Type 2 Diabetes In Children

Type 2 diabetes, a condition that usually affects the metabolisms of sugar (glucose) in adults can also occur in children.

It is usually caused by obesity and thus loosing weight can help prevent the development of type 2 diabetes. This can be achieved through increased physical activity and a healthy diet.

Signs and symptoms of type 2 diabetes in children include:

• Increased thirst and urination.
• Increased hunger
• Weight loss despite eating more than usual to relieve hunger.
• Fatigue
• Blurred vision
• Slow-healing sores or frequent infections.
• Areas of darkened skin usually in the armpit or neck.

Type 2 diabetes is caused when the body becomes resistant to insulin or when the pancreas stops producing enough insulin.  The exact mechanisms of how this develops is unknown. Excessive weight gain, inactivity and genetic factors seem to play a role.

Tests used to diagnose type 2 diabetes in children include:

• Glycated hemoglobin (A1C) test - which can indicate the amount of sugar in the blood for the past two to three months. This tests works by measuring the amount of glucose attached to hemoglobin, the oxygen carrying protein of red blood cells. An A1C level of 6.5 percent or higher indicates diabetes.

  The American Academy of Pediatrics (AAP) recommends A1C testing every three months to ensure the blood sugar level goals are met. The American Diabetes Association has introduced a formula that translates the A1C into what is known as an estimated average glucose (eAG). The eAG more closely correlates with daily blood sugar readings.

  An A1C of 7 percent translates into an eAG of 154 mg/dL (8mmol/L). An elevated A1C level may be an indication that the insulin regimen is not effective.

• Random blood sugar test - which can be taken at any time. Regardless of when a child last ate, a random blood sugar level of 200 mg/dL (11.1 mmol/L) indicates diabetes.

Treatment of type 2 diabetes in children includes:

• Medications such as metformin (Fortamet, Glucophage, Glumatza) which reduces the amount of sugar the liver releases into the blood. Side effects of this drug include nausea, stomach upset, diarrhea and headaches.

• Insulin therapy which can be given as an injection or insulin pump. Insulin cannot be given orally because the enzymes of the stomach destroy it. A fine needle or an insulin pen, which looks similar to ink pens can be used to inject insulin under the skin. Multiple daily injections usually consist of different types of insulin (Long-acting and regular insulin).

  An insulin pump is a small device about the size of a cellphone that can be worn outside the body. A tube connects the reservoir to a catheter that is inserted under the skin of the abdomen. It can be worn as a waistband, in a pocket or as a specially designed pump belt.

  Pumps are programmed to dispense specific amounts of rapid-acting insulin automatically. This steady dose of insulin is known as the basal rate, and it replaces any long-acting insulin that a person was using. Types of insulins which are available include, rapid-acting, long-acting and intermediate acting insulin.

• Regular monitoring of blood sugar levels. This can be performed by using a meter that can measure the level of sugar in blood. Blood can be taken from the finger.
• Healthy eating and monitoring carbohydrates.
• Regular exercising, at least 30 minutes of aerobic exercise on most days of the week. There is ongoing research for new treatments for type 1 diabetes, such as pancreas, islet cell and stem cell transplant.

Type 2 diabetes in children can be prevented by:

• Eating a healthy diet low in fat and calories which includes fruits, vegetables and whole grains.
• Encouraging a child to take part in physical activities.
• Losing excessive weight.

Currently, there is no approved alternative remedies for type 2 diabetes in children.

Some children may require a counselor or therapist to help them cope with the lifestyle changes associated with type 2 diabetes.

Proper treatment and management of symptoms of type 2 diabetes can help prevent the development of serious complications.

Children, as well as their parents can join support groups for encouragement and better understanding of type 2 diabetes.

There are several risks and complications associated with type 2 diabetes in children.

Risk factors for type 2 diabetes developing in children include:

• A family history of diabetes
• Being overweight
• Reduced physical activity
• Being of African-American, Asian, Hispanic or Native-American descent.

Complications of type 2 diabetes in children include:

• Eye damage which can lead to cataracts or retinopathy or blindness.
• Foot damage due to nerve damage or poor blood supply to the foot.
• Skin conditions caused by fungal or bacterial infections.
• Kidney damage (nephropathy) as a result of damage of the tiny blood vessel clusters in the kidneys that normally filter waste from the blood.
• Nerve damage (neuropathy) occurs due to the damage of the vessels that nourish the nerves.
• Heart and vessel damage which can lead to high blood presure, high cholesterol, stroke and heart disease.