Type 2 Diabetes in Children
Learning About Type 2 Diabetes
Under normal circumstances, rising glucose levels (a type of sugar) in the blood cause the pancreas to produce the hormone 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 progressively less sensitive to insulin and, therefore, very large amounts are required for glucose control. Unfortunately, the pancreas cannot maintain this elevated 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 so mild as to escape attention.
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 adequate amounts of insulin. Therefore, 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 quite common in type 1 diabetes.
Finding the Causes and Risk Factors
Obesity is the major cause of most type 2 diabetes because the tissue of overweight people frequently becomes resistant to insulin. Since physical activity improves tissue sensitivity to insulin, physically inactive people also have tissues that are more insulin resistant.
The short-term effects of type 2 diabetes include:
Possible long-term effects of type 2 diabetes include:
Screening and Diagnosing
According to the American Diabetes Association (ADA), doctors should begin to screen children for diabetes at age 10 or puberty, whichever comes first, 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, the risk factors for type 2 diabetes include:
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 their 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, dietician, 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:
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. Vigorous daily play should also be encouraged in school and at home. Rather than spending time online, watching TV, or playing video games, children should have fun exercising.
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Last reviewed May 2012 by Brian Randall, MD