Type 2 Diabetes in Children

Years ago, it was rare to hear about a child with type 2 diabetes. Doctors used to think kids only got type 1. It was even called juvenile diabetes for a long time.

Not anymore. Now, according to the CDC, more than 208,000 people younger than 20 have diabetes. That number includes both type 1 and type 2 diabetes.

Here's what you need to know if your child is diagnosed with type 2.

What Is Type 2 Diabetes?

You've probably heard diabetes and high blood sugar mentioned together. Here's what happens. Your digestive system breaks down carbohydrates into a type of sugar called glucose. Your pancreas creates a hormone, known as insulin, that moves glucose from your blood into your cells, where it’s used for fuel.

In type 2 diabetes, the cells in your child's body don’t respond to the insulin, and glucose builds up in their bloodstream. This is called insulin resistance. Eventually, the sugar levels in their body get too high for it to handle. That could lead to other conditions in the future, like heart disease, blindness, and kidney failure.

Who Gets It?

Type 2 diabetes is most likely to affect kids who are:

  • Girls
  • Overweight
  • Have a family history of diabetes
  • American Indian, African American, Asian, or Hispanic/Latino
  • Have a problem called insulin resistance

The single biggest cause of type 2 diabetes in children is extra weight. In the U.S., nearly 1 out of every 3 children are overweight. Once a child gets too heavy, they're twice as likely to get diabetes.

One or more of these things may contribute to extra weight or obesity:

  • Unhealthy eating
  • Lack of physical activity
  • Family members (alive or dead) who've been overweight
  • Rarely, a hormone problem or other medical condition

As with adults, type 2 diabetes is more likely to affect children who carry extra weight around the middle.

What Are the Symptoms?

At first, there may be no symptoms. Over time, you may notice:

Take your child to the doctor if you notice any of these symptoms.

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How Is It Treated?

The first step is to get your child to the doctor. They can tell if they're overweight based on their age, weight, and height. They’ll test their blood sugar to see if they have diabetes or prediabetes. If they do have diabetes, it may take a few extra steps to find out if it's type 1 or type 2.

Until they know for sure, they may give them insulin. Once they confirm it's type 2 diabetes, they’ll ask you to help them make lifestyle changes. They may suggest they take a medication called metformin. It and insulin are the only two blood sugar-lowering medicines approved for kids younger than age 18, but others are being studied.

Your child should get a hemoglobin A1c test every 3 months. This test measures their average blood sugar levels over that period.

They’ll need to check their blood sugar:

  • When they start or change treatment
  • If they don't meet their treatment goals
  • If they have to take insulin
  • If they take a sulfonylurea drug

The doctor will teach you both how to test blood sugar and tell you how often. Most experts suggest three or more times a day if they're on insulin. If they're not, they can check less often, but should do it after meals. They can use a traditional finger stick test or a continuous glucose monitor.

Steps You Can Take

To keep your child’s eating on track and blood sugar controlled:

  • Work with a dietitian to create a meal plan: Three meals a day and a few scheduled snacks in between. Keep portion sizes sensible.
  • Have about the same amount of carbs at each meal to help prevent blood sugar spikes after eating. Carbs affect blood sugar more than other foods do.
  • Show your child how to count carbs.
  • Pack your child’s school lunch. If they're going to buy lunch, know what's on the menu so you can better manage their insulin and rest of their meals.
  • Pack boxes with juice, snacks, sugar tablets, and other things your child needs to treat low blood sugar. Put their name on the box and give one to your child, school nurse, and a teacher.
  • Plan for them to eat about the same time each day.

They should also get exercise for at least 60 minutes every day. Limit their screen time at home to less than 2 hours a day.

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Get Your Child Involved

One of the best things you can do for your child is to have them take part in managing their condition. The more they do, the more confident they’ll be.

Use your best judgment for what you think your child can handle. Even as they take on more responsibilities, keep an eye on things and give support when needed.

At ages 3-7, they can:

  • Choose which finger to use to check blood sugar levels.
  • Pick where to get the insulin shot.
  • Count before taking out the insulin pen or syringe.

At ages 8-11, they may:

  • Give themselves insulin while you watch.
  • Notice low blood sugar symptoms and treat themselves.
  • Learn carb counting and start picking some healthy food choices.

At age 12 and up, they may:

  • Check blood sugar and take insulin increasingly on their own.
  • Count carbs.
  • Set reminders on when to take pills or check levels.

Teen years can bring new challenges. Physical changes during puberty that can make it harder to control blood sugar. Also, weight and body image issues may start to show up. Watch your child for emotional issues, like depression and anxiety, and look out for eating disorders, too. If you have concerns, talk to their doctor. You may want to consider therapy.

Tips to Keep Your Child Safe

Follow these tips to help keep your child safe and healthy at home and at school:

  • Make sure that your child wears a medical ID bracelet or necklace at all times. This is especially important when they're not with you.
  • Give the school a detailed written plan for how to manage your child’s condition, including how to give insulin injections, meal and snack schedules, and a target blood sugar range. You can create this yourself or use a template called the Diabetes Medical Management Plan.
  • Create a 504 or an Individualized Education Program. These documents take what’s in your child’s diabetes medical plan and spell out the school’s responsibilities. They help keep your child safe and make sure they get the same education and opportunities as everyone else.
  • Make sure your child’s school, coaches, friends’ parents, and others know how to reach you and your child’s doctor in case of emergency.
  • Teach your child, family, and anyone responsible for your child how to notice low blood sugar and what to do about it.

Try to keep calm when your child makes mistakes managing diabetes. You need your child to feel comfortable telling you when something’s wrong instead of trying to hide it.

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Can You Prevent It?

The same steps used to treat type 2 diabetes in children can also prevent it. Reduce calories, unhealthy fats, and sweets in your child's diet. Make sure they get physical activity each day. Studies show that exercise has a dramatic effect on reducing insulin resistance. These are two important ways to help your child get down to and stay at a healthy weight and normal blood sugar levels.

Special Concerns

Children -- especially teens -- may have a tough time making changes to prevent or manage type 2 diabetes. Here are some ways you can help:

  • Talk with your child honestly about health and weight. Be supportive. Encourage them to speak up about their concerns.
  • Don't separate your child for special treatment. Your entire family can benefit from making changes in diet and activity.
  • Make changes slowly. Just as it took time for diabetes to develop, it will take time to achieve better health.
  • Do more activities your child enjoys. Lower the amount of time your family spends watching TV or playing video games.
  • If your child refuses to follow their plan, try to find out why. Teens, for example, are dealing with hormone changes, demands on their time, peer pressure, and other things that seem more important to them than their health.
  • Set small, easy-to-reach goals. Plan special rewards for your child when they meet each goal. Then move on to the next.
  • Talk to a diabetes educator, doctor, dietitian, or other diabetes professional for more ideas on how to help your child become healthier.

By working together, you, your child, and their diabetes health care team can be sure they remain healthy for years to come.

WebMD Medical Reference Reviewed by Michael Dansinger, MD on February 18, 2019

Sources

SOURCES: 

American Diabetes Association: "Friends & Family: Their Responses to Your Child's Diabetes," "Teens & Young Adults."
WebMD Medical News: "Obesity Doubles Kids' Risk of Diabetes: To Save Kids' Health, U.S. Must Tackle Childhood Obesity, Doctor Says."
American Academy of Pediatrics.
KidsHealth: “Treating Type 2 Diabetes.”
Mayo Clinic: “Blood Glucose Meter: How to Choose,” “Type 2 Diabetes in Children.”
HealthyChildren.org: “Type 2 Diabetes: Tips for Healthy Living.”
Hormone Health Network: “Type 2 Diabetes in Children.”
American Diabetes Association: “Food and Fun,” “Back-to-School Tips,” “Serious Lows,” “Communicating with Your Child.”
National Diabetes Services Scheme: “What Should I Eat?”
Texas Children’s Hospital: “Your child has type 2 diabetes: What’s a parent to do?”
Children’s of Alabama: “Age Related Guidelines for Diabetes.”
CDC: “Managing Diabetes at School Playbook.”

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