Diabetes Mellitus Type 2 In Children

GENERAL INFORMATION:

What is diabetes mellitus type 2? Diabetes (deye-ah-BEE-teez) mellitus is a disease affecting 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 body cells. The four types of diabetes are type 1, type 2, other specific types, and gestational diabetes. With type 2 diabetes, your child's body has trouble using insulin or is not making enough insulin. It usually begins during puberty but can also start even in younger children.

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. In insulin resistance, 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 working and stop making insulin. When this happens, sugar will build up in his blood.

What puts my child at risk of having diabetes mellitus type 2? Your child may have an increased risk of having type 2 diabetes if he has any of the following:

• High blood pressure and high cholesterol (fat) levels in the body.
  
  
• Someone else in your family has type 2 diabetes.
  
  
• Weight more than what your child's caregiver recommends
  
  
• If your child is Native American, African American, Latino, Asian American or Pacific Islander.

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. Your child may have any of the following:

• Blurred vision (eyesight).
  
  
• Frequent urination.
  
  
• Hungry most of the time.
  
  
• Losing weight without trying.
  
  
• More thirsty than usual.

How is diabetes mellitus type 2 diagnosed? Type 2 diabetes is diagnosed with blood sugar tests. Caregivers will test your child's blood sugar twice to be sure that he has diabetes. A positive blood sugar result should be repeated the next day. Your child may have any of the following blood sugar tests:

• Casual plasma glucose: This may be the first blood sugar test done if your child has symptoms of diabetes. Your child may have diabetes if his blood sugar is 200 mg/dl (milligrams per deciliter) or higher.
  
  
• Fasting plasma glucose: After your child has fasted (no food or liquid) for eight hours, his blood sugar will be checked. Your child may have diabetes if his blood sugar is 126 mg/dl or higher.
  
  
• Oral glucose tolerance test (OGTT): Your child's blood will be drawn two or more times during this test. After fasting, the first sample of blood will be taken. Your child will then be given a glucose drink. Two hours after drinking the liquid, the second sample of blood will be taken. A blood sugar result of 200 mg/dl or higher may mean your child has diabetes.

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 by having him eat the right foods and exercising. Your child may need to take diabetes medicine daily. You and your child will learn how to check your child's blood sugar at home. Your child's blood sugar level may have to be checked three or more times each day.

How do we check my child's blood sugar levels? Your child's caregiver will teach you and your child how to use a glucose monitor. This is a small device that tells how much sugar is in your child's blood. The monitor uses a small drop of blood from a prick on your child's finger. Record your child's blood sugar results in a diary each time you check it. Bring the diary with you when you see your child's caregiver.

What other health problems can diabetes mellitus type 2 cause? Having uncontrolled diabetes for a long time can damage your child's nerves, veins, and arteries. This can cause damage to his feet and legs. The buildup of sugar can also damage organs in your child's body. Uncontrolled diabetes can affect your child's eyes, kidneys and heart.

How can diabetes mellitus type 2 be controlled?

• Diet: A diabetes nurse or a dietitian will help you learn what your child needs to eat and how food affects his diabetes. Caregivers may suggest the following:
  
  
  • Your child's caregiver may suggest that you keep track of the amount of carbohydrate your child eats. Eating too much carbohydrate at one time can cause your child's blood sugar to rise to a very high level. Carbohydrates are found in starches (bread, cereal, starchy vegetables, and beans), fruit, fruit juice, milk, and yogurt. Sweets, such as candy, desserts, or regular soda also contain carbohydrates.
    
    
  • Choose foods for your child that are low in fat, saturated fat, and cholesterol. Lean cuts of meat, fish, and skinless poultry (chicken and turkey), and low fat milk are good examples.
    
    
  • Your child should not skip meals. Make sure your child eats the same amount of food for his meals and snacks about the same time every day. Continue to offer a variety of healthy foods along with your child's favorite foods. Your dietitian or caregiver will help you find a meal plan and schedule that works best for your child.
  
  
• Exercise: Controlling your child's weight by exercising can change the amount of insulin his body needs. Try to get him to be active at least 30 minutes every day. Playing can be a very good exercise. Develop biking and walking paths around school. Work with your child's caregiver to plan the best exercise program for your child

Where can I find support and more information? Having a child with type 2 diabetes is life-changing for you and your family. Accepting that your child has diabetes may be hard. School age children want to be like their friends. Your child may feel different because he has to take diabetes medicine, test his blood, and follow a meal plan. If your child is a teenager, doing these things make the normal troubles of adolescence even more difficult. Talk to your child's caregiver about how to help your child. You may want to join a support group which is a group of people who also have type 2 diabetes. Contact the following for more information:

• American Association of Diabetes Educators
  American Association of Diabetes Educators
  100 West Monroe Street, Suite 400
  Chicago, IL 60603-1901
  Phone: 1-800-338-3633
  Web Address: http://www.aadenet.org
  

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

• Juvenile Diabetes Research Foundation International
  120 Wall Street
  New York, NY 10005-4001
  Phone: 1-800-533-2873
  Web Address: http://www.jdf.org
  

CARE AGREEMENT:

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

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