BDA


Type 2 Diabetes in Children


Definition

Definition of Type 2 diabetes in children Type 2 diabetes in children is a condition that affects the way your child’s body metabolizes sugar (glucose). The amount of glucose in the blood is too high because the body cannot use it properly. Insulin, a hormone in our body, is needed to allow glucose to pass into the body’s cells to provide. Type 2 diabetes develops in your child when they can still produce some insulin, but not enough, or when the cells do not respond to the insulin produced properly (known as insulin resistance).

Type 2 diabetes used to be called adult-onset diabetes, because in the past it was mostly associated with adults. However, in recent years type 2 diabetes in children is rising. In Bermuda, like other countries such as the US and UK, the rise has mirrored the obesity epidemic.

There is plenty to do to help manage or prevent type 2 diabetes in children. Such as, encouraging healthy eating, ensuring plenty of activities and exercise and maintaining a healthy weight. If diet and exercise is not enough to control type 2 diabetes, oral medications or insulin can be used.

Symptoms

Type 2 diabetes in children may develop gradually with few or no signs or symptoms. Some may experience:

  • Increased thirst and urination
  • Increased hunger
  • Blurred vision
  • Tiredness or fatigue
  • Frequent infections
  • Acanthosis nigricans

Knowing the Risks

Researchers don’t fully understand why some children develop type 2 diabetes and others don’t; however, it is clear that certain factors increase the risk:
Risks of Type 2 diabetes in children

  • Weight: Being overweight is a primary risk factor for type 2 diabetes in children. Your GP or pediatrician can help assessing whether; your child is overweight by measuring their (body mass index) BMI. If their BMI is over the 85th percentile then that is considered overweight. Being overweight is not the only risk factor therefore some children of normal weight can develop type 2 diabetes.
  • Inactivity: The less active your child is, the greater is his or her risk for developing diabetes. Keeping physically active helps your child’s body to use glucose for energy, makes your child’s cells more responsive to insulin and helps control their weight.
  • Family History: Having a parent, sibling, grandparent, aunt, uncle or cousin with type 2 diabetes increases your child’s risk of developing diabetes.
  • Race: Children of certain races, especially Afro-Caribbean, Hispanics, Asians and Pacific Islanders, are more likely to develop type 2 diabetes.
  • Sex: Type 2 is more common in girls than in boys during childhood.

Diagnosis

Your general practitioner or pediatrician will order one or two blood tests to make a diagnosis of Type 2 diabetes. The following tests can be used to diagnose diabetes in children:
Diagnosis of Type 2 diabetes in children

  • Random blood sugar: A blood sample is taken at a random time. Regardless of your child’s last meal a random blood sugar level 200 mg/dL or higher is suggestive of diabetes.
  • Hemoglobin (A1C) test: This blood test is reflective of the average blood sugar level over the past 2-3 months. An A1C level of 6.5 % or higher on 2 separate tests suggests diabetes. A result of 5.7% -6.4% is considered pre-diabetes.
  • Fasting blood sugar: A blood sample is taken after an overnight fast. A fasting blood sugar level 125 mg/dL or higher indicates diabetes. A fasting blood sugar level from 100-125 mg/dL is considered prediabetes.
  • Oral glucose tolerance test: For this test, your child fasts overnight, and the fasting blood sugar level is measured. Then, your child drinks a sugary liquid, and blood sugar levels are tested periodically for the next several hours. A reading of more than 200 mg/dL after two hours indicates diabetes. A reading between 140 and 199 mg/dL indicates prediabetes.
If your child is diagnosed with diabetes, the doctor may do other tests to distinguish between type 1 and type 2 diabetes — which often require different treatment strategies because in type 1 diabetes, the pancreas no longer makes insulin.

Complications

In the early stages of Type 2 Diabetes your child may feel fine, however preventing the complications of diabetes should be taken seriously. Diabetes can potentially affect every part of the body, the organs that are most at risk are heart and blood vessels, nerves, kidney’s and eyes. Keepings your child’s blood sugar close to normal can dramatically reduce the risk of him or her developing these complications.

After the diagnosis

After your doctor makes the diagnosis, they will help organize a diabetes treatment team for your child: this will include a certified diabetes educator and dietician. You and your child may have several visits with them initially to help establish the best treatment plan, support and monitoring schedule for your child. Part of their goal will be to help your family make the necessary lifestyle changes to be successful with managing diabetes.

Copings and Support

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 complications.

Counseling and support

Talking to a counselor or therapist may help your child or you to cope with the lifestyle changes that come with a type 2 diabetes diagnosis. Your child should understand that he or she has done nothing “wrong” and are not alone. It maybe helpful for them to understand that diabetes is common in Bermuda and many other countries, and most of them have type 2. The Bermuda Diabetes Association can help your child find encouragement and understanding in a type 2 diabetes support group for children and yourself. If your child understands that they are not alone, they may be more eager to monitor and manage the disease.

Prevention

Healthy lifestyle choices can prevent type 2 diabetes in children and its complications. 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. Cut out or limit soft drinks and most fruit juices. Avoid bringing regular soda into the house to minimize temptation.
  • Get more physical activity. Encourage your child to get active. Sign up for a sports team or dance lessons, or look for active things to do together. Aim for an hour a day.
  • Lose excess pounds. Help your child make permanent changes in his or her eating and exercise habits.
  • Reduce screen time. Watching TV, surfing the internet, and playing video games don’t count as exercise. The American Academy of Pediatrics encourages families to limit screen time to 1 hour/day.
    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.

References

Mayo Clinic Staff. Type 2 diabetes in children. Pages 1-15. April 2012.Mayo Clinic
DiabetesUK Care.Connect.Campaign. Type 2 diabetes in children. Pages 1-3. April 2012. Diabetes UK
Ferrell, Keith. Type 2 Diabetes: A Manageable Epidemic. Healthy Children Magazine, Summer 2007. Pages 1-3. April 2012. HealthyChildren.org