Image: Two girls on exercise balls.

Type 2 Diabetes in Children: Identifying Risks and Management

Type 2 diabetes is a condition in which the body is unable to produce enough insulin, preventing the uptake of glucose by the body’s cells. Blood glucose becomes elevated and symptoms such as increased thirst, increased urination, increased appetite, nighttime urination or new-onset bedwetting may occur. Insulin resistance – a state in which the body is unable to respond to the insulin produced – is the underlying cause and it may occur due to genetics or lifestyle.

What are the risk factors for developing type 2 diabetes?

  • Obesity.
  • A positive family history. It is estimated that one-half to three-quarters of children and adolescents with type 2 diabetes have at least one affected parent. In identical twins with one twin being affected, the other has an almost 90 percent chance of developing the disease.
  • Ethnicity and race. Native Americans, African Americans, Hispanics, Asian Americans and Pacific Islanders have a higher prevalence of the disease.
  • Gender and age. Adolescent girls are more likely to develop the type 2 diabetes as compared to boys.
  • Prenatal states. Low birth weight for age infants and those born to mothers with diabetes developing during pregnancy.

Is type 2 diabetes an epidemic?

As the number of children being classified as obese since the early 1990s has increased, so too have the number of children with type 2 diabetes. The disease used to be rare in children and adolescents, but by the end of the early 2000s about one in five children with diabetes could be classified as having type 2. In adolescents between 15-19 years old, this may approach one in every two patients in some high-risk ethnic groups.

What should parents do to help their child avoid a type 2 diabetes diagnosis?

Although the development of type 2 diabetes is associated with certain risk factors, its occurrence may be delayed or even prevented. Despite genetics and lifestyle being important factors leading to its development, the exact contribution of each is currently unknown. What is known, is that if a child engages in regular physical activity and avoids consuming unhealthy food, the risk may be decreased.

What can parents do to manage symptoms in a child with type 2 diabetes?

With proper management which includes diet, physical activity and medication use, the symptoms of diabetes may be decreased or eliminated. In addition to identifying the symptoms, parents can encourage their children to engage in regular physical activity as opposed to playing electronic games or watching television.

By providing healthy diet options and a supportive environment, parents may enable their children to effectively manage the disease. Reappearance or worsening of the symptoms may be clues of uncontrolled disease. These symptoms together with a pattern of elevated blood glucoses, may be evidence that a medication dose increase or change is necessary.  

Lastly, since blood glucose testing in a key part of management, active parental participation in testing their child’s glucoses, or active supervision, are also important.

Rohan Henry, MD, MS
Dr. Henry received his medical degree from the University of the West Indies, Kingston, Jamaica, in 2000 and went on to pediatric internship/residency at the University of Maryland Medical Center in Baltimore followed by a pediatric endocrinology fellowship at the University of Washington School of Medicine in Seattle. During his endocrinology fellowship, he also completed a Master of Science in Epidemiology at the University of Washington’s School of Public Health.Dr. Henry’s clinical interests include adrenal and thyroid disorders. His teaching activities include education on growth and thyroid disorders to the medical student clerkship group and also disorders of the adrenal gland to the pediatric residents.

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