The symptoms of type 2 diabetes in children
According to the National Center for Chronic Disease Prevention and Health Promotion, doctors in the United States diagnosed diabetes in around 5,300 children and adolescents aged 10–19 years between 2011 and 2012.
Problems with controlling blood sugar, or glucose, characterize diabetes. The pancreas usually assists a person's blood sugar control by releasing a hormone called insulin.
This allows blood glucose to enter the cells, leaving the bloodstream, and bringing down the blood sugar level.
However, in a child or adult with type 2 diabetes, the body either does not produce enough insulin or develops insulin resistance, in which case the cells become less sensitive to the effects of this hormone.
Type 2 diabetes is a long-term illness that can lead to serious complications if a person does not receive treatment. At the moment, there is no cure.
However, with a carefully controlled diet, lifestyle adjustments, and medication to control blood sugar, the disease can enter long-term remission.
In this article, we look at the effects of type 2 diabetes in children.
In a child with type 2 diabetes, the body is either resistant to insulin or it cannot produce enough.
Similar symptoms develop in adults and children with type 2 diabetes.
However, type 2 diabetes often has a slow, gradual onset. Because of this, symptoms can be difficult to detect, and some children may have no symptoms at all.
According to the Centers for Disease Control and Prevention (CDC), around 30.3 million people in the U.S. have diabetes, and 7.2 million of those do not have a diagnosis.
Children and adults with 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. This might result in a child urinating more often.
- Increased thirst: Children with type 2 diabetes might start expressing a need to drink more than usual. More urination can cause dehydration and may lead a child to feel especially thirsty.
- Fatigue: When the body does not use blood sugar effectively, fatigue might develop. 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. This 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.
Causes and risk factors
Type 2 diabetes can develop in anyone, including children. The condition is more likely to develop in people who are overweight or obese.
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.
According to the CDC, obesity affected 13.7 million children and adolescents aged 2–19 years between 2015 and 2016 in the U.S. This is roughly equal to 18.5 percent of the population.
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 the lower ranges.
BMI is one method for comparing height and weight to provide an overview of health, although people should use it as a general guide more than an accurate representation.
Secondhand smoke might also be a risk factor, according to a prospective cohort study from 2013. The researchers looked at results from a survey of 37,343 women in France who had given information on their exposure to secondhand smoke during their childhoods.
Women with parents who smoked tobacco when they were growing up had a risk of type 2 diabetes that was 18 percent higher when the researchers compared it with those whose parents did not smoke.
Other risk factors for type 2 diabetes in children include:
- having a parent or sibling with the condition
- being of Asian, Pacific Islander, African, Native American, or Latino descent
- physical signs of insulin resistance, such as acanthosis nigricans
Obesity causes insulin resistance, which increases the risk of type 2 diabetes.
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 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 (mmol).
- 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.
Treatment for type 2 diabetes is usually similar in children and adults.
However, as some children may not be able to monitor blood sugar regularly, some adults, such as those at their school, may need preparation and training in how to check a child's blood glucose.
Teachers, coaches, and responsible care providers will also need to know how to administer insulin for children with type 1 and 2 diabetes who need daily shots. Other adults that may look after 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 blood sugar 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 interventions are also extremely important. These include weight management, regular physical activity, and dietary changes.
Children taking insulin, and perhaps all children with diabetes, should also 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, as they may not know the symptoms of hypoglycemia to raise concern. If a child loses consciousness as a result of low blood sugar, a diabetes bracelet can help an adult administer the correct medication.
A doctor may also prescribe other medications that help the body respond better to insulin. The child may need to monitor their blood glucose level regularly, as well.
The doctor will individualize the treatment and diet plan according to the child's age, needs, and the severity of the condition.
Prevention of type 2 diabetes largely involves developing healthful lifestyle habits, such as the following:
Maintaining a healthy body weight
Ensuring that body weight stays within a normal range for a person's height and gender, and race can reduce the risk of type 2 diabetes.
A doctor or dietitian can advise the parent and child on target weight ranges and recommend an individualized program for losing weight, if necessary.
Eating a well-balanced diet
If a child has type 2 diabetes, they should limit intake of added sugars and carbohydrates with a high ranking on the glycemic index (GI).
Carb counting can ensure that a person consumes fewer 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 level than those with a low GI.
Children with type 2 diabetes should generally eat low-GI foods, or those with scores under 55, such as sweet potato, 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 fruits, vegetables, lean proteins, and whole grains.
This food range supports more effective blood glucose control and reduces the risk of type 2 diabetes.
Exercising for at least 60 minutes each day will help children maintain a healthy weight.
Regular exercise is essential for maintaining a healthy 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 should encourage children to play outside, engage in sporting activities, and limit time in front of a screen if possible.
It may be helpful for adults to encourage children and adolescents to cut back on video games, television, and similar devices.
Other complications and conditions that medical professionals associate with type 2 diabetes include:
- high blood pressure
- high cholesterol levels in the blood
- eye damage, or diabetic retinopathy
- nerve damage, or diabetic neuropathy
- kidney damage and failure, or diabetic nephropathy
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.
Encouraging healthful lifestyle habits, involving 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.
How can I tell if my child has type 1 diabetes.
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 the more common in children. Children with type 1 diabetes are more often at a normal weight or have lost weight, but overweight children 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 the doctor if your child has new symptoms of increasing thirst or urination, weight loss you can’t explain, or you have other concerns about symptoms of diabetes.Karen Gill, MD Answers represent the opinions of our medical experts. All content is strictly informational and should not be considered medical advice.
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