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Type 2 diabetes is a chronic condition that can develop at any age, though it is uncommon before adolescence. It often has a slow, gradual onset, which can make it difficult to detect and diagnose in children.

According to the National Diabetes Statistics Report, 2020, about 210,000 children and adolescents under the age of 20 years in the United States have received a diagnosis of diabetes.

Type 2 diabetes is less common than type 1 diabetes in youth. The Statistics Report shows that doctors in the U.S. diagnosed type 2 diabetes in about 5,758 children and adolescents aged 10–19 years between 2014 and 2015.

The rates of children with type 2 diabetes are increasing along with rises in those with obesity.

Type 2 diabetes is a lifelong condition that can lead to serious complications if a person does not receive treatment.

However, with a carefully controlled diet, lifestyle adjustments, and medication to control blood sugar, the condition can enter long-term remission.

In this article, we look at the effects of type 2 diabetes in children.

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Type 2 diabetes often has a slow, gradual onset. Due to this, symptoms can be difficult to detect, and some children may have no symptoms at all.

Statistics show that about 34.2 million people in the U.S. have diabetes, and 7.3 million of those may not have a diagnosis.

The symptoms are similar in younger children, adolescents, and adults. Children with type 2 diabetes may experience the following symptoms:

  • Increased urination: A child with type 2 diabetes might urinate more frequently than they did before the condition developed. When there is an excess of sugar in the blood, the body excretes some of it in the urine, and excess water follows it.
  • Increased thirst: Children with type 2 diabetes might start expressing a need to drink more than usual. This is because more urination can cause dehydration, leading to thirst.
  • Fatigue: When the body does not use blood sugar effectively, a child may develop fatigue. The emotional and physical discomfort of living with the more severe effects of diabetes might also cause persistent feelings of fatigue.
  • Blurred vision: High blood sugar levels can draw fluid from the lenses of the eyes, making it harder to focus.
  • Darkened skin: Insulin resistance might lead to the development of a skin condition called acanthosis nigricans, which can cause areas of skin to darken. It often affects the armpits and the back of the neck.
  • Slow wound healing: High blood sugar levels can lead to longer healing times for sores and skin infections.

Problems with controlling blood sugar, or glucose, characterize diabetes. The pancreas usually helps a person control their blood sugar by releasing a hormone called insulin.

Insulin allows blood glucose to enter the cells, leaving the bloodstream and bringing down a person’s blood sugar level.

In a child or adult with type 2 diabetes, the body either does not produce enough insulin or develops insulin resistance, in which the cells become less sensitive to the effects of this hormone.

Type 2 diabetes can develop in anyone, including children. The condition is more likely to develop in people with overweight or obesity.

In the past, the medical community referred to type 2 diabetes as either adult-onset or non-insulin-dependent diabetes. However, the condition is occurring in an increasing number of children and adolescents as rates of obesity continue to rise.

Obesity increases the risk of type 2 diabetes by causing insulin resistance. This occurs when organs and tissues do not respond appropriately to insulin or absorb enough sugar from the blood.

Insulin resistance results in high blood sugar levels (hyperglycemia), a lower tolerance for glucose, more inflammation, and the production of too much glucose in the liver.

According to the Centers for Disease Control and Prevention (CDC), obesity affected about 18.5% of people aged 2–19 in the U.S. in 2015–2016.

The authors of a study from 2017 found that people under 25 years old who fell into the body mass index (BMI) ranges for obesity were four times more likely to develop type 2 diabetes than those in lower BMI ranges.

BMI is one method for comparing height and weight to provide an overview of health, although people should use it more as a general guide than as an accurate representation.

Secondhand smoke might also be a risk factor, according to a prospective cohort study from 2013. The researchers looked at the results of a survey of 37,343 females in France who had provided information on their exposure to secondhand smoke during their childhood.

Females with parents who smoked tobacco when they were growing up had a risk of type 2 diabetes that was 18% higher than those whose parents did not smoke.

Over 75% of children with type 2 diabetes have a close relative who has it, either due to genetics or shared lifestyle habits. Having a parent or sibling with type 2 diabetes is linked with an increased risk.

According to the CDC, type 2 diabetes is more common among people who are African American, Hispanic or Latino American, American Indian, or Alaska Native. Some Pacific Islanders and Asian Americans are also at higher risk.

To diagnose type 2 diabetes, a doctor will ask about the child’s symptoms, and they may take a blood sample to check glucose levels.

The doctor may also use a simple urine test to screen for sugar in the urine.

In the U.S., blood tests to diagnose diabetes include:

  • Fasting blood glucose: Doctors perform this test in the morning when the child has an empty stomach. A fasting blood glucose result of more than 126 milligrams per deciliter (mg/dl) is an indicator of diabetes.
  • Glycated hemoglobin (A1C): This test checks the amount of glucose that attaches to red blood cells over time. Doctors consider a diabetes diagnosis if the A1C measurement is greater than 6.5% or 48 millimoles per liter.
  • Random blood glucose: A doctor requests this test at a random time during the day. The medical community considers someone to have diabetes if their random blood glucose level is higher than 200 mg/dl.

For a reliable diagnosis, a medical professional may need to perform these tests on two separate occasions.

A doctor may also request multiple tests to check other factors, such as glucose tolerance.

Learn about random glucose testing here.

The treatment for type 2 diabetes is usually similar in children and adults, including diet, lifestyle, and exercise recommendations, though the FDA have approved fewer drugs for children.

A child with type 2 diabetes may need to monitor their blood glucose level regularly.

If a child is unable to do this themselves, a parent or caregiver may need preparation and training in how to check a child’s blood glucose.

Teachers, coaches, and responsible care providers may also need to know how to administer insulin for children with type 1 and 2 diabetes who need daily shots. Other adults who may care for the child, such as a babysitter or relative, will require similar guidance.

For children with type 2 diabetes who are taking insulin, caregivers may also need to know how and when to administer glucagon shots in situations where a child’s blood sugar level drops too far. Glucagon is a hormone that stimulates the release of stored glucose from the liver. It can be vital for reversing bouts of hypoglycemia, or low blood sugar.

Daily lifestyle choices are extremely important for children with diabetes. These include weight management, regular physical activity, and dietary changes.

Children taking insulin, and perhaps all children with diabetes, should wear diabetes bracelets that include vital information in case they become unresponsive during a hypoglycemic episode.

The bracelet should read “diabetes” on one side and provide necessary details, such as “insulin-controlled,” on the other.

This is especially important for children who are taking insulin because they may not know the symptoms of hypoglycemia well enough to be able to ask for help. If a child loses consciousness as a result of low blood sugar, a diabetes bracelet can help an adult understand the correct medication necessary for treatment.

A doctor may also prescribe other medications that help the body respond better to insulin.

The doctor will individualize the treatment and diet plan according to the child’s age and needs and the severity of the condition.

There is a wide range of diabetes bracelets available for purchase online.

Prevention of type 2 diabetes largely involves developing healthful lifestyle habits, such as the following:

Maintaining a moderate body weight

Ensuring that body weight stays within a moderate range for a person’s height and sex can reduce the risk of type 2 diabetes.

A doctor or dietitian can advise the parent or caregiver and child on target weight ranges and recommend an individualized program for losing weight, if necessary.

Eating a well-balanced diet

Each person’s body responds differently to different types of foods and diets, and there is no single best diet for diabetes.

If a child has type 2 diabetes, doctors typically recommend limiting the intake of added sugars and carbohydrates with a high ranking on the glycemic index (GI).

Measuring carbohydrate intake can ensure that a person consumes no more carbohydrates than the doctor recommends in their individualized diet plan. No single recommended carbohydrate intake is right for every person.

The type of carbohydrate is also important to consider. GI measures the speed at which glucose enters the bloodstream after people have eaten a particular food. Foods with a high GI score cause a quicker increase in blood glucose levels than those with a low GI.

Low-GI foods include sweet potatoes, most fruits, and oatmeal.

Breads and pastries made with white flour may cause blood sugar spikes. Instead, a diet for managing type 2 diabetes should include plenty of vegetables, lean proteins, and whole grains. Fruit is a great dessert option for children or adults with diabetes.

This food range supports more effective blood glucose control.

Read about some of the best foods for people with diabetes here.

Exercising

Regular exercise is important for maintaining a moderate weight and overall good health in children with diabetes.

The World Health Organization (WHO) recommend that children between 5–17 years of age get at least 60 minutes of moderate or vigorous physical activity every day. Adults can encourage children to play outside and engage in sports, if possible.

It may also be helpful for adults to encourage children and adolescents to cut back on video games, television, and similar devices and to create opportunities for active time as a family.

Children with type 2 diabetes are at risk of potentially serious complications, mostly later in life, including heart disease and stroke. These risks increase if diabetes is not well-controlled.

Other complications and conditions that medical professionals associate with type 2 diabetes include:

Type 2 diabetes is becoming more common in children as rates of childhood obesity continue to increase.

The condition can be challenging to detect and diagnose in children. Doctors are not yet sure of the long-term effects of having type 2 diabetes at a young age.

Healthful lifestyle habits, such as a well-balanced diet and plenty of physical activity, can help prevent and treat type 2 diabetes in children.

It is also essential that caregivers have the right provisions and knowledge to avoid or respond quickly to emergency situations.

Q:

How can I tell if my child has type 1 or type 2 diabetes?

A:

Symptoms of type 1 and type 2 diabetes are similar in many ways, and it is not always immediately possible to tell which type a child has.

Even though the rate of type 2 diabetes is increasing faster than type 1, it is type 1 diabetes that is still more common in children. Children with type 1 diabetes are more often at a moderate weight or have lost weight, but children with overweight can develop type 1 diabetes, too.

Children with type 1 diabetes usually develop symptoms more quickly, and they are often more ill than children with type 2 diabetes when doctors diagnose them. Talk to a doctor if a child has new symptoms of increased thirst or urination, unexplained weight loss, or if there are other concerns about symptoms of diabetes.

Karen Gill, MDAnswers represent the opinions of our medical experts. All content is strictly informational and should not be considered medical advice.