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Type 2 Diabetes and Kids

Not Just For Grown-Ups Anymore


Updated August 10, 2009

Type 2 Diabetes and Kids

Photo by Dan Colcer

According to the New England Journal of Medicine, type 2 diabetes represents 45 percent of all newly diagnosed cases of diabetes in children and adolescents. Type 2 diabetes used to be known as "adult onset" diabetes, occurring most often in people 40 year or older. Rising childhood obesity rates in recent years have caused a corresponding increase in previously "adult only" conditions. Type 2 diabetes, elevated blood pressure, high cholesterol, insulin resistance as well as sleep apnea and gallbladder problems are found more often in overweight and obese kids than ever before. Obesity is thought to be the number one cause of childhood type 2 diabetes.

Children are considered overweight when they are in the 85th percentile or above for weight compared to other children their age. Growth charts are used by pediatricians to track a child's height and weight. Usually measurements are taken at every yearly physical.

Diagnosing Type 2 Diabetes in Children

Diagnosis of childhood type 2 diabetes can be difficult because it often develops without symptoms. The usual symptoms include increased urination, increased thirst and weight loss, but a majority of kids who have type 2 don't show these signs. A simple urinalysis test performed at the pediatrician's office will show increased glucose in the urine, but often will not show the elevated ketones that would be present in an adult.

The American Diabetes Association (ADA) recommends screening kids at the age of 10 who are overweight who also have other risk factors for type 2 diabetes, such as family history, signs of insulin resistance, and ethnicity. Screening would include a fasting blood glucose test (FPG) and/or a oral glucose tolerance test (OGTT).

Treatments and Medications

If your child has been diagnosed with type 2 diabetes, you need to keep his blood glucose levels in the normal range.

Higher than normal blood glucose levels set the stage for serious complications down the road. This damages the body's blood vessels and can lead to blindness (retinopathy), nerve damage (neuropathy) and kidney failure (nephropathy). Cardiovascular problems such as heart disease and strokes can also result after many years of having diabetes.

Weight loss and exercise are still the number one priority for helping your child manage diabetes. Fat cells are more resistant to insulin than muscle cells, so reducing body fat and increasing muscle mass enables your child to use insulin much more efficiently. This will help lower blood glucose levels and keep them as close to normal as possible.

Sometimes, kids may need medications to help lower blood glucose. Insulin is sometimes prescribed, if diet and exercise is not enough. The FDA has not approved adult oral diabetes medications for use in children as yet, but they haven't formally disapproved them either. There are ongoing studies to research the safety and effectiveness of some oral diabetes medications in children and adolescents, and the FDA does offer a list of drugs that have been shown to be effective for pediatric use.

Your Child's Health Care

It's not easy to manage type 2 diabetes, even for adults, sometimes. It's a disease that needs to be controlled on many fronts. Eating plans, exercise routines, and medications, combined with keeping track of blood glucose levels, can be overwhelming for parents and kids alike. If insulin is prescribed, then there is the issue of learning about dosing and injection techniques for both you and your child.

It's important to enlist the help of a qualified pediatrician, pediatric endocrinologist or a certified diabetes educator who can help you learn how to manage the disease. A dietitian or nutritionist can help you plan your child's meals and an exercise counselor can teach your child the tools to become more active and provide a structured exercise program.

Keeping good control of blood glucose levels means monitoring your child's blood glucose periodically throughout the day. Many blood glucose monitors are available. Unfortunately, the only way to measure blood glucose is by pricking your child's finger or forearm. Understandably, this can cause some apprehension for both you and your child. But keep in mind that keeping blood glucose as close to normal as possible is the only way to prevent your child from developing the complications later on.

Additional information resources for parents...


"Type 2 Diabetes in Children." Diabetes Care Vol. 23, Number 3, Mar 2000 pages 1-9. 05 Jun 2007.

"Update of List of Approved Drugs for which Additional Pediatric Information May Produce Health Benefits in the Pediatric Population." Center for Drug Evaluation and Research. Jan 2006. U.S. Food and Drug Administration. 05 Jun 2007.

"What You Need to Know about Type 2 Diabetes in Children." Children with Diabetes. 19 Oct. 2005. 5 Jun 2007.

William H. Dietz, MD, PhD, and Thomas N. Robinson, MD, MPH, "Overweight Children and Adolescents." The New England Journal of Medicine Vol. 352:2100-210919 May 2005 06 Jun 2007.

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