After kids or teens are diagnosed with
type 2 diabetes
, the next step for parents and doctors is creating a treatment
plan that allows kids to manage their condition and stay healthy
and active. Doctors or members of your child's
diabetes health care team
may call this a diabetes management plan.
Treatment plans for type 2 diabetes differ from child to child,
based on your child's needs and the suggestions of your
child's diabetes health care team.
Type 2 Diabetes Treatment Basics
The
blood glucose level
is the amount of glucose in the blood.
Glucose
is a sugar that comes from the foods we eat, and it's also
formed and stored inside the body. It's the main source of
energy for the cells of the body, and it's carried to each cell
through the bloodstream.
Insulin
is a hormone that allows the glucose to get into the cells. In type
2 diabetes, the body doesn't respond normally to insulin, so
glucose is less able to enter the cells. This causes the blood
glucose level to rise.
For children with diabetes, the goals of treatment are to
control the condition in a way that helps minimize symptoms and
prevent short- and long-term health problems, while making sure a
child has normal physical, mental, emotional, and social growth and
development.
High levels of blood glucose, or blood sugar, can cause both
short- and long-term health problems, so a major goal of treatment
for kids with diabetes is to keep blood sugar levels in a healthy
range. It is also important to treat other conditions that can be
associated with type 2 diabetes, like obesity, high blood pressure,
or abnormal blood lipid (fat) levels.
In general, kids with type 2 diabetes need to:
- eat a healthy, balanced diet and follow a meal plan
- get regular exercise
- take medications as prescribed
- monitor blood sugar levels regularly
Helping kids with type 2 diabetes switch to healthier habits is
a key part of treatment. Because most children with type 2 diabetes
are overweight when they are diagnosed, it's important to
promote healthy eating and physical activity to prevent further
weight gain or to encourage weight loss while making sure kids grow
and develop properly.
Eat a Healthy, Balanced Diet and Follow a Meal Plan
Weight gain occurs when a person eats more calories, or energy,
than he or she uses up through physical activity. The body stores
those extra calories as fat. Over time, excessive weight gain can
lead to
obesity
and diseases related to obesity like type 2 diabetes and heart
disease.
Kids with type 2 diabetes who are trying to manage their weight
still need energy to develop normally. To get it, they'll need
enough calories to grow without gaining too much fat. The best way
for a child with type 2 diabetes to manage his or her weight is to
eat nutritious foods and exercise.
Many parents worry, "What can I feed my child with type 2
diabetes?" The answer is simple: a balanced, healthy diet.
Kids with diabetes benefit from the same kind of diet as people
without diabetes - one that includes a variety of nutritious foods
that help the body grow and function properly.
The three main types of nutrients found in foods are
carbohydrates
(carbs), proteins, and fats, which all provide energy in the form
of calories. Foods containing carbohydrates cause blood sugar
levels to go up the most. Foods that contain mainly protein and/or
fat don't affect blood sugar levels as much as foods with
carbohydrates, but they still contain calories. Our bodies need all
of the nutrients - in varying amounts - to function normally.
You and the diabetes health care team will create a
diabetes meal plan
for your child that incorporates foods with all of the essential
nutrients. Meal plans typically consist of guidelines for providing
your child breakfast, lunch, and dinner with small, scheduled
snacks.
The diabetes meal plan won't restrict your child to eating
specific foods, but it will guide you in selecting choices from the
basic
food groups
to achieve a nutritious balance. A meal plan is based on your
child's age, activity level, schedule, and food likes and
dislikes. It should also be flexible enough to accommodate special
situations like parties and holidays. The meal plan should make it
easier to keep your child's blood sugar within his or her goal
range.
Your child's diabetes meal plan may also recommend limiting
extra fat and "empty" calories (foods that contain lots
of calories but few nutrients like vitamins and minerals). To reap
the benefits of a healthy diet, everyone should limit these foods,
anyway, because eating too much of them can lead to weight gain or
long-term health problems like heart disease, for which people with
diabetes are already at risk.
Portion Control is Key
Portion control - even of healthy foods - is key for kids with
type 2 diabetes because they generally weigh more than kids their
age who don't have the disease. As you're following your
child's meal plan, be wary of special foods marketed to people
with diabetes. Sugar-free and fat-free foods are not always
calorie-free or even low-calorie foods. And remember, to get to a
healthy weight, kids need to cut back on extra calories, not eat
more of them.
A registered dietitian (RD) can help you choose and cook
healthier foods, read food labels, and learn how much food your
child should be eating in a day. The RD can also adjust meal
plans depending on how your child is doing with regard to meeting
weight management goals. If you haven't met a dietitian as part
of your child's diabetes health care team, ask your child's
doctor for a referral to see one.
Get Regular Exercise
Exercise
is good for everyone - adults and children - with or without
diabetes. But overweight children and teens with type 2 diabetes
tend to be less active than children without diabetes, so exercise
is a very important part of the treatment plan. Exercise helps
improve the body's response to insulin, which helps to control
blood sugar levels. It also helps the body burn more calories,
which can promote a loss of excess body fat. And it's healthier
for growing kids who are overweight to burn more calories through
exercise than to severely restrict the amounts of food they can
eat.
Regular physical activity may also help reduce the risk of other
chronic illnesses, like cancer. In addition to all of these
benefits, exercise can help kids with diabetes:
- keep
blood lipids
and
blood pressure
under control
- get and keep their heart, lungs, and blood vessels in good
shape
- feel more normal by doing things that kids without diabetes
can do
Kids don't have to be athletic to reap the benefits of
physical activity. Things like walking the dog, helping around the
house, and playing outside with friends are great - anything that
gets your child moving regularly can go a long way toward helping
your child's diabetes.
Avoid Problems During Exercise
To help avoid problems during exercise, kids with type 2
diabetes may need to:
- have an extra snack prior to activity
- carry snacks, water, and supplies with them when they
exercise
- check their blood sugar levels before, during, and after
exercise
- wear a medical identification bracelet (this should be worn
always, but it's even more important when exercising)
- make sure their coaches know about their diabetes and what to
do if problems occur
Your child's diabetes health care team will offer specific
suggestions to help your child get ready for exercise or join a
sport. They'll also give you written instructions to help you
and your child respond to any diabetes problems that may occur
during exercise, like
hypoglycemia
(low blood sugar), or
hyperglycemia
(high blood sugar).
Take Medications as Prescribed
Sometimes, a combination of diet and exercise are enough to
control blood sugar levels in a child with type 2 diabetes. Other
times, pills that help the child's insulin work better need to
be taken as well. These pills are not a form of insulin.
Sometimes pills for diabetes - even when combined with diet and
exercise - still aren't enough to keep blood sugar levels under
control, and a child with type 2 diabetes must take insulin. The
acids and digestive juices in the stomach and intestines would
break down and destroy insulin if it was swallowed, so it can't
be taken in a pill. The only way to get insulin into the body right
now is with an injection or an
insulin pump
.
There is no-one-size-fits-all insulin schedule - the types of
insulin used and number of daily injections your child needs will
depend on your child's diabetes management plan. Usually,
children inject a combination of different types of insulin to
handle the sugar that circulates in the blood both after eating and
in between meals.
You can't turn off the action of insulin once it's been
injected, so insulin doses need to be adjusted to handle the rise
in blood sugar that occurs with meals and provide the amounts of
insulin the body needs between meals and overnight. Eating meals at
regular times generally makes this easier to accomplish. Although
eating on schedule may work well for younger children, sticking to
a routine may be a bigger challenge for older kids, whose school,
sleep, and social schedules may not be as routine. Your child's
diabetes health care team can help you work through any problems
your child may be having with scheduling meals and insulin
injections.
The promising news about type 2 diabetes is that by following a
balanced diet, getting regular physical activity, and achieving a
healthy weight for height, blood sugar levels can improve
significantly. In some kids, following the treatment plan for type
2 diabetes can even eliminate the need for medication
altogether.
Monitor Blood Sugar Levels
Another part of treating type 2 diabetes involves checking blood
sugar levels regularly and responding to the results. Frequent
testing is necessary to help control blood sugar levels, so that
kids with diabetes feel well, grow and develop normally, and have a
reduced risk of developing long-term diabetes problems. Your
child's diabetes treatment plan will recommend how many times a
day your child's blood sugar levels should be checked -
it's the only way to know how your child is doing with blood
sugar control.
Your child's diabetes team will also let you know what your
child's target blood sugar levels should be. In general, kids
with type 2 diabetes should test their blood sugar levels with a
blood glucose meter
at least twice a day, but your child may need to test more
frequently if he or she is taking insulin, has just been diagnosed,
or is having problems with blood sugar control.
A blood glucose meter tells you what your child's blood
sugar level is at the moment you test. Another type of blood sugar
test, the
glycosylated hemoglobin
(hemoglobin A1c or HbA1c) test, can give an indication of what your
child's blood sugar levels have been like over the past few
months.
Putting it All Together
Treating and managing diabetes may seem complicated and
overwhelming at times. But your child's diabetes health care
team is there for you. Your child's diabetes management plan
should be easy to understand, detailed, and written down for easy
reference. You should also have the names and phone numbers of your
child's diabetes health care team members in case of
emergencies or if you have questions about how to take care of your
child's diabetes.
In addition to the diabetes treatments mentioned above, you may
also hear about alternative or complementary treatments for
diabetes, such as herbal remedies and vitamin or mineral
supplements. Not enough studies have been done to prove their
effectiveness, although research is presently being done to study
their possible benefits. Aside from being potentially ineffective,
these practices can even be dangerous for kids and teens with type
2 diabetes, especially if they are used to replace medically
recommended treatments. Talk to your child's diabetes health
care team if you have questions.
Each day, researchers all over the world are working to find a
cure for diabetes, and many treatment advances have occurred to
make treatment easier and more effective. Insulin may soon be
available in pill, patch, and spray forms, and an artificial
pancreas
- a device that senses blood sugar and gives insulin - is currently
being tested. Although these new developments are exciting, all of
them still need extensive testing - especially for use in children
- before they become available.
Reviewed by:
Steven Dowshen, MD
Date reviewed: April 2007
Note: All information is for educational purposes only. For specific medical advice,
diagnoses, and treatment, consult your doctor.
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