Pediatric Type 2 Diabetes

Pediatric Type 2 Diabetes

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Summary

Type 2 diabetes, previously called adult-onset diabetes is the most common type of diabetes.  With type 2 diabetes, the body does not use insulin correctly.  

Expanded Overview

Type 2 diabetes is a disease that has as its main symptom a high level of sugar (glucose) in the blood. It is the most common form of diabetes.  It is often called non-insulin-dependent diabetes, or adult-onset diabetes.

With type 2 diabetes, the fat, liver and muscle cells don’t work properly with insulin to use or to store the glucose that is in the diet. This is called “insulin resistance.”

When the glucose can’t get into the cells, it remains in the blood and builds up until there is too much. This is called hyperglycemia.

It is common for people with type 2 diabetes to show no symptoms early in life. It can be years before symptoms show up.

Target glucose levels:

  • Before a meal: 90 - 130
  • 2 hours after a meal: less than 160

Causes

  • Family History
  • Obesity

Prevention 

Unlike type 1 diabetes, research has shown that there are some ways to prevent type 2 diabetes, or at least delay its onset. Lifestyle changes, such as becoming more active and making sure your weight stays in a healthy range, help ward off type 2 diabetes.

Symptoms

  • Blurred vision
  • Feeling extremely tired
  • Frequent / slow to heal infections - bladder, kidney, and skin
  • Frequent urination
  • Increased / decreased appetite
  • Pain / numbness in hand and feet
  • Thirst
  • Weight loss

Complications

It is important to know the long-term complications of untreated diabetes. If you experience any of these complications, please discuss this with your endocrinologist and primary care provider.  

  • Cardiovascular disease
  • Eye disease
  • Kidney disease
  • Nerve disease

Testing and Diagnosis

  • Blood glucose test - A blood sugar test takes a sample of blood to see how much glucose is present. The test can be done after your child has not eaten anything for at least 8 hours (fasting) or at any time of the day (random).
  • Glucose tolerance tests - This test mimics what happens in your child’s body after he or she eats. At the start, a baseline blood sample is taken. Your child will be given a drink containing a set amount of glucose (usually 75 grams). For the next three hours, another blood sample will be taken every 30 to 60 minutes
  • Hemoglobin A1c (Hgb A1c) tests - These give an indication of the average blood sugar over the past three months. This type of test may be used in the diagnosis of type 2 diabetes. More often, it is a way to track how well your child’s blood sugar has been controlled during treatment.
  • Urine glucose tests - High levels of sugar in the blood may “spill over” into urine. This is known as glycosuria.

Not every child needs these tests. Your provider will work with you and your child to determine what should be done.

Treatment

There are two goals in treating type 2 diabetes. 

  1. Lower blood glucose to as close too normal as possible.
  2. Prevent long-term problems.

Diet and Exercise

  • Diet - The foods your child eats also affect blood sugar levels. The treatment team will help with meal planning to balance the fat, protein, and carbohydrates that your child eats. Meal plans will be adjusted to fit your child’s lifestyle and tastes.
  • Exercise - Regular exercise is even more important when your child has diabetes. It tends to:
    • Lower blood sugar even without medication
    • Burn extra calories and fat to help manage weight
    • Improve blood pressure
    • Increase energy
    • Help handle stress

Talk to your child’s doctor before starting an exercise program. Children with type 2 diabetes usually need to take special steps before, during and after periods of activity.

Medication

  • Oral Medication - If diet and exercise are not enough to keep your child’s blood sugar under control, the next step is usually medication. There are several different classes of medicines that can be used. Which one your child’s doctor chooses depends on many factors. In some cases, more than one drug may be given.
  • Insulin - If diet, exercise, and these medications do not control your child’s blood sugar, the next step may be prescribing insulin. This helps replace the insulin that your child’s body is no longer producing. Because acid in the stomach destroys it, insulin must be injected.

Living with type 2 diabetes is a lifelong project.  Educating your child, your family and other caregivers takes on great importance.  Children’s Health offers an extensive training program covering what you and your child will need to know.

 

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