Type 2 diabetes in children

Overview

Type 2 diabetes in children is a long-term, also called chronic, condition. It affects the way a child's body uses sugar for fuel. Sugar also is called glucose. Without treatment, the condition causes sugar to build up in the bloodstream. This can lead to serious complications.

Type 2 diabetes happens more often in adults. In fact, it used to be called adult-onset diabetes. But the growing number of children with obesity has led to more type 2 diabetes diagnoses in younger people.

There's much you can do to help prevent or manage type 2 diabetes in your child. Urge your child to eat healthy foods, get plenty of physical activity, and get to and stay at a healthy weight. If healthy eating and exercise aren't enough to manage type 2 diabetes, your child may need to take medicine by mouth or have insulin shots.

Symptoms

Type 2 diabetes in children comes on so slowly that you may not see symptoms. Sometimes a healthcare professional diagnoses the condition during a routine checkup.

Some children might have these symptoms because of too much sugar in their bloodstreams:

• Increased thirst and hunger.
• Urinating often.
• Tiredness.
• Blurred vision.
• Darkened areas of skin, most often around the neck or in the armpits and groin. Darkened skin may look dark brown or black on brown or Black skin and light brown or tan on white skin.
• Weight loss without trying. This is less common in children with type 2 diabetes than in children with type 1 diabetes.
• Yeast infections.

When to see a doctor

See your child's healthcare professional if you see any symptoms of type 2 diabetes. Without treatment, the condition can cause great damage.

The American Diabetes Association suggests screening in children who:

• Have started puberty or have reached the age of 10.
• Are overweight or have obesity.
• Have at least one other risk factor for type 2 diabetes.

Causes

Experts don't know the exact cause of type 2 diabetes. But family history and genes seem to be part of the cause. What is clear is that children with type 2 diabetes can't use sugar, also called glucose, the way their bodies need to.

Most of the sugar in the body comes from food. When food is digested, sugar enters the bloodstream. Insulin allows sugar to enter the cells and lowers the amount of sugar in the blood.

A gland called the pancreas makes insulin. It sits behind the stomach. The pancreas sends insulin to the blood when you eat. When your blood sugar level starts to drop, the pancreas slows down the amount of insulin that goes into the blood.

When your child has type 2 diabetes, this process doesn't work as well. And instead of fueling cells, sugar builds up in your child's bloodstream. This can happen because:

• The pancreas doesn't make enough insulin.
• The cells resist the insulin and don't let in as much sugar.

Risk factors

Researchers don't know why some children get type 2 diabetes and others don't, even if their risk factors are alike. But certain factors raise the risk, including:

• Weight. Being overweight is a strong risk factor for type 2 diabetes in children. The more fatty tissue children have, the more the cells resist insulin. This is mainly true for fatty tissue inside and between the muscle and skin around the belly.
• Not being active. The less active children are, the greater their risk of type 2 diabetes.
• Eating habits. Eating a lot of red meat, processed foods, saturated fat and sugar is linked with a higher risk of prediabetes.
• Family history. Children's risk of type 2 diabetes rises if they have a parent, sibling, grandparent, aunt or uncle with the condition.
• Race or ethnicity. It's not clear why, but certain people are more likely to get prediabetes. In the United States, these include Black, Hispanic, American Indian and Asian American people.
• Age and sex assigned at birth. Many children get type 2 diabetes in their early teens. But it can happen at any age. Teens assigned female at birth are more likely to get type 2 diabetes than are teens assigned male at birth.
• Gestational diabetes. Children born to someone who had gestational diabetes during pregnancy have a higher risk of getting type 2 diabetes.
• Low birth weight or preterm birth. Babies with low birth weights have a higher risk of getting type 2 diabetes. So do babies born before 39 to 42 weeks of pregnancy, called premature.

Type 2 diabetes in children is often linked with metabolic syndrome and polycystic ovarian syndrome.

Metabolic syndrome

People who have certain conditions with obesity may have a higher risk of diabetes, heart disease and stroke. Those with three or more of these conditions often are diagnosed with what is called metabolic syndrome:

• High blood pressure.
• Low levels of high-density lipoprotein (HDL) cholesterol, the "good" cholesterol.
• High triglycerides.
• High blood sugar levels.
• Large waist size.

Polycystic ovary syndrome

Polycystic ovary syndrome (PCOS) affects people assigned female at birth. It happens after puberty. An imbalance of hormones causes PCOS. Symptoms include weight gain, irregular menstrual periods, and excess face and body hair.

People with PCOS often have issues with how their bodies turn food into energy, called metabolism. Those issues can lead to insulin resistance and type 2 diabetes.

Complications

Type 2 diabetes can affect nearly every organ in your child's body. These include the blood vessels, nerves, eyes and kidneys. The long-term complications of type 2 diabetes come on little by little over many years. With time, diabetes complications may be life-threatening.

Complications of type 2 diabetes for children and teens may come on faster and be more serious than complications for adults with type 2 diabetes. They may include:

• High cholesterol.
• Heart and blood vessel conditions.
• Stroke.
• Nerve damage.
• Kidney damage.
• Eye conditions, including blindness.

Keeping your child's blood sugar level close to the standard range most of the time can greatly lower the risk of these complications. To help your child prevent diabetes complications:

• Work with your child to stay at good blood sugar levels.
• Teach your child about healthy eating and staying active.
• Have regular visits with your child's diabetes treatment team.

Prevention

Healthy-lifestyle choices can help prevent type 2 diabetes in children. Urge your child to:

• Eat healthy foods. Offer your child foods low in fat and calories. Focus on fruits, vegetables and whole grains.
• Get more physical activity. Help your child be active. Sign up your child for a sports team or dance lessons.

Make healthy eating and physical activity a family affair. The lifestyle choices that can help prevent type 2 diabetes in children can do the same for adults.