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Canadian Med Center

Type 2 Diabetes in Children: Prevention, Management, and Treatment

Tuesday 19 March 2024
Diabetes
6 minute(s) read
By Kiran Altaf

Table of Contents

I. What is Type 2 Diabetes?

II. Preventing and Managing Type 2 Diabetes in Children

III. Diagnosing Type 2 Diabetes in Children

IV. Treating Type 2 Diabetes in Children

V. Conclusion

The prevalence of type 2 diabetes in children has been on an alarming rise due to the increasing rates of childhood obesity. As of 2017, over 28,000 children in the U.S. were diagnosed with type 2 diabetes, and if current trends continue, that number is predicted to skyrocket to approximately 220,000 by 2060. [1]

In this article, we’ll discuss how to prevent, manage, diagnose, and treat type 2 diabetes in children.

What is Type 2 Diabetes?

When we eat, our digestive system breaks down carbohydrates into simple sugars, with glucose being the primary energy source for our cells. To fuel these cells, glucose must leave the bloodstream and enter the cells. [2]

Insulin, a hormone produced by the pancreas, plays a crucial role in this process. As it travels through the blood, insulin signals the cells to take up glucose. When blood glucose levels rise, such as after a meal, the pancreas produces more insulin to facilitate the movement of glucose into the cells. [2]

However, in individuals with type 2 diabetes, there are two main problems at play: insulin resistance and insufficient insulin production.

  • Insulin resistance occurs when the cells in our body do not respond properly to insulin. Normally, insulin acts like a key, unlocking the cells to allow glucose to enter and provide energy. However, with insulin resistance, this key no longer works effectively. As a result, glucose builds up outside the cells, leading to high blood sugar levels.
  • Insufficient insulin production: The pancreas works harder to produce more insulin to compensate for insulin resistance. Initially, this helps regulate glucose levels. However, over time, the pancreas becomes overwhelmed and unable to produce enough insulin to meet the body's needs, leading to insufficient insulin production. [2]

The combination of insulin resistance and insufficient insulin production results in persistently high blood sugar levels, which is the hallmark of type 2 diabetes. [2]

Preventing and Managing Type 2 Diabetes in Children

a group of kids running

Type 2 diabetes was once rare in children, which is why it was previously called adult-onset diabetes. However, with rising rates of childhood obesity, more and more children are being diagnosed with type 2 diabetes, some as early as age 10. [3]

The good news is that parents and guardians can take steps to help prevent type 2 diabetes in kids and properly manage it if diagnosed.

  • Weight control: Overweight children, especially those with excess belly fat, are more likely to develop insulin resistance, which is a precursor to type 2 diabetes. Insulin resistance often has no symptoms, but some children may develop dark, velvety patches of skin called acanthosis nigricans in body folds and creases. They may also have other conditions related to insulin resistance, like high blood pressure, high cholesterol, and polycystic ovarian syndrome (PCOS). Managing weight can help reduce insulin resistance and lower diabetes risk.
  • Physical activity: Being physically active helps the body use insulin more efficiently, reducing insulin resistance. Aim for children to get 60 minutes or more of exercise per day. Make activity fun by encouraging participation in sports teams, planning active family outings like hiking or biking, and limiting screen time to 2 hours per day.
  • Create healthy habits at a young age: The hormone changes during puberty make it more difficult for the body to use insulin properly, especially in girls. This helps explain why many children are diagnosed with type 2 diabetes in their early teens. That’s why it’s critical to help children establish healthy habits before puberty starts. [3]

Preventing type 2 diabetes requires establishing new healthy habits as a family. When everyone participates, healthy changes become the new normal. Here are some easy tips to implement:

  • Drink more water and limit sugary beverages
  • Eat more fruits and vegetables
  • Involve kids in preparing healthier meals
  • Eat slowly and stop when full
  • Avoid eating while watching TV or using computers
  • Shop for groceries on a full stomach to avoid temptation
  • Don't force kids to clean their plates
  • Make physical activity fun for the whole family
  • Encourage kids to join a sports team or engage in activities they enjoy
  • Limit screen time to no more than two hours a day
  • Plan active outings such as hiking or biking to encourage physical activity [3]

Diagnosing Type 2 Diabetes in Children

To diagnose type 2 diabetes, doctors will first ask about any symptoms the child is experiencing. Type 2 diabetes can cause the following symptoms in children:

  • Increased urination
  • Increased thirst
  • Tiredness
  • Blurry vision [4]

In addition to asking about symptoms, doctors will conduct blood and urine tests to check glucose levels. For an accurate diagnosis, doctors may repeat these tests on separate occasions.

  • Fasting blood glucose test: This test is done after the child has fasted overnight and provides a measurement of the glucose in the blood. A fasting blood glucose level higher than 126 milligrams per deciliter (mg/dl) indicates type 2 diabetes.
  • Glycated hemoglobin (A1C) test: This blood test measures the average blood glucose levels over the past 2 to 3 months. An A1C level greater than 6.5% or 48 millimoles per liter confirms the diagnosis of diabetes.
  • Random blood glucose test: This test measures blood glucose levels at a random point in time. A random blood glucose level over 200 mg/dl suggests type 2 diabetes. [5]

Treating Type 2 Diabetes in Children

a mom teaching her diabetic child how to inject insulin

Type 2 diabetes treatment in children generally follows the same guidelines as for adults, focusing on diet, exercise, and lifestyle changes. However, there are some important differences to consider when managing this condition in young patients.

  • Regular monitoring of blood glucose levels is essential, but children may need help from parents or caregivers with testing. Training on proper technique and equipment use is important for anyone assisting with glucose monitoring. [5]
  • Insulin therapy is commonly required due to the more rapid progression of type 2 diabetes in children. Responsible adults, like teachers and coaches, should be informed on proper insulin administration if the child needs injections during school or activities. [5]
  • Diabetes identification bracelets are highly recommended for all children on insulin therapy. These bracelets clearly state "diabetes" and other vital details to alert helpers if the child has a severe hypoglycemic episode. [5]
  • Medication options are more limited for children compared to adults. Metformin is usually the first oral drug prescribed, along with insulin, as needed. Other FDA-approved medications for pediatric type 2 diabetes include liraglutide, exenatide, Synjardy, and empagliflozin (Jardiance). More research is still needed to expand safe drug treatments for children with type 2 diabetes. [6] [1]

Conclusion

Treating type 2 diabetes in children requires close monitoring and management, with age-appropriate education and support from parents, caregivers, and healthcare providers. Maintaining blood glucose control while allowing for normal childhood development and activities requires a thoughtful, team-based approach.

To learn more about diabetes, visit our diabetes blog.

The content in this article is intended for informational purposes only. This website does not provide medical advice. In all circumstances, you should always seek the advice of your physician and/or other qualified health professionals(s) for drug, medical condition, or treatment advice. The content provided on this website is not a substitute for professional medical advice, diagnosis, or treatment.

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