What is type 2 diabetes?

This is a disorder that disrupts how the body uses sugar. It is sometimes called "type 2 diabetes mellitus."

All the cells in the body need sugar to work normally. Sugar gets into the cells with the help of a hormone called insulin. Insulin is made by the pancreas, an organ in the belly. If there is not enough insulin, or if cells in the body don't respond normally to insulin, sugar builds up in the blood. That is what happens to people with diabetes.

There are 2 different types of diabetes:

• In type 1 diabetes, the pancreas makes little or no insulin.

• In type 2 diabetes, the pancreas still makes some insulin, but the cells in the body stop responding normally. Eventually, the pancreas cannot make enough insulin to keep up.

Type 2 diabetes has become more common in children and teens. In most cases, it starts around the time of puberty, or soon after. The risk is higher in children with obesity.

What are the symptoms of type 2 diabetes?

Some children do not have any symptoms at first.

When symptoms do happen, they are related to high blood sugar. They can include:

• Needing to urinate often

• Intense thirst

• Blurry vision

If type 2 diabetes is not managed, it can lead to serious problems over time.

Is there a test for type 2 diabetes?

Yes. To diagnose diabetes, doctors can use different tests. They all involve measuring the amount of sugar in the blood, called "blood sugar" or "blood glucose":

• One test measures the child's blood sugar at the time the blood sample is taken. This test might be done:

  • In the morning, after "fasting" (not eating anything for at least 8 hours)

  • At a random time without fasting, if the child has symptoms of high blood sugar

  • A few hours after drinking a special, sweet drink

• Another test shows what the child's average blood sugar has been for the past 2 to 3 months. This is called "hemoglobin A1C," or just "A1C." It can be checked at any time of the day, even if the child has recently eaten.

The doctor or nurse can use your child's test results, along with their symptoms and other information, to figure out if they have diabetes.

How is type 2 diabetes treated?

The goals of treatment are to manage your child's blood sugar and lower the risk of future problems.

Treatment might include:

• Lifestyle changes – This is an important part of managing diabetes. It includes:

  • Eating healthy foods – Changing how your child eats can help manage their blood sugar and prevent some of the problems diabetes can cause. In general, a healthy diet means eating lots of fruits, vegetables, whole grains, and low-fat dairy products. It is best to avoid drinks with added sugar, like soda, juices, and sports drinks.

    It helps to work with a dietitian (expert on food and eating). They can help make sure your child gets the nutrients they need. It can also help to involve the whole family in making new habits for healthy eating.

  • Getting plenty of physical activity – This usually means trying to be active for at least 1 hour each day. It is also important to limit screen time and other activities that involve sitting.

  If your child has obesity, losing weight is an important part of managing their diabetes. Changing their diet and exercise habits can help with weight loss. But eating well and being active are also good for their overall health.

• Medicines – Many medicines can help lower blood sugar. Some children need to take pills or get shots to help their body make more insulin or help insulin do its job. Others need insulin shots.

  Depending on your child's medicines, you might need to check their blood sugar regularly at home. But not everyone with type 2 diabetes needs to do this. Your child's doctor or nurse will tell you if you should be checking their blood sugar, and when and how to do this.

Different people will help take care of your child and teach you what to do at home. Your child's diabetes team will probably include a doctor, diabetes nurse, dietitian, and maybe a mental health counselor and a pharmacist. They will see your child regularly and make sure their diabetes is well managed. At school, the school nurse and other staff will help manage your child's diabetes.

How else can I help my child?

You should:

• Learn about diabetes – The more you know about it, the better you can manage it.

• Learn to check your child's blood sugar – The diabetes team will show you how. You might need to prick their fingertip and then use a "blood glucose meter." Some children use a device that measures their sugar level all the time. This is called "continuous glucose monitoring."

• Keep your child's blood sugar levels in the right range – Very high or very low levels can cause serious problems. This needs treatment right away. Also, having high blood sugar levels over many years can damage the kidneys, eyes, nerves, and blood vessels.

• Learn the symptoms of high and low blood sugar – They can be different, depending on the child's age. Sometimes, a child's blood sugar can get too high or too low without causing any symptoms. Always check your child's blood sugar if you are not sure.

• Learn what to do when your child's blood sugar level is too low or too high – Know when to treat it at home and when to go to the hospital or call for an ambulance.

• Check your child's ketones, if their doctor tells you to – Ketones are chemicals that can build up in the blood if the sugar level gets too high. They are a sign of "diabetic ketoacidosis," which is a dangerous condition that requires treatment right away. If you need to check ketones, the doctor or nurse will tell you when and how to do this.

• Have your child wear a medical bracelet, if they take insulin – This way, other people will know about their situation in case of an emergency.

• Talk to your child about their diabetes – Teens can often be involved in taking care of themselves. For example, they might be able to check their own blood sugar or prepare their supplies. Supervise your child closely as they learn.

When should I call the doctor?

Your child's diabetes team will tell you when to call for help or advice. Make sure you know how to reach them. You should also tell them if you have any questions about how to manage your child's diabetes.

Call right away if:

• Your child's blood sugar is too high or low.

• You think your child got too much or too little insulin.

• Your child's ketones are high.

• Your child is feeling sick.