Diabetes Mellitus Type 2 In Adolescents

What is it? Diabetes (di-uh-b-tees) is also called diabetes mellitus (mel-uh-tus). There are 2 main types of diabetes. Your teenager has Type 2 Diabetes. It may be called non-insulin dependent or adult onset diabetes. Type 2 diabetes is more common in overweight people who are older than 40 years and are not active. But, Type 2 Diabetes has recently become more common in overweight teenagers and it usually starts during puberty. There is no cure for diabetes but your teenager can have a long and active life if his diabetes is controlled.

How did my teenager get Type 2 Diabetes?

  • Insulin is a hormone (a special body chemical) made by the pancreas. The pancreas is an organ that lies behind the stomach. Much of the food we eat is turned into sugar in the stomach. This sugar goes into the blood and travels to the cells of your teenager's body to be used for energy. Insulin acts as a "key" to help sugar enter the cells.


  • With Type 2 Diabetes your teenager's body does not react to the insulin as it should. This causes sugar to build up in his blood. Your teenager can probably control his diabetes with diet and exercise since he has Type 2 Diabetes. But, your teenager may need to take oral medicine that helps the pancreas make more insulin or use insulin better. Or, your teenager may need insulin shots.


Signs and Symptoms: There are several problems that happen when your teenager has diabetes. He may get hyperglycemia (high blood sugar), hypoglycemia (low blood sugar), or ketoacidosis. Following are the signs and symptoms of each of these problems.

  • Hyperglycemia: Your teenager may have one or more of the following symptoms of hyperglycemia (hi-per-gli-c-mee-uh) or high blood sugar.


    • Blurry vision.


    • Fatigue (feeling very tired).


    • Hungry all of the time.


    • Losing feeling in his feet or having tingling in his feet.


    • Sores that take a long time to heal.


    • Urinating often.


    • Very dry skin.


    • Very thirsty and drinking a lot of liquids.


  • Hypoglycemia:


    • Your teenager may have problems with hypoglycemia (hi-po-gli-c-me-uh) because he has diabetes. This is when your teenager's blood sugar level falls too low. It may be caused by having too much insulin in his blood or your teenager may not have eaten enough. Ask your teenager's caregiver for the CareNote about diabetic hypoglycemia for more information.


    • If your teenager has the following symptoms of low blood sugar, treat it immediately with something that has sugar. Good choices for treating low blood sugar are orange juice, sugar cubes, or hard candy.


      • Being confused or acting "spacey" or drunk.


      • Fatigue (feeling very tired).


      • Feeling weak and dizzy.


      • Feeling very hungry.


      • Having a headache and feeling irritable.


      • Having a very fast heart beat.


      • Looking pale.


      • Trembling and sweating with a cold clammy feeling.


      • Unconscious (passing out) and going into a coma.


  • Ketoacidosis (kee-toe-ah-suh-doe-sus). Diabetes can cause ketoacidosis which is when the blood sugar stays too high for too long without being treated. This can cause your teenager's body to start breaking down body fats for energy rather than using blood sugar. Wastes called ketones are left behind. This may happen when your teenager is sick or under a lot of stress. Or, it can happen if your teenager has eaten too much or has not taken enough insulin. Ketoacidosis can be a very serious and needs to be treated right away. Ask for the CareNote about ketoacidosis for more information. Following are the signs and symptoms of ketoacidosis.


    • Confused or trouble thinking clearly.


    • Fatigue (feeling tired).


    • Fast deep breathing at rest.


    • Fruity-smelling breath.


    • Finally, going into a coma.


Can diabetes cause other health problems? High blood sugar levels may damage other body tissue and organs over time. Diabetes can even cause death if left untreated. But, if your child's blood sugar is well controlled other health problems may not happen.

  • Having uncontrolled diabetes for a long time can damage your teenager's nerves, veins, and arteries. This can cause damage to his feet and legs. With time, it could cause your teenager to need to have his feet or legs amputated.


  • The buildup of sugar can also damage organs in your teenager's body. Uncontrolled diabetes can effect your teenager's eyes, kidneys and heart.


Tests: Caregivers will ask your teenager questions about his medical history and his symptoms of diabetes.

  • Following are some of the blood tests your teenager may have done to find out if he has Type 1 Diabetes. Caregivers will want to test your teenager twice to be positive that he has diabetes.


    • OGTT: This is an oral glucose tolerance test. Your teenager must fast (not eat or drink anything) for a certain number of hours before this test. Caregivers will tell you how long to have your teenager fast. Your teenager will then be given a glucose syrup to drink in the caregiver's office or at the lab. A sample of your teenager's blood will be taken and tested 2 hours later. Your teenager has diabetes if his blood sugar is 200 mg/dL (milligrams per deciliter) or greater.


    • Fasting Glucose: Your teenager must also fast for this test. But, his blood can be drawn as soon as you arrive at the caregiver's office or lab. Your teenager does not have to drink the glucose syrup and wait another 2 hours. Your teenager may have diabetes if his blood sugar is 126 mg/dL (milligrams per deciliter) or greater.


    • If your teenager has the symptoms of diabetes, caregivers may do a blood test anytime of the day (whether or not he has fasted). If your teenager's blood sugar is greater than 200mg/dL, he may have diabetes. But, your teenager will need another test on another day, as in any diabetes testing, to be positive that he has diabetes.


  • Once caregivers know that your teenager has diabetes, he will need other blood tests to see how well controlled his diabetes is. The hemoglobin A1c test or " H-b-A-1-c" shows a "snapshot" of your teenager's average blood sugar over the last 3 months. All people with diabetes should have an H-b-A-1-c test twice a year. Your teenager may need the test every 3 months if his blood sugar stays too high. The H-b-A-1-c goal for people with diabetes is less than 7%. Work with caregivers to change your teenager's diabetes treatment plan if his test result is 8% or higher.


Treatment: The most important thing you must do is help your teenager control his blood sugar. Caregivers will work with your teenager to help keep his blood sugar levels within a "target range." This means that your teenager's blood sugar is not too high or too low. To do this your teenager has to find the right balance of diabetic medicine, food intake, and physical activity for him. Food raises blood sugar levels while diabetic medicines and physical activity lower blood sugar levels. Caregivers will also work with your teenager to make sure your teenager grows and develops normally for his age. And, they want to make sure that your teenager grows up happy and emotionally strong.

  • How does my teenager check his blood sugar levels? You and your teenager will be taught how to use a glucose monitor (special computer). This monitor tests the amount of sugar in your teenager's blood. Ask your teenager's caregiver for the CareNote about how to check blood sugar for more information.


  • Does my teenager have to change his diet? Food puts sugar in your teenager's body. You can help control your teenager's blood sugar by making sure he eats the right kinds and amounts of food. Your teenager may not grow to his full adult height if his blood sugar is out of control during his teenage years. It is also easier to stay healthy if your teenager keeps his weight within normal range for his height. A diabetes nurse or dietitian (di-uh-tih-shun) will help your teenager learn what to eat and how food effects his diabetes. These caregivers will help your teenager develop a weight loss plan that works for him.


  • Why is physical activity important if my teenager has diabetes?


    • Exercise and physical activity help keep your teenager's blood sugar level under control by helping his body better use insulin. It also makes the heart stronger and keeps your teenager healthy. Exercise and controlling your teenager's weight can change the amount of insulin his body needs. So, it is very important to work with caregivers to help plan the best exercise and activity program for your teenager.


    • The best exercise is the one your teenager likes. Only aerobic exercises done for longer than 25 minutes or longer help heart health. These activities include jogging, walking, swimming, or bicycling. Participating in sports such as basketball and soccer are also good ways to get exercise while being with friends.


Coping:

  • It is normal to feel scared, confused, and anxious because your teenager has diabetes. Teenagers are worried about being "different" from their peers (friends) and may not want anyone to know about their diabetes. Your teenager may feel "different" because he has to take diabetic medicine, test his blood, and eat certain foods. Having to do these things can make the normal troubles of adolescence even more difficult. Your teenager wants to think and act like his peers, such as using drugs, alcohol, and tobacco. Talk about these things with your teenager's caregiver.


  • Having a teenager with diabetes requires a lot of self-care. There is a lot to learn about diabetes. The more you know about diabetes, the easier it will be for your teenager to live an active life. Both you and your teenager should learn all that you can. Ask your teenager's caregiver, diabetes nurse, or dietitian about classes for diabetes. Also, you can call or write one of the following organizations for more information.


  • American Diabetes Association
    1660 Duke Street
    Alexandria, VA 22314
    Phone: 1 (800) 232-3472
    Web Address: http://www.diabetes.org
  • Juvenile Diabetes Foundation International
    The Diabetes Research Foundation
    120 Wall Street
    New York, NY 10005-4001
    Phone: 1 (800) JDF-CURE
    Web Address: http://www.jdfcure.org

Care Agreement

You have the right to help plan your teenager's care. To help with this plan you and your teenager must learn about diabetes and how it is treated. You can then discuss treatment options with your teenager's caregivers. Work with them to decide what care will be used to treat your teenager.

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