Type 2 Diabetes in Children

Type 2 diabetes is a chronic condition that affects how the body uses sugar (glucose) for energy. When a child’s blood glucose level is too high, it can lead to complications over time. Type 2 diabetes is becoming increasingly common in children and adolescents. 

Children with type 2 diabetes need to monitor their blood sugar levels. They may also require regular oral medication or insulin injections. 

This article will provide an overview of type 2 diabetes in children, including the symptoms, risk factors, and treatment options.

What Is Type 2 Diabetes?

Children and teens with type 2 diabetes cannot use glucose for energy, and the level in the blood becomes too high.

The pancreas is an organ that produces the hormone insulin, which allows glucose to enter the body’s cells and be used for energy. When a child’s cells do not respond normally to insulin, the pancreas makes more. Eventually, the pancreas cannot keep up, and the blood glucose level becomes too high. This then leads to type 2 diabetes. 

Children and adolescents with type 2 diabetes are at increased risk of heart disease, vision loss, kidney disease, and other health problems.

Symptoms in Children

Many children and adolescents with type 2 diabetes do not have symptoms. Symptoms can develop over time. You may notice signs of low or high blood sugar in your child, including:

• Increased thirst or dry mouth
• Hungrier than usual 
• Increased urination or accidents
• Fatigue
• Reports of blurred vision
• Sores that do not heal
• Frequent infections

Causes

The exact cause of type 2 diabetes is unknown, but genetics does play a role. Type 2 diabetes occurs when a child or adolescent has insulin resistance over time. Insulin resistance refers to the cells' inability to respond to insulin and use glucose for energy. 

When we eat, food is broken down, and sugar enters the bloodstream. This triggers the pancreas to make insulin, which allows glucose to enter the cells and be used for energy. When the cells cannot respond to insulin, glucose stays in the bloodstream. 

Risk Factors

There are several known risk factors for type 2 diabetes in children. These include:

• Being diagnosed with prediabetes (high blood sugar levels that are not high enough to be diagnosed as diabetes)
• Family history
• Body weight in the overweight or obese range
• Lack of physical activity
• Diet high in sugar, red meat, processed foods, and sweetened beverages
• High triglyceride level (a type of fat in the blood)
• Low high-density lipoprotein (HDL) level (considered "good" cholesterol)
• Metabolic syndrome (a group of diseases that increase your risk of developing heart disease, type 2 diabetes, and stroke)
• Polycystic ovary syndrome (PCOS) (ovaries that produce an abnormally high amount of androgens)

Diagnosis

If you suspect your child has type 2 diabetes, make an appointment for them to see their healthcare provider immediately. Type 2 diabetes requires ongoing treatment.

Your child’s provider will likely start the appointment with a physical exam and thorough medical history. They will ask you about your child’s symptoms, diet, activity level, and any family members who have diabetes. 

Diagnostic tests to expect include:

• A1C test: Measures the average blood sugar over the past three months
• Fasting plasma glucose (FPG) test: Measures the current blood sugar level, which requires fasting for eight hours before the test
• Random plasma glucose (RPG) test: Measures the current blood glucose level without fasting

Treatment

The purpose of treatment of type 2 diabetes in children is to manage blood sugar levels. This is usually done through healthy lifestyle changes such as diet and exercise. If lifestyle changes are ineffective, your child’s healthcare provider may recommend insulin or other diabetes medications. Regular blood glucose monitoring is also important to your child’s treatment.

If your child has recently been diagnosed, your medical team may include your healthcare provider, a registered dietitian, a certified diabetes care and education specialist, and other providers if needed.  

Healthy Eating

A healthy diet can help manage blood glucose levels and prevent the need for medications. Children with type 2 diabetes benefit from a diet rich in fruits, vegetables, whole grains, nuts, lean protein, healthy fats, and fiber. A registered dietitian can work with your family to develop a healthy eating plan that includes your child’s favorite foods and even occasional treats.

Physical Activity

For children with type 2 diabetes, physical activity helps use extra glucose and improves the body’s response to insulin. Aim for 60 minutes of physical activity daily. This can be broken up into several 10–15-minute sessions. Choose activities that your child enjoys. Exercising as a family is a great way to make physical activity a part of your child’s life. 

Blood Glucose Monitoring 

Monitoring blood glucose levels is an integral part of treatment for people with type 2 diabetes, especially for those taking insulin or other medications that could cause low blood sugar. Your healthcare provider will explain how and when to check your child’s level.

Medications 

When lifestyle changes are not effective at controlling your child’s blood glucose levels, the next step is medication, which may include:

• Glumetza (metformin): This oral pill lowers the sugar that a child’s liver releases into the bloodstream between meals and helps the cells use insulin more effectively.
• Victoza (liraglutide): This injection helps the body release more insulin from the pancreas after meals. Possible side effects include nausea and diarrhea.
• Insulin: If your child’s blood sugar levels remain high, they may need insulin injections. The hormone insulin allows sugar into cells to be used for energy. Insulin may be given in a long-acting form once daily or in a rapid-acting form with meals. It is usually administered with a syringe or insulin pen. 
• Jardiance (empagliflozin): This oral pill lowers the sugar reabsorbed by a child's kidneys.
• Synjardy (empagliflozin and metformin hydrochloride): This oral pill is a combination of Glumetza and Jardiance.

Prevention

Type 2 diabetes is preventable in children and adolescents. Prevention strategies include weight loss (if needed), a healthy diet, and physical activity. Talk with your healthcare provider about your child's healthy weight range.

Living With Diabetes

Much of the management of diabetes falls on a child’s parents or guardians. This includes checking blood sugar levels, providing healthy meals and snacks, encouraging regular exercise, and administering medications if prescribed. Caregivers also need to be aware of the signs of high or low blood sugar levels and how to treat them. 

Regular appointments with your child’s healthcare team are essential. Your child’s providers will review their blood sugar levels, nutrition plan, exercise schedule, and weight range. 

Monitoring your child’s emotional well-being is also important. Depression is commonly associated with a diagnosis of type 2 diabetes. Research shows that the rate of depression in children and adolescents with diabetes is three times higher than in those without diabetes.

Summary

Type 2 diabetes in children is a chronic condition that affects how the body uses glucose for energy. Possible symptoms include increased thirst, hunger and urination, fatigue, blurred vision, sores that don’t heal, and frequent infections. Type 2 diabetes is preventable in children. Maintaining a healthy weight, eating a nutritious diet, and staying physically active can prevent and treat this condition. 

A Word From Verywell 

Type 2 diabetes is a serious condition that requires treatment. Managing your child’s condition likely feels overwhelming. Stay in close contact with your child’s healthcare team and ask questions. Learning about type 2 diabetes takes time. Take comfort in knowing that you are not alone as you manage your child's health.