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Diabetes: Type 2

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KEY POINTS

  • Type 2 diabetes means that there is too much glucose (sugar) in your child’s blood. Your child’s body makes insulin but cannot use it well to get glucose from the blood into the cells.
  • Too much glucose in your child’s blood can cause problems such as heart disease, stroke, blindness, and kidney failure.
  • Your healthcare provider will help you learn to manage your child’s diabetes by testing blood glucose levels, providing a variety of healthy foods, helping your child stay physically active, and helping your child take all medicines as prescribed.

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What is type 2 diabetes?

Having diabetes means that there is too much glucose (sugar) in your child’s blood. Your child’s body breaks down some of the foods your child eats into glucose. The blood carries the glucose to the cells of the body. Your child needs some glucose in the cells for energy, but too much glucose in the blood is not good for your child’s health.

What is the cause?

Diabetes is a problem with the way the body makes or uses insulin. Insulin is a hormone made by the pancreas, which is an organ in the upper belly. Your child’s body uses insulin to help move glucose from the blood into the cells. When the body does not make enough insulin or has trouble using its own insulin, glucose cannot get into the cells and builds up in your child’s blood. Diabetes can damage small blood vessels and nerves, causing problems in the eyes, heart, brain, kidneys, skin, and feet.

The exact cause of type 2 diabetes is not known. Your child has a higher risk of having type 2 diabetes if you have a family background of Alaska Native, American Indian, African American, Hispanic/Latino, Asian American, or Pacific Islander. The risk is also increased if your child has a family history of type 2 diabetes, doesn't get enough physical activity, has a high-calorie diet, or is overweight.

If you had gestational diabetes when you were pregnant, your child has a higher risk of type 2 diabetes.

This type of diabetes usually starts in adulthood. However, more teenagers and even children are developing type 2 diabetes.

What are the symptoms?

Symptoms may start suddenly, or they may develop over days to weeks. Most people, however, have no symptoms for months or years. It is very important to get blood glucose levels checked as often as your healthcare provider recommends.

Not everyone has the same symptoms. Symptoms may include:

  • Urinating a lot
  • Increased thirst
  • Increased hunger
  • Blurry vision
  • Feeling tired all the time
  • Unexpected weight gain or weight loss
  • Dry, itchy skin
  • Frequent infections of the skin, gums, or bladder
  • Frequent yeast infections of the vagina
  • Infections of the foreskin in uncircumcised males
  • Thickened, darkened skin on the neck or in body folds such as under the arms

If diabetes is not diagnosed and treated, your child’s blood glucose could get so high that it causes your child to go into a coma and die.

How is it diagnosed?

Your child’s healthcare provider will ask about your child’s symptoms and medical history and examine your child. Your child will have tests to measure the level of glucose in the blood. Tests may include:

  • Fasting blood glucose test (FBG). For this test, your child’s blood glucose is tested in the morning after not eating any food or drinking anything except water for at least 8 hours.
  • Hemoglobin A1C. The A1C is a blood test that can be used to check your child’s average blood glucose over the past 2 to 3 months.
  • Glucose tolerance test (GTT). For this test, a sample of your child’s blood is taken when your child has not eaten anything since the night before. Then your child drinks a special glucose drink and the blood is tested again 1 to 2 hours later. Your child’s blood glucose may be tested several more times after the first test, every 30 to 60 minutes.
  • Random blood glucose test (RBS) at a time when your child has been eating normally.

Your child may have other blood tests to see what type of diabetes your child has.

How is it treated?

The goal of treatment is to control the level of glucose in your child’s blood and keep it in a normal range. Controlling your child’s blood glucose can prevent or delay serious problems caused by diabetes.

When your child has type 2 diabetes, high blood glucose can often be controlled by eating a healthy foods, staying physically active, and losing weight if your child is overweight. You need to check your child’s blood glucose regularly to make sure your child’s meal plan and physical activity are working well. If your child’s meal plan and physical activity are not controlling your child’s blood glucose, then your child will need to take medicine to help keep glucose levels normal. It is also important to learn about diabetes, including recognizing and treating symptoms of high and low blood glucose levels.

  • Meal Planning

Your healthcare provider will give you guidelines about which foods your child should eat and how many calories to eat each day. Your child’s prescribed meal plan will include a lot of lean protein, complex carbohydrates such as whole grain pastas breads, and cereals, fresh fruits and vegetables, and foods high in fiber. Your child may be able to have a snack with glucose sometimes, but your child’s regular meal plan should not include sugary food such as soft drinks, candy, and desserts. You will also learn how to space your child’s meals so your child eats as often as needed.

Your provider may refer you to a dietitian or diabetes educator for help with meal planning. Choosing healthy foods for your child’s meal plan may help with weight loss if needed and improve overall health. Sometimes losing just a few pounds can lower your child’s blood glucose enough to keep your child from needing to take medicine to treat the diabetes.

  • Physical activity

Physical activity is very important. Physical activity improves blood flow, uses up more of the glucose in the blood, and helps your child’s body use insulin better. Getting enough physical activity is all some children need to control their blood glucose. A good activity plan can help control your child’s blood glucose level. It also helps keep your child healthy and avoid some of the problems caused by diabetes. Talk to your healthcare provider about the right activity plan for your child.

  • Medicine

If your child’s blood glucose can’t be controlled with meal planning and physical activity, your healthcare provider may prescribe an oral medicine to lower it. Your child may also need more than 1 type of medicine to keep the blood glucose levels in a normal range. Your child may need shots of insulin if meal planning, physical activity, and oral medicines are not keeping blood glucose levels normal. Your child can learn to give himself shots of insulin between the ages of 10 or 11 years.

When your child takes medicine for diabetes, you must carefully follow your provider's directions for checking your child’s blood glucose. This will help keep your child’s blood glucose from getting too high or too low. Blood glucose that is too low can make your child sick and cause headaches, nausea, cold sweats, and seizures. It can even be life-threatening if it gets too low.

  • Blood glucose tests

You will learn how to check your child’s blood glucose with a small machine called a blood glucose meter. Your provider will tell you when and how often you need to check your child’s blood glucose. When your child is 7 to 10 years old, your child can learn how to test blood glucose levels.

You will need to keep a record of your child’s blood glucose measurements and bring it to every appointment. Your provider will check the record at appointments to see if any changes need to be made to your child’s medicine.

Your child may have an A1C test every 3 to 6 months to check overall control of blood glucose levels. The A1C test is a way of measuring average glucose over a 3-month period. It’s a good way to see if your child’s diabetes is under control. However, it does not replace daily blood glucose measurements. Daily checks of blood glucose show whether your child’s treatment is working throughout the day.

  • Education

When your child is diagnosed with diabetes, there is a lot to learn about the disease. This education is usually done for 2 or 3 days at a diabetes clinic. This education is very important. Ask your healthcare provider about your choices.

Healthcare providers will teach you what diabetes is, and how to give shots of the proper amounts of insulin if needed. You will learn how to test for glucose in the blood and for ketones in the blood or urine. You will learn how to treat high and low blood glucose and other ways to keep your child healthy.

How can I take care of my child?

You can learn to take good care of your child in a few weeks and your child can keep doing most of your child’s favorite activities. You need to work with your healthcare provider, change your child’s eating habits, add or continue physical activities, maintain a healthy weight, and check your child’s blood glucose on the schedule your provider advises.

Carefully controlling blood glucose and taking care of any other health problems your child has may prevent or delay serious health problems. Good control of diabetes depends on following the meal and physical activity plans prescribed by your healthcare provider to keep your child’s blood glucose in the target range. If your child’s diabetes is not controlled by meal planning and physical activity, it is important for your child to take medicines as directed by your healthcare provider. Follow the full course of treatment prescribed by your healthcare provider. In addition:

  • Try to always have your child’s meals, snacks, and physical activity at the same time each day. Your child should carry a protein snack, such as cheese and crackers or peanuts, to make sure your child eats as often as needed.
  • Follow your healthcare provider's instructions for testing your child’s blood and adjusting the insulin dosage according to the results of the blood tests.
  • Get your child’s eyes checked as often as your provider recommends.
  • Make sure that your child stays physically active as advised by your child’s provider. Help your child to limit sitting time.
  • Get other medical problems treated, especially high blood pressure and high cholesterol.
  • Your child should carry a medical ID such as a card or bracelet that says he or she has diabetes.
  • Learn about diabetes and its complications so you can make the correct decisions to control your child’s blood glucose levels. There is a lot to learn. It's good for everyone in your family to learn about diabetes.
  • Following all of the steps to manage your child’s diabetes may feel overwhelming. If you or your child feel stressed or depressed, talk with a counselor.

Children with diabetes are faced with the same pressures as other kids. They may be curious about smoking, drinking alcohol, or using drugs. Smoking speeds up damage to the heart and blood vessels. Alcohol and drugs can affect blood glucose and can cause nerve damage over time. Talk to your child about the risks of smoking, drinking alcohol, and using drugs.

Ask your child’s provider:

  • How and when you will get your child’s test results
  • If there are activities your child should avoid and when your child can return to normal activities
  • How to take care of your child at home
  • What symptoms or problems you should watch for and what to do if your child has them

Make sure you know when your child should come back for a checkup. Keep all appointments for provider visits or tests. Be sure to take your child’s glucose logs or glucose meter to all appointments.

How can I help prevent type 2 diabetes?

Unlike type 1 diabetes, type 2 can be prevented or delayed. Even if there is a history of diabetes in your family, your child may be able to prevent or delay the disease if your child:

  • Keeps a healthy weight.
  • Stays physically active as advised by your child’s provider. Help your child to limit sitting time.
  • Eats a variety of healthy foods that includes fruits, vegetables, lean protein, and high-fiber grains. It’s best to limit sugars, soda, desserts, white rice, white potatoes, and foods made with white flour. Your child should choose whole grain and whole wheat breads and cereals instead.

If you have a family history of diabetes or your child is overweight, have blood glucose levels checked as often as recommended by your healthcare provider.

You can get more information from:

Developed by Change Healthcare.
Pediatric Advisor 2019.4 published by Change Healthcare.
Last modified: 2019-09-20
Last reviewed: 2019-01-22
This content is reviewed periodically and is subject to change as new health information becomes available. The information is intended to inform and educate and is not a replacement for medical evaluation, advice, diagnosis or treatment by a healthcare professional.
© 2018 Change Healthcare LLC and/or one of its subsidiaries
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