Type 2 Diabetes in Children - Information, Prevention, Treatment

Type 2 diabetes in children has been on the rise in recent decades, especially among middle school children and adolescents.

In 2000, the American Diabetes Association convened and developed a panel of experts to review current trends in order to come to a better understanding regarding the prevention, diagnosis and treatment of type 2 diabetes in youth.

Nearly a decade later (time of writing), the condition continues to receive widespread media coverage as the obesity rate in America, especially among children, escalates. Like Type 2 diabetes in adults, this chronic condition affects the way a child’s body can metabolize sugar (glucose).

As in adults, Type 2 diabetes in children can be prevented and managed. All children should be encouraged to establish healthy eating habits that will serve them throughout their lives. In addition, children should know that regular exercise must be incorporated into their daily routines so that a healthy weight can be maintained.

Symptoms of Type 2 Diabetes in Children

Type 2 diabetes in children generally develops gradually. Some children may not experience symptoms, or may not realize that the issues they have been experiencing signal that their body no longer functions normally. Parents and caregivers must be vigilant regarding the children’s health, as often children do not know how to express their symptoms.

Other children will have obvious symptoms like a noticeable increase in thirst and subsequent frequent urination. As excess sugar builds in the system, fluid leaches from the tissues, resulting in a feeling of dehydration that brings on pangs of thirst. Hunger, too, may increase in intensity and frequency as the sugar can no longer move into the cells to produce energy, and muscles and organs become energy depleted. The brain sends and receives signals to consume more and more food in order to try and restore the balance.

There are more signs and symptoms of Type 2 diabetes in children. For example, despite consuming more calories, some diabetic children begin to lose weight, because without energy sugar supplies, the muscle tissues and fat stores begin to shrink. Lack of an established energy source, in addition to sugar deprivation in the cells, leads to fatigue and irritability.

As the condition progresses, a child’s vision may begin to blur as fluid retreats from the eyes’ lenses, making it difficult for the child to focus properly. You may notice that the child’s scrapes, bruises or sores take longer than normal to heal, or that he / she seems to have frequent infections.

Children often develop a condition called acanthosis nigricans, or patches of dark velvety skin especially in the folds and creases of the body, like the armpit and neck area. This also signals insulin resistance.

Diagnosis

Many pediatricians and family practitioners now screen for Type 2 diabetes in children during routine blood tests, especially in children at high risk for developing the disease. These include children with a family history of the condition, youths with a body mass index (BMI) over the 85th percentile, and children in one of the racial groups genetically predisposed to the condition - Native American, Latino / Hispanic, Pacific Islander, and African American.

Once the aforementioned symptoms of Type 2 diabetes in children have manifested, children without predisposition will be tested as well. At diagnosis, most type 2 diabetic children display obesity or significant excess weight. They usually have sugar in the urine though they may not have ketones. Approximately 5% have ketoacidosis when first diagnosed.

An estimated 45 to 80% of those with Type 2 diabetes in children also have at least one parent with the disease. An estimated 90% of children have already developed the classic shiny dark patches on the skin (acanthosis nigricans), which can also be found on the webbing between the fingers and toes.

Importance of Diet and Lifestyle Habits

The alarming increase in the number of children with Type 2 diabetes underscores the importance of environmental factors determining susceptibility to the condition - namely poor diet and sedentary lifestyle. Maintaining the proper balance between blood sugar levels and insulin in order to ensure insulin function requires careful attention to a proper diet and exercise.

In Type 2 diabetes in children, inappropriate insulin action progresses to complete failure of insulin-producing cells, so preventative measures remain of key importance. Once diabetes has entered a full blown stage, reversal may be very difficult.

Puberty - Possible Turning Point

The onset of puberty, due to fluctuating and changing hormonal levels, has been identified as a significant landmark in the development of Type 2 diabetes. If the child already demonstrates a predisposition to the disease (both hereditary and environmental), puberty may well tip the balance towards diabetes.

However, cases as young as a child of 4 years old have been reported. Currently, the medical community continues to investigate appropriate treatments for Type 2 diabetes in juveniles, as only a few decades ago the condition remained virtually unheard of.

Prevention and Treatment

Treatment currently follows the plan for adults, although preventative measures have been by far the more successful. Once diabetes reaches a critical stage, fewer than 10% of patients can maintain optimal control without the use of supplementary medications. In part, this lies in the nature of the symptoms, which increase the desire for food and drink in an individual already carrying excess weight.

Furthermore for a variety of reasons, obese individuals have difficulty adhering to the stringent exercise routine that diabetes maintenance calls for, because exercise may be more difficult and strenuous, or because they feel embarrassment for their condition. For obese children, the idea of exercising with their peers may be frightening or uncomfortable, and meal planning for children can be challenging regardless of medical condition.

It may be helpful for the family to participate in diabetes self management education, in coordination with the family physician, nutritionist and an exercise specialist. During this educational period, those who suffer from Type 2 diabetes in children can learn to self-monitor glucose levels, come to better understand the importance of diet and exercise, and explore different diabetes management options.

A registered dietician experienced in pediatrics can help the family plan meals together, meals that have all the health benefits, yet take into account financial and cultural preferences, while an exercise specialist can help the family better integrate and instill life-long exercise habits.

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