Before, the only people diagnosed with Type 2 diabetes were older adults. However, times have changed. In the past 20 years, new cases of Type 2 diabetes in childhood have increased from less than 5 percent to more than 20 percent of all new diagnoses. What is causing this disturbing trend? What is Type 2 diabetes, and how can we protect our children from this disease?
Type 2 diabetes is the form of diabetes in which the body is resistant to the action of insulin. Insulin levels rise, and when the body can no longer make enough insulin, blood sugars rise. This is different from Type 1 diabetes, in which the body stops making insulin.
Although Type 1 diabetes is still more common among children, Type 2 diabetes — previously called adult onset or non-insulin-dependent diabetes — is becoming more common among adolescents and even younger children. Type 2 diabetes occurs in children as young as 6, and is increasing at an alarming rate, primarily due to the epidemic of obesity in children and adolescents.
Type 2 diabetes is also more common among some ethnic groups, such as African Americans, Hispanics, Asians and Native Americans. Another risk factor is a family history of Type 2 diabetes or if diabetes occurred in the mother during pregnancy.
There are a number signs parents should watch for if they suspect their child has diabetes, including:
▪ Frequent urination or new bed-wetting.
▪ Increased thirst and appetite.
▪ Decreased energy.
▪ Unexplained weight loss.
▪ Genital yeast infection.
Another sign that your child is at risk for Type 2 diabetes is the appearance of darker and thicker skin on your child’s neck or armpits, which may make skin appear dirty.
Obese children who have fat concentrated around the stomach are at greater risk for Type 2 diabetes than children with fat distributed more evenly throughout the body. Type 2 diabetes is also often associated with other medical conditions, such as high blood pressure, high cholesterol, early puberty and increased liver fat.
Children with Type 2 diabetes are at high risk for complications such as eye or kidney damage from high sugars when the condition is not well-controlled. The good news is that parents can help Type 2 children manage their condition.
The best treatment is prevention, which can be accomplished with a healthy diet and active lifestyle for the whole family. It is important that parents set a good example for their children, especially when other family members have Type 2 diabetes.
Some tips for success include using a good calorie-counting application on your mobile phone that will teach you to make smart food choices. Avoid drinks with high calories like juice (even natural juice), shakes and sodas. Limit snacks to only one afternoon snack with 100 calories or less. Don’t eat dinner late or close to bedtime. Avoid skipping meals, including breakfast, which is an important meal. If your child does not like the school lunch, send a healthy lunch to school instead. Avoid foods like chips, pizza and fast food. Try to serve vegetables without high-calorie dressing or cheese when your child wants to eat extra food.
It is important that your child be active. Try to have them exercise 30 to 60 minutes every day. It’s even better if the whole family exercises together. Good sleep habits are also beneficial. Staying up late at night and taking naps increases the risk of Type 2 diabetes.
Limit leisure screen time to one to two hours a day. This includes TV, non-educational computer time, video games and smartphones.
If Type 2 diabetes develops in children but is caught early, it can usually be treated by taking Metformin one to two times a day. However, Metformin is only approved in children older than 12, and if your child’s diabetes is moderate to severe, he or she may require insulin injections and will need to test their blood sugar several times a day.
In many cases, though, your child’s diabetes can improve with weight control and exercise, even allowing some children to stop taking medication.
Children with Type 2 diabetes usually see a diabetes specialist, called an endocrinologist, to help manage the diabetes. The endocrinologist will usually work with a team that includes a certified diabetes educator, a nutritionist and a psychologist.
If you suspect your child has diabetes, immediately contact your pediatrician, who can do a blood test and may also do special tests such as an Oral Glucose Tolerance Test. If your child needs care for diabetes, you can also call 305-243-2920 to schedule an appointment at the University of Miami Health System.
Janine Sanchez, M.D., is director of the Pediatric Diabetes Program at UHealth – the University of Miami Health System. For more information, visit UHealthSystem.com/patients/pediatrics.