Diabetes Mellitus Type 2 In Children

What is diabetes mellitus type 2?

Diabetes mellitus is a disease that affects how your child's body makes insulin and how it uses glucose (sugar). Insulin is a hormone that helps your child's body use sugar by allowing the sugar to enter cells. With type 2 diabetes, your child's body has trouble using insulin, or is not making enough insulin. It usually begins during puberty, but younger children may also have it.

What causes diabetes mellitus type 2?

No one knows for sure what causes type 2 diabetes. Normally, when blood glucose level increases, the pancreas (an organ that lies behind the stomach) makes insulin to lower blood glucose levels. In type 2 diabetes, your child may have insulin resistance. This means your child's pancreas keeps making insulin but his body cannot use the insulin correctly. The pancreas keeps making insulin to try to control your child's blood sugar. After many years, your child's pancreas may just stop making insulin. When this happens, sugar will build up in his blood.

What puts my child at risk for diabetes mellitus type 2?

Your child has a higher risk for type 2 diabetes if he weighs more than his caregiver suggests, and 2 or more of the following are true:

• Your child has high blood pressure or high cholesterol (fat) levels in the blood.
  
  
• Your child was born smaller than normal.
  
  
• Your daughter has polycystic ovary syndrome (PCOS).
  
  
• Your child's mother has diabetes, or had diabetes while she was pregnant.
  
  
• Someone else in the family has type 2 diabetes.
  
  
• Your child is Native American, African American, Latino, Asian American or Pacific Islander.
  
  
• Your child has a skin disorder called acanthosis nigricans.

What are the signs and symptoms of diabetes mellitus type 2?

Your child may have high blood sugar levels for a long time before symptoms appear. He may have any of the following:

• More thirst than usual
  
  
• Frequent urination
  
  
• Blurred vision
  
  
• More hunger than usual
  
  
• Weight loss without trying

How is diabetes mellitus type 2 diagnosed?

Your child may need tests to check for type 2 diabetes mellitus by the time he is 10 years old. Type 2 diabetes is diagnosed with blood sugar tests. Your child may have any of the following tests:

• Blood glucose: A blood sample is collected and tested to check how much sugar is in it.
  
  
• Fasting plasma glucose: After your child has fasted (no food or liquid) for 8 hours, his blood sugar level will be checked.
  
  
• Oral glucose tolerance test (OGTT): Your child's blood will be drawn 2 or more times during this test. The first sample of blood is taken after your child fasts. He will then be given a glucose drink. Two hours after he drinks the liquid, the second sample of blood will be taken.
  
  
• Hemoglobin A1C (HbA1C) test: This blood test shows the average amount of sugar in your child's blood over the past 2 to 3 months.

How is diabetes mellitus type 2 treated?

Type 2 diabetes can be treated and controlled most of the time. The goal is to help keep your child's blood sugar at normal levels. This can be done with a healthy diet and regular exercise. Your child may also need to take diabetes medicine.

How are blood sugar levels checked?

You and your child may need to learn how to check his blood sugars. Caregivers will teach you how to use a glucose monitor. This is a small device that tells how much sugar is in the blood. The monitor uses a small drop of blood from a prick of your child's finger. Ask caregivers what your child's blood sugar levels should be before and after he eats a meal. Ask them when and how often your child's blood sugar should be tested. He may need to have his blood sugar level checked at least 3 times each day. Write the blood sugar results in a diary each time they are checked. Bring the diary when you take your child to see his caregiver. Ask your child's caregiver how to use the results of blood tests to change your child's diet, exercise plan, and medicine, if changes are needed.

What other health problems can diabetes mellitus type 2 cause?

Uncontrolled diabetes for a long time can damage your child's nerves, veins, arteries, and organs. This can cause damage to his feet and legs, eyes, kidneys, and heart. Your child may need tests to check for the following:

• High cholesterol: Your child will need to have his blood fat levels checked if he is at puberty, or is not yet at puberty but there is a history of high cholesterol in your family. Talk to your child's caregiver about any family history of high cholesterol.
  
  
• Kidney damage: Your child may need yearly tests to check for kidney damage. Ask your child's caregiver when these tests need to be done.
  
  
• Eye disorders: Your child may need tests to check for retinopathy. Retinopathy is an eye disorder that can occur with diabetes. Ask your child's caregiver how often these tests need to be done.
  
  
• Celiac disease: Your child may need a blood test to check for a disorder called celiac disease that affects the digestion of food. Children with diabetes are more likely to have this disorder. Celiac disease reduces the body's ability to absorb nutrients from food and can lead to weight loss and malnutrition.
  
  
• Thyroid disease: Your child may need a blood test to check for thyroid disorders that can occur with diabetes. Autoimmune problems with the thyroid gland can cause it to make too much or too little thyroid hormone.

How can diabetes mellitus type 2 be prevented or controlled?

• Weight loss: Ask caregivers if your child needs to lose weight. Ask them to help you and your child create a weight loss program.
  
  
• Medicines: Make sure your child takes his medicines as ordered. Ask for more information about the medicines that your child needs to take.
  
  
• Diet: A dietitian will create a meal plan that will help your child keep his blood sugar levels under control. This caregiver may suggest the following:
  
  
  • Choose foods low in fat, saturated fat, cholesterol, and sodium. Examples of low-fat foods are lean cuts of meat, fish, skinless poultry (chicken and turkey), and low-fat milk. Use less table salt and limit foods that are high in sodium. Some foods that are high in sodium are soy sauce, processed meats (bologna, hot dogs), crackers, potato chips, and soups.
    
    
  • Choose foods that are good sources of fiber and complex carbohydrates, such as vegetables, whole grain breads and cereals, and legumes. Legumes include garbanzo, pinto, and kidney beans, and lentils.
    
    
  • The dietitian may suggest you limit how much carbohydrate your child eats at one time to prevent his blood sugar from getting too high. Carbohydrates are also found in fruit and dairy foods such as milk and yogurt. Limit or avoid sweets, such as candy, desserts, or regular soda that contain simple carbohydrates from sugar. When your child eats simple carbohydrates, sugar moves into his blood too fast.
    
    
  • Your child should not skip meals to control his blood sugar level, because it may fall too low.
  
  
• Exercise: Regular exercise helps blood sugar levels stay in the best range, and decreases your child's risk for heart disease. It can also help your child lose weight, and improve how he feels overall. Have your child do at least 30 minutes of moderate exercise, 5 days a week. Playing can be a very good exercise. Work with your child's caregiver to plan the best exercise program for your child.

What other care will my child need for diabetes mellitus type 2?

• Vaccinations: A vaccination is a shot of medicine to help prevent your child from getting sick. Ask your child's caregiver about the vaccinations that your child may need.
  
  
  • Influenza vaccine: This vaccine helps prevent influenza (flu). Everyone older than age 6 months should get a yearly influenza vaccine. Get the vaccine as soon as it is available, usually in October or November each year.
    
    
  • Pneumococcal vaccine: Your child should also get an extra pneumococcal vaccine when he is 2 years old or older.
  
  
• Medical alert identification: Make sure your child always wears a medical alert bracelet or necklace or carries a card that says he has diabetes. You may get one from your local drugstore or ask your caregiver where to get these items.
  
  
• Talk to officials at your child's school: Make sure your child's teachers know he has diabetes. Provide instructions about what to do if your child has symptoms of high or low blood sugar levels at school.
  
  
• Smoking:
  
  
  • Do not let anyone smoke around your child. Breathing in cigarette smoke can harm your child's body in many ways. Your child is more likely to get certain types of infections if he breathes in cigarette smoke. Being around cigarette smoke can also affect your child’s lungs and cause breathing problems. Do not let anyone smoke inside your home. If you smoke, you should quit. Quitting smoking will improve your health and the health of those around you. Ask your caregiver for more information about how to stop smoking if you are having trouble quitting.
    
    
  • Do not let your child smoke: Smoking worsens the problems that can occur with diabetes, such as poor blood flow to the feet. Your child is more likely to get heart disease, lung disease, cancer, and other health problems if he smokes. Ask your child's caregiver for help and more information about how to stop smoking if your child smokes.
  
  
• Sexually active girls: If you have an older daughter who has diabetes, talk to her about how diabetes affects pregnancy. Explain the risk of problems when diabetes is poorly managed. Ask her caregiver for more information about diabetes, birth control, and pregnancy.

Where can I find support and more information?

School aged children want to be like their friends. Your child may feel different because of the lifestyle changes that are needed with diabetes. Talk to caregivers about how you can support and help your child. You and your child or family may want to see a mental health worker (talk therapist). This caregiver can help your child take an active role in managing diabetes. Contact the following for more information:

• American Diabetes Association
  1701 North Beauregard Street
  Alexandria , VA 22311
  Phone: 1- 800 - 342-2383
  Web Address: http://www.diabetes.org
  

When should I contact my child's caregiver?

Contact your child's caregiver if:

• Your child is vomiting or has an upset stomach.
  
  
• Your child feels weak or very tired.
  
  
• Your child feels dizzy, has headaches, or gets easily irritated.
  
  
• Your child has numbness in his arms or legs.
  
  
• Your child has red, dry skin.
  
  
• You have questions or concerns about your child's disease, medicine, or care.

When should I seek immediate help?

Seek care immediately or call 911 if:

• Your child has blurred or double vision.
  
  
• Your child has trouble staying awake or focusing.
  
  
• Your child is shaking or sweating.
  
  
• Your child's breath has a fruity, sweet smell.
  
  
• Your child's breathing is deep and labored, or rapid and shallow.
  
  
• Your child's heartbeat is fast and weak.

Care Agreement

You have the right to help plan your child's care. Learn about your child's health condition and how it may be treated. Discuss treatment options with your child's caregivers to decide what care you want for your child.

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The above information is an educational aid only. It is not intended as medical advice for individual conditions or treatments. Talk to your doctor, nurse or pharmacist before following any medical regimen to see if it is safe and effective for you.

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