call my child's healthcare provider?

Call your child’s healthcare provider if they are at risk for diabetes or if they show any of the symptoms of type 2 diabetes listed above. Contact your provider if your child has a diagnosis of type 2 diabetes and current symptoms get worse or new symptoms appear. If your child doesn't respond to the typical treatments for type 2 diabetes, they may be referred to an endocrinologist for additional evaluation.

Key points about type 2 diabetes in children

• Diabetes is a condition in which the body can't make enough insulin. Or can't use insulin normally. Type 2 diabetes is a metabolic disorder.

• High blood sugar can cause problems all over the body. It can damage blood vessels and nerves. It can harm the eyes, kidneys, and heart.

• Risk factors for type 2 diabetes include family history, excess weight, and not enough exercise.

• Children at higher risk of type 2 diabetes should be screened. Screening is done with blood tests.

• Treatment includes a healthy diet, regular exercise, and weight loss. Medicines and insulin may be needed in some cases.

• Regular checkups are especially important for children with diabetes

Next steps

Tips to help you get the most from a visit to your child’s healthcare provider:

• Know the reason for the visit and what you want to happen.

• Before your visit, write down questions you want answered.

• At the visit, write down the name of a new diagnosis, and any new medicines, treatments, or tests. Also write down any new instructions your provider gives you for your child.

• Know why a new medicine or treatment is prescribed and how it will help your child. Also know what the side effects are.

• Ask if your child’s condition can be treated in other ways.

• Know why a test or procedure is recommended and what the results could mean.

• Know what to expect if your child does not take the medicine or have the test or procedure.

• If your child has a follow-up appointment, write down the date, time, and purpose for that visit.

• Know how you can contact your child’s provider after office hours. This is important if your child becomes ill and you have questions or need advice.