Diabetes Mellitus Type 2 In Children

What is diabetes mellitus type 2?

Diabetes mellitus type 2 is a disease that affects how your child's body uses glucose (sugar). Insulin is a hormone that helps his body take sugar out of his blood and use it for energy.

What causes diabetes mellitus type 2?

Normally, when the blood sugar level increases, the pancreas makes more insulin. Type 2 diabetes develops because either your child's body cannot make enough insulin, or he has insulin resistance. Insulin resistance means his pancreas keeps making insulin but his body cannot use it correctly. After many years, his pancreas may stop making insulin.

What increases my child's risk of diabetes mellitus type 2?

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

• 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 any of the following signs of insulin resistance or conditions related to insulin resistance:
  
  
  • High blood pressure or high cholesterol
    
    
  • Acanthosis nigricans
    
    
  • Polycystic ovary syndrome (PCOS)
    
    
  • Born smaller than normal

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.

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

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.

• Blood glucose test: A sample of your child's blood is tested for the amount of sugar it contains.
  
  
• Fasting plasma glucose test: After your child has fasted for 8 hours, his blood sugar level is tested.
  
  
• Oral glucose tolerance test: After your child has fasted for 8 hours, his blood sugar level is tested. He is then given a glucose drink. His blood sugar level is checked 1 hour and again 2 hours after he drinks the glucose. Caregivers look at how much his blood sugar level increases from the first check.
  
  
• A1c 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 controlled. The goal is to help keep your child's blood sugar at a normal level. He must eat the right foods and exercise. He may also need to take medicine if he cannot control his blood sugar level with nutrition and exercise.

How do I check my child's blood sugar level?

You will be taught how to check a small drop of blood with a glucose monitor. You may need to check your child's blood sugar level at least 3 times each day. Ask his caregiver when and how often to check during the day. Ask what your child's blood sugar levels should be before and after he eats. Write down the results and show them to your child's caregiver. He may use the results to make changes to your child's medicine, food, or exercise schedules.

What should my child eat?

A dietitian will help you create a meal plan that will help your child keep his blood sugar levels under control. Do not let your child skip meals. His blood sugar level can get too low if he takes medicine and does not eat.

• Keep track of carbohydrates: Your child's blood sugar level can get too high if he eats too many carbohydrates in one meal or snack. His dietitian will help you plan meals and snacks that have the right amount of carbohydrates.
  
  
• Offer low-fat and low-sodium foods: Examples of low-fat foods are lean cuts of meat, fish, skinless poultry (chicken and turkey), and low-fat milk. Limit foods that are high in sodium. Sodium is found in salty foods. Some examples are soy sauce, potato chips, and soup. Do not add salt to food you cook. Limit your child's use of table salt.
  
  
• Offer high-fiber foods: Foods that are a good source of fiber include vegetables, whole grain bread, and beans.

How can my child's diabetes be managed?

• Keep all follow-up appointments: Your child's caregiver may want him to have additional tests to check his blood pressure, cholesterol, and A1c.
  
  
• Medicines: Make sure your child takes his insulin and other medicines as directed.
  
  
• Exercise: Exercise can help keep your child's blood sugar level steady. Have your child exercise for at least 60 minutes on most days of the week. Work with your child's caregiver to plan the best exercise program for your child. Your child may need a carbohydrate snack before, during, or after he exercises if he is taking diabetes medicine or insulin. If his blood sugar level is less than 100 mg/dL, give him a carbohydrate snack before exercise. Examples are 4 to 6 crackers, ½ banana, 8 ounces (1 cup) of milk, or 4 ounces (½ cup) of juice.
  
  
• Weight loss: Ask caregivers if your child needs to lose weight, and how much to lose. Ask them to help you and your child create a weight loss program.

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

• Medical alert identification: Make sure your child always wears medical alert jewelry or carries a card that says he has diabetes. Ask your child's 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.
  
  
• No smoking: Cigarette smoke can worsen the problems that occur with diabetes. Do not smoke around your child, and do not let others smoke around him. Do not let your child smoke. Ask your child's caregiver for information about how to stop smoking if you need help quitting.
  
  
• Pregnancy education: If you have an older daughter who has diabetes, explain the risk of problems when diabetes is poorly managed. Ask her caregiver for more information about diabetes, birth control, and pregnancy.
  
  
• Vaccines: Diabetes can put your child at risk of serious illness if he gets the flu or pneumonia. Ask your child's caregiver if your child should get a flu or pneumonia vaccine, and when to get the vaccine.

What are the risks of diabetes mellitus type 2 in children?

• Even with treatment, your child may be at an increased risk of thyroid or Celiac disease. If he is diagnosed after puberty, he may need cholesterol and other blood levels checked regularly. Certain medicines used to treat diabetes may increase the risk of pancreas or thyroid problems.
  
  
• Uncontrolled diabetes can damage your child's nerves, veins, and arteries. High blood sugar levels may damage other body tissue and organs over time, such as your child's eyes and kidneys. Diabetes can be life-threatening if it is not treated.

Where can I find 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 more tired than usual.
  
  
• 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 condition or care.

When should I seek immediate care?

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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