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Type 2 Diabetes in Children
WHAT YOU NEED TO KNOW:
What is type 2 diabetes?
Type 2 diabetes is a disease that affects how your child's body uses glucose (sugar). Type 2 diabetes develops because either the body cannot make enough insulin, or it cannot use the insulin correctly.
What increases my child's risk for type 2 diabetes?
Your child has a higher risk for type 2 diabetes if he or she is overweight, and at least 2 of the following are true:
- A member of your child's family has type 2 diabetes.
- Your child is Native American, African American, Latino, Asian American or Pacific Islander.
- Your child has high blood pressure, high cholesterol, or is female and has polycystic ovary syndrome.
What are the signs and symptoms of type 2 diabetes?
Your child may have had high blood sugar levels for a long time before symptoms appear. Your child may have no symptoms or any of the following:
- More hunger or thirst than usual
- Frequent urination
- Dark patches of skin under the arms or in the groin area
- Tired feeling
- Blurred vision
- Tingling, numbness, or pain in the hands or feet
How is type 2 diabetes diagnosed?
Your child may need tests to check for type 2 diabetes by the time he or she is 10 years old:
- An A1c test shows the average amount of sugar in your child's blood over the past 2 to 3 months. Your child's healthcare provider will tell you the level that is right for your child. The goal is usually below 7.5%.
- A fasting plasma glucose test is when your child's blood sugar level is tested after he or she has fasted for 8 hours. Fasting means your child has not eaten anything or had anything to drink except water.
- A random glucose test can be done any time of day, no matter how long ago your child ate.
- An oral glucose tolerance test starts with a fasting blood sugar level check. He or she is then given a glucose drink. His or her blood sugar level is checked again after 2 hours. Healthcare providers look at how much your child's blood sugar level increases from the first check.
- Genetic testing may be done to check for genes that cause diabetes.
How is type 2 diabetes treated?
Type 2 diabetes is treated with lifestyle changes, oral medicine, and insulin.
- The goal is to help control your child's blood sugar level. Also, the goal is to decrease or delay complications of diabetes such as neuropathy and retinopathy. Type 2 diabetes can cause complications in children sooner than in adults.
- Your child's healthcare provider will decide which treatment is right for your child. Some children can control blood sugar levels with a nutrition plan and exercise. Your child may start receiving insulin injections. Insulin is given if it is not clear if your child has type 1 or type 2 diabetes. Insulin is also given if your child's blood sugar is above 250 mg/dL or A1c above 8.5%. Instead, your child may be given an oral medicine. This medicine will help your child's body properly use insulin that is made naturally. Your child may need both insulin and the oral medicine to control his or her blood sugar levels.
- Your child will have a diabetes care team. His or her care team may include physicians, nurse practitioners, and physician assistants. It may also include nurses, dietitians, exercise specialists, pharmacists, and a dentist. You, your child, and other family members will also be part of the team. The team will make goals and plans to manage diabetes and other health problems. The plans and goals will be specific to your child's needs.
What is diabetes education?
Diabetes education will start right away. Members of your child's team will teach you and your child the following:
- How to check your child's blood sugar level: You and your child will learn what his or her blood sugar level should be. You will be given information on when to check your child's blood sugar level. You will learn what to do if his or her level is too high or too low. Write down the times of your checks and your child's levels. Take them to all follow-up appointments.
- About insulin: You, your child, and your family members will be taught how to draw up and give insulin. You will learn how much insulin your child needs and what time to inject insulin. You will be taught when not to give insulin. You will also be taught how to dispose of needles and syringes.
- About nutrition: A dietitian will help you make a meal plan to keep your child's blood sugar level steady. You will learn how food affects your child's blood sugar levels. You will also learn to keep track of sugar and starchy foods (carbohydrates). Do not let your child skip meals. Blood sugar levels may drop too low if your child has received insulin and does not eat.
- Exercise and diabetes: You and your child will learn why exercise is important. A plan will be made for your child's exercise. Your child's healthcare provider will tell you what a healthy weight for your child would be. He or she will help you and your child make a plan to get to that weight and stay there. Encourage your child to be active for at least 60 minutes on most days of the week. Help your child include activities 3 days each week that strengthen his or her muscles and bones.
What do I need to know about nutrition for my child?
A dietitian will help you and your child create a meal plan. The plan will help keep your child's blood sugar level steady. The following are tips to help you to start helping with your child's nutrition:
- Keep track of carbohydrates (sugar and starchy foods). Your child's blood sugar level can get too high if he or she eats too many carbohydrates. His or her dietitian will help you plan meals and snacks that have the right amount of carbohydrates.
- Give your child low-fat and low-sodium foods. Examples of low-fat foods are lean meat, fish, skinless chicken or turkey, and low-fat milk. Limit high-sodium foods, such as potato chips and soup. Do not add salt to food you cook. Limit your child's use of table salt.
- Give your child high-fiber foods. Foods that are a good source of fiber include vegetables, whole-grain bread, and beans.
What else can I do to help my child manage type 2 diabetes?
- Go to all follow-up appointments. Your child will need to return to have his or her A1c checked. The care team will make sure that treatment is working. Your child's treatment may need to be adjusted. Write down questions that you and your child have so you remember to ask them during his or her visits.
- Make sure your child always wears medical alert jewelry or carries a card that says he or she has diabetes. Ask your child's healthcare provider where to get these items.
- Give instructions to your child's school and care providers. Make sure your child's teachers and care providers know he or she has diabetes. Provide written instructions about what to do if your child has symptoms of high or low blood sugar levels.
- Do not smoke around your child. Do not let others smoke around him or her. Do not let your older child smoke. Nicotine and other chemicals in cigarettes and cigars can cause lung and heart damage. Cigarette smoke can worsen the problems that occur with diabetes. Ask your healthcare provider for information if you or child currently smoke and need help to quit. E-cigarettes or smokeless tobacco still contain nicotine. Talk to your healthcare provider before you or your child use these products.
- Ask about vaccines. Your child has a higher risk for serious illness if he or she gets the flu or pneumonia. Ask your child's healthcare provider if your child should get a flu or pneumonia vaccine, and when to get the vaccine.
What are the risks of type 2 diabetes in children?
Uncontrolled diabetes can damage your child's nerves and arteries. High blood sugar levels can damage his or her eyes and kidneys. Diabetes is life-threatening if it is not controlled. Control your child's blood glucose levels to help prevent complications.
When should I contact my child's care team?
- Your child has a low blood sugar level and it does not improve with treatment.
- Your child's blood sugar level is above 240 mg/dL and does not come down after a dose of insulin.
- Your child has ketones in his or her blood or urine.
- Your child has a fever.
- Your child has nausea or is vomiting and cannot keep any food or liquid down.
- Your child has symptoms of a low blood sugar level, such as trouble thinking, sweating, or a pounding heartbeat.
- Your child has blurred or double vision.
- Your child's breath has a fruity, sweet smell, or his or her breathing is deep and labored.
- Your child's heartbeat is fast and weak.
When should I contact my child's healthcare provider?
- Your child's blood sugar levels are higher than his or her target goals.
- Your child often has blood sugar levels that are too low.
- Your child has abdominal pain, diarrhea, or is vomiting.
- Your child has numbness in his or her arms or legs.
- Your child has warm, red patches of skin or a wound that does not heal.
- Your child is anxious or depressed.
- You have questions or concerns about your child's condition or care.
Care AgreementYou 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 healthcare providers to decide what care you want for your child. 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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