The diagnosis of type 2 diabetes is becoming increasingly common
in U.S. kids and teens, especially in those who are overweight.
Some studies report that between 8% and 45% of children who've
been newly diagnosed with diabetes have the form known as type 2,
depending on geographic location and racial/ethnic group.
Diabetes is a chronic condition that needs close attention, but
with some practical knowledge, you can become your child's most
important ally in learning to live with the disease.
What Is Diabetes?
Diabetes is a disease that affects how the body uses
glucose
, the main type of sugar in the blood. Glucose comes from the foods
we eat and is the major source of energy needed to fuel the
body's functions.
After you eat a meal, your body breaks down the foods you eat
into glucose and other nutrients, which are then absorbed into the
bloodstream from the gastrointestinal tract. The
glucose level
in the blood rises after a meal and triggers the
pancreas
to make the hormone
insulin
and release it into the bloodstream. But in people with diabetes,
the body either can't make or respond to insulin properly.
Insulin works like a key that opens the doors to cells and
allows the glucose in. Without insulin, glucose can't get into
the cells (the doors are "locked" and there is no key)
and so it stays in the bloodstream. As a result, the level of sugar
in the blood remains higher than normal. High blood sugar levels
are a problem because they can cause a number of symptoms and
health problems.
What Is Type 2 Diabetes?
There are two major types of diabetes:
type 1
and
type 2
. Both type 1 and type 2 diabetes cause blood sugar levels to
become higher than normal. However, they cause high blood sugar
levels to occur in different ways.
Type 1 diabetes
(formerly called insulin-dependent diabetes or juvenile diabetes)
occurs when the person's own immune system attacks and destroys
the cells of the pancreas that produce insulin. Children with type
1 diabetes need insulin to help keep their blood sugar levels
within a normal range.
Type 2 diabetes (formerly called
non-insulin-dependent diabetes
) is different. In contrast to someone with type 1 diabetes,
someone with type 2 diabetes still produces insulin. But the body
doesn't respond to the insulin normally. Glucose is less able
to enter the cells and do its job of supplying energy (doctors call
this
insulin resistance
). This causes the blood sugar level to rise, making the pancreas
produce even more insulin. Eventually, the pancreas can wear out
from working overtime to produce extra insulin. Then, the pancreas
may no longer be able to produce enough insulin to keep a
person's blood sugar levels within a normal range.
People with insulin resistance may or may not develop type 2
diabetes - it all depends on whether the pancreas can produce
enough insulin to keep blood sugar levels normal. Repeatedly high
blood sugar levels are a sign that a person has developed
diabetes.
Children and teens with type 2 diabetes use diet, exercise, and
medicines that improve the body's response to insulin to
control their blood sugar levels. Sometimes kids and teens with
type 2 diabetes may need to take
insulin shots
or use an
insulin pump
, too.
Who Gets Type 2 Diabetes?
Although no one knows for certain what causes type 2 diabetes,
there seems to be a genetic component to developing it. In fact,
it's estimated that 45% to 80% of children with type 2 diabetes
have at least one parent with diabetes and may have a significant
family history of the disease. In some cases, a parent may be
diagnosed with type 2 diabetes at the same time as his or her
child.
Most children and adults who develop type 2 diabetes are
overweight
. Excess fat makes it harder for the cells to respond to insulin.
And being inactive further reduces the body's ability to
respond to insulin. In the past, doctors called this type of
diabetes
adult-onset diabetes
because it almost exclusively affected overweight adults. Today,
that description is no longer accurate. More kids and teens are
being diagnosed with type 2 diabetes, probably because more kids
and teens are overweight.
Certain ethnic groups also tend to be more prone to developing
type 2 diabetes, including people of Native American, African
American, Hispanic/Latino, or Asian/Pacific Island descent. Also,
children who have reached
puberty
are more likely to develop the disease than younger children,
probably because of normal rises in the levels of hormones that can
cause insulin resistance during this stage of rapid growth and
physical development.
Signs and Symptoms of Type 2 Diabetes
The symptoms of type 2 diabetes aren't always obvious and
they can take a long time to develop. Sometimes, there are no
symptoms. It's important to remember that not everyone with
insulin resistance or type 2 diabetes develops these warning signs,
and not everyone who has these symptoms necessarily has type 2
diabetes.
But a child or teen who develops type 2 diabetes may:
- urinate frequently.
The kidneys respond to high levels of glucose in the blood by
flushing out the extra glucose in urine. A child with a high
blood sugar level needs to urinate more frequently and in larger
volumes.
- drink a lot of liquids.
Because the child is peeing so frequently and losing so much
fluid, he or she can become very thirsty. He or she drinks a lot
in an attempt to keep the levels of body water normal.
- feel tired often
because the body can't use glucose for energy properly.
Sometimes, children and teens with type 2 diabetes, insulin
resistance, or obesity may also develop thick, dark, velvet-like
skin around the neck, armpits, groin, between fingers and toes, or
on elbows and knees - a cosmetic skin condition called acanthosis
nigricans.
Polycystic ovary syndrome (PCOS) in girls is also often
associated with insulin resistance. PCOS is a hormone problem that
can cause the ovaries to become enlarged and develop fluid-filled
sacs called cysts. Girls with this condition often have irregular
periods or may stop having periods altogether, and they are more
likely to get excess facial and body hair growth. PCOS can also
result in fertility problems.
Children and teens with insulin resistance or type 2 diabetes
are also more likely to develop
hypertension
(high blood pressure) or abnormal levels of blood fats (
cholesterol
and triglycerides). When these problems cluster together in a
person, doctors call this
metabolic syndrome
. People with metabolic syndrome have a greater risk of developing
heart disease, stroke, and other health problems.
Diabetes can also cause long-term complications in some people,
including heart disease, stroke, vision impairment, and kidney
damage. Diabetes can also cause other problems in the blood
vessels, nerves, and gums. These problems don't usually show up
in kids or teens with type 2 diabetes who have had the disease for
only a few years. However, they can occur in adulthood in some
people with diabetes, particularly if their diabetes hasn't
been well controlled.
Doctors can determine if a person has diabetes by testing blood
samples for glucose. Even if a child or teen doesn't have any
symptoms of type 2 diabetes, doctors may order blood tests to check
for it in kids who are more likely to get it - like those who are
overweight.
If you think your child has symptoms of diabetes, talk to your
child's doctor, who may refer you to a
pediatric endocrinologist
, a doctor who specializes in the diagnosis and treatment of
children with diseases of the
endocrine system
, such as diabetes and growth disorders.
Living With Type 2 Diabetes
A child or teen with type 2 diabetes may need to:
- eat a healthy diet to help achieve a normal body weight while
getting the nutrients needed to grow and develop. Doctors may
recommend a low-salt or low-fat diet, especially if the child has
conditions such as high blood pressure or abnormal blood fat
levels.
- participate in physical activity regularly. Exercise helps
increase the body's response to insulin, and it helps the
body burn more calories, which can promote the loss of excess
body fat.
- get to and maintain a normal body weight.
- monitor blood sugar levels regularly.
- take insulin or other medications which help the body respond
to insulin more effectively.
- work closely with their doctors and diabetes health care team
to help achieve the best possible control of their diabetes and
be monitored for signs of diabetes complications and other health
problems that occur more frequently in children with type 2
diabetes.
Living with diabetes is a challenge, no matter what a
child's age, but young children and teens often have special
issues to deal with. Young children may not understand why the
blood testing and medications are necessary. They may be scared,
angry, and uncooperative.
Teens may feel different from their peers and may want to live a
more spontaneous lifestyle than their diabetes allows. Even when
they faithfully follow their treatment schedule, teens with
diabetes may feel frustrated when the natural adolescent body
changes during puberty may make their diabetes somewhat harder to
control.
Having a child with diabetes may seem overwhelming at times, but
you're not alone. Your child's diabetes care team is not
only a great resource for dealing with medical issues, but also for
supporting and helping you and your child cope and live with
diabetes.
What's New in the Treatment of Type 2 Diabetes?
Doctors and researchers are developing new equipment and
treatments to help children cope with the special problems of
growing up with diabetes.
Some kids and teens are already using new devices that make
blood glucose testing and insulin injections easier and more
effective. One of these devices is the insulin pump, a mechanical
device that can be programmed to deliver insulin more like the
pancreas does.
Researchers are also testing ways to stop diabetes before it
starts. For example, scientists are studying whether diabetes can
be prevented in those who may have inherited an increased risk for
the disease.
Until scientists have perfected ways to better treat and
possibly even prevent or cure diabetes, parents can help their
children lead happier, healthier lives by giving constant
encouragement, arming themselves with knowledge about the disease,
and making sure their children eat properly, exercise, and stay on
top of glucose levels every day. Doing so will enable kids to do
all the things that other children do while helping them grow up to
be healthy, well-adjusted, productive adults.
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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