More children are being diagnosed with this blood sugar condition. Learn how to help manage or prevent this chronic disease in your child.
Type 2 diabetes in children is a chronic disease that affects the way your child's body processes sugar (glucose) for fuel. Without treatment, the disorder causes sugar to build up in the bloodstream, which can lead to serious long-term consequences.
Type 2 diabetes occurs more commonly in adults. In fact, it used to be called adult-onset diabetes. But the increasing number of children with obesity has led to more cases of type 2 diabetes in younger people.
There's plenty you can do to help manage or prevent type 2 diabetes in your child. Encourage your child to eat healthy foods, get plenty of physical activity and maintain a healthy weight. If healthy eating and exercise aren't enough to control type 2 diabetes, oral medication or insulin treatment may be needed.
Type 2 diabetes in children may develop so gradually that there are no noticeable symptoms. Sometimes, the disorder is diagnosed during a routine check-up.
Some children might experience these signs and symptoms as a result of too much sugar in their bloodstreams:
See your child's health care provider if you notice any of the signs or symptoms of type 2 diabetes. Undiagnosed, the disease can cause serious damage.
Diabetes screening is recommended for children who have started puberty or are at least 10 years old, who are overweight or obese, and who have at least one other risk factor for type 2 diabetes.
The exact cause of type 2 diabetes is unknown. But family history and genetics appear to play an important role. What is clear is that children with type 2 diabetes can't process sugar (glucose) properly.
Most of the sugar in the body comes from food. When food is digested, sugar enters the bloodstream. Insulin allows sugar to enter the cells — and lowers the amount of sugar in the blood.
Insulin is produced by a gland located behind the stomach called the pancreas. The pancreas sends insulin to the blood when food is eaten. When the blood sugar level starts to drop, the pancreas slows down the secretion of insulin into the blood.
When your child has type 2 diabetes, this process doesn't work as well. As a result, instead of fueling cells, sugar builds up in your child's bloodstream. This can happen because:
Researchers don't fully understand why some children develop type 2 diabetes and others don't, even if they have similar risk factors. However, it's clear that certain factors increase the risk, including:
Type 2 diabetes in children is often associated with metabolic syndrome and polycystic ovarian syndrome.
When certain conditions occur with obesity, they are associated with insulin resistance and can increase the risk of diabetes — and heart disease and stroke. A combination of the following conditions is often called metabolic syndrome:
Polycystic ovary syndrome (PCOS) affects young females after puberty. PCOS is caused by an imbalance of hormones, resulting in signs such as weight gain, irregular menstrual periods, and excess face and body hair. People with PCOS often have problems with metabolism that can result in insulin resistance and type 2 diabetes.
Type 2 diabetes can affect nearly every organ in your child's body, including the blood vessels, nerves, eyes and kidneys. The long-term complications of type 2 diabetes develop gradually over many years. Eventually, diabetes complications may be severe or even life-threatening.
Complications of type 2 diabetes are related to high blood sugar and include:
Keeping your child's blood sugar level close to the standard range most of the time can dramatically reduce the risk of these complications. You can help your child prevent diabetes complications by:
Healthy-lifestyle choices can help prevent type 2 diabetes in children. Encourage your child to:
Better yet, make it a family affair. The lifestyle choices that can help prevent type 2 diabetes in children can do the same for adults.
If diabetes is suspected, your child's health care provider will likely recommend a screening test. There are several blood tests to diagnose type 2 diabetes in children.
Your health care provider may recommend additional tests to distinguish between type 1 diabetes and type 2 diabetes, because treatment strategies for each type differ.
Treatment for type 2 diabetes is lifelong and can include:
You'll work closely with your child's diabetes treatment team — including a health care provider, certified diabetes care and education specialist, registered dietitian, and other specialists as needed. The goal of treatment is to keep your child's blood sugar within a certain range. This target range helps to keep your child's blood sugar level as close to the standard range as possible.
Your child's health care provider will let you know what your child's blood sugar target range is, and may also set an A1C target. These numbers may change as your child grows and changes and so will your child's diabetes treatment plan.
Food is a big part of any diabetes treatment plan, but that doesn't mean your child has to follow a strict "diabetes diet." Your health care provider may recommend weight loss to achieve and maintain a healthy weight. Blood sugar levels can improve with weight loss.
Your child's dietitian will likely suggest that your child — and the rest of the family — consume foods that are high in nutritional value and low in fat and calories.
Healthy eating includes a diet high in fruits, vegetables, nuts, whole grains and olive oil. Choose foods low in fat and calories and high in fiber. Eat a variety of foods to help achieve your child's goals without compromising taste or nutrition.
Your child's dietitian can help you create a meal plan that fits your child's food preferences and health goals, as well as help you plan for occasional treats. Your dietitian is also likely to recommend that your child:
Everyone needs regular aerobic exercise, and children who have type 2 diabetes are no exception. Physical activity helps children control their weight, uses up sugar for energy, and makes the body use insulin more effectively. This can lower blood sugar.
Make physical activity part of your child's daily routine. Activity time doesn't have to be all at once — it's OK to break it down into smaller chunks of time. Encourage your child to get at least 60 minutes of physical activity daily or, better yet, exercise with your child.
There are three medications that have been approved by the Food and Drug Administration (FDA) for treating type 2 diabetes in children.
Insulin. Sometimes, insulin may be needed if your child's blood sugar levels are very high. Insulin allows sugar into the cells for energy, reducing the amount of sugar in the bloodstream.
There are a number of different insulins, but a long-acting insulin once a day, along with a short- or rapid-acting insulin with meals, is often used for type 2 diabetes in children. Insulin is typically delivered via a syringe or an insulin pen.
With lifestyle changes and other medications, your child may be able to be weaned off insulin.
Your health care provider will let you know how often you or your child need to check and record your child's blood sugar. Children who take insulin usually need to test more frequently, possibly four times a day or more.
Depending on treatment needs, continuous glucose monitoring may be an option. Frequent testing is the only way to make sure that your child's blood sugar level remains within the target range.
These procedures are not an option for everyone. But for teens who are significantly obese — a body mass index (BMI) at or above 35 — having weight-loss surgery may lead to improved management of type 2 diabetes.
Your child will need regular appointments to ensure good diabetes management. Visits with your child's health care provider can include a review of your child's blood sugar patterns, typical eating habits, physical activity, weight and medication if taken. Healthy-lifestyle changes can reduce the need for medications.
Your health care provider may check your child's A1C levels. The American Diabetes Association generally recommends an A1C of 7% or lower for all children and teens with diabetes.
Your health care provider will also periodically check your child's:
Your child's health care provider will likely recommend a flu shot for your child every year, and may recommend the pneumonia vaccine and the COVID-19 vaccine if your child is age 5 or older.
Despite your best efforts, sometimes problems will arise. Certain short-term complications of type 2 diabetes — such as low blood sugar, high blood sugar, diabetic ketoacidosis and hyperosmolar hyperglycemic state — require immediate care.
Hypoglycemia is a blood sugar level below your child's target range. Blood sugar levels can drop for many reasons, including skipping a meal, eating fewer carbohydrates than planned, getting more physical activity than typical or injecting too much insulin. Children with type 2 diabetes have less risk of low blood sugar than do kids with type 1 diabetes.
Signs and symptoms of low blood sugar include:
Teach your child the symptoms of low blood sugar. When in doubt, your child should always do a blood sugar test. If a blood glucose meter isn't readily available and your child is having symptoms of a low blood sugar, treat for low blood sugar and then test as soon as possible.
If your child has a low blood sugar reading:
Hyperglycemia is a blood sugar level above your child's target range. Blood sugar levels can rise for many reasons, including illness, eating too much, eating certain types of foods, and not taking enough diabetes medication or insulin.
Signs and symptoms of high blood sugar include:
If you suspect hyperglycemia, check your child's blood sugar. You might need to adjust your child's meal plan or medications. Contact your child's health care provider if your child's blood sugar is regularly above his or her target range.
A severe lack of insulin causes your child's body to produce certain toxic acids (ketones). If excess ketones build up, your child may develop a potentially life-threatening condition known as diabetic ketoacidosis (DKA). DKA is more common in children with type 1 diabetes but can sometimes occur in children with type 2 diabetes.
Signs and symptoms of DKA include:
If you suspect DKA, check your child's urine for excess ketones using an over-the-counter ketone test kit. If the ketone levels are high, call your child's health care provider or seek emergency care.
Hyperosmolar hyperglycemic state (HHS) may develop over a period of a few days in children with type 2 diabetes. The extremely high blood sugar level of HHS — 600 mg/dL or higher — may develop with severe infections, illness or other medical conditions. The body's attempt to get rid of the high level of sugar by passing it in the urine results in severe dehydration.
Signs and symptoms of HHS include:
HHS can be life-threatening and requires emergency care.
Helping your child follow the diabetes treatment plan takes round-the-clock commitment. But careful management of type 2 diabetes can reduce your child's risk of serious complications.
As your child gets older:
You'll need to work with your child's school nurse and teachers to make sure they know the symptoms of high and low blood sugar levels. The school nurse might need to administer insulin or check your child's blood sugar.
Federal law protects children with diabetes, and schools must make reasonable accommodations to ensure that all children get a proper education.
Contact your child's health care provider, certified diabetes care and education specialist, or registered dietitian between appointments if your child's blood sugar is consistently out of the target range your health care provider recommended. Also contact the care team if you're not sure what to do in a certain situation.
Living with type 2 diabetes isn't easy — for you or for your child. Good diabetes management requires a lot of changes, especially in the beginning. That's why some diabetes specialists regularly include a social worker or psychologist as part of their diabetes care teams. Don't forget that you're not alone and your diabetes treatment team can help.
If you notice that your child or adolescent is persistently sad or pessimistic, or experiences dramatic changes in sleeping habits, friends or school performance, have your child assessed for depression.
Rebellion also may be an issue, particularly for teens. A child who has been very good about sticking to the diabetes treatment plan may rebel in the teen years by ignoring diabetes care. Additionally, experimenting with drugs, alcohol and smoking can be even more dangerous for people with diabetes.
Talking to a counselor or therapist may help your child or you cope with the dramatic lifestyle changes that come with a diagnosis of type 2 diabetes. Websites that offer support include the American Diabetes Association (ADA).
Your child's family health care provider or pediatrician will probably make the initial diagnosis of diabetes. However, you'll likely then be referred to a specialist in metabolic disorders in children (pediatric endocrinologist).
Your child's health care team also generally includes a certified diabetes care and education specialist and a registered dietitian.
Here's some information to help you get ready for your appointment.
Before your appointment take these steps:
Some basic questions to ask your child's health care provider include:
Don't hesitate to ask additional questions during the appointment.
Your doctor is likely to ask you a number of questions, such as: