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DIABETES MELLITUS TYPE 2 IN CHILDREN

(DIABETES MELLITUS - ADULT ONSET)
Diabetes Mellitus Type 2 in Children

WHAT YOU NEED TO KNOW:

What is diabetes mellitus type 2? Diabetes mellitus type 2 is a disease that affects how your child's body uses glucose (sugar). Normally, when the blood sugar level increases, the pancreas makes more insulin. Insulin helps move sugar out of the blood so it can be used for energy. Type 2 diabetes develops because either the body cannot make enough insulin, or it cannot use the insulin correctly. After many years, your child's pancreas may stop making insulin.

What increases my child's risk for diabetes mellitus type 2? Your child has a higher risk for type 2 diabetes if he is overweight, and at least 2 of the following are true:

  • A member of your child's family has type 2 diabetes.

  • Your child is Native American, African American, Latino, Asian American or Pacific Islander.

  • Your child has high blood pressure, high cholesterol, or is female and has polycystic ovary syndrome.

What are the signs and symptoms of diabetes mellitus type 2? Your child may have high blood sugar levels for a long time before symptoms appear. Your child may have any of the following:

  • More hunger or thirst than usual

  • Frequent urination

  • Weight loss without trying

How is diabetes mellitus type 2 diagnosed? Your child may need tests to check for type 2 diabetes mellitus by the time he is 10 years old. Your child may need any of the following:

  • An A1c test shows the average amount of sugar in your child's blood over the past 2 to 3 months.

  • A fasting plasma glucose test is when your child's blood sugar level is tested after he has fasted for 8 hours. Fasted means he has not eaten anything or had anything to drink except water.

  • An oral glucose tolerance test starts with a fasting blood sugar level check. He is then given a glucose drink. His blood sugar level is checked again after 2 hours. Healthcare providers look at how much your child's blood sugar level increases from the first check.

How is diabetes mellitus type 2 treated? Type 2 diabetes can be controlled. The goal is to help keep your child's blood sugar at a normal level. He must eat healthy foods, and exercise regularly. He may also need medicine by mouth or insulin if he cannot control his blood sugar level with nutrition and exercise.

How do I check my child's blood sugar level? You will be taught how to check a small drop of blood with a glucose monitor. You may need to check your child's blood sugar level at least 3 times each day. Ask your child's healthcare provider when and how often to check during the day or night. Before meals, your child's blood sugar should be between 90 and 130 mg/dL. At bedtime, it should be between 90 and 150 mg/dL. You may need to check for ketones in your child's urine or blood if his level is higher than directed. Write down the results and show them to your child's healthcare provider. He may use the results to make changes to your child's medicine, food, or exercise schedules.

How to check your blood sugar

What do I need to know about nutrition for my child? A dietitian will help you create a meal plan to keep your child's blood sugar level steady. Do not let your child skip meals. His blood sugar level may drop too low if he takes insulin and does not eat.

  • Keep track of carbohydrates (sugar and starchy foods). Your child's blood sugar level can get too high if he eats too many carbohydrates. His dietitian will help you plan meals and snacks that have the right amount of carbohydrates.

  • Give him low-fat and low-sodium foods. Examples of low-fat foods are lean meat, fish, skinless chicken or turkey, and low-fat milk. Limit high-sodium foods, such as potato chips and soup. Do not add salt to food you cook. Limit your child's use of table salt.

  • Give him high-fiber foods. Foods that are a good source of fiber include vegetables, whole grain bread, and beans.

What else can I do to manage my child's diabetes?

  • Go to all follow-up appointments. Your child may need to return to have his A1c checked at least twice a year. The healthcare provider will tell you what your child's A1c should be. He may also need tests to check his blood pressure, cholesterol, eyes, and feet.

  • Encourage your child to exercise for at least 60 minutes on most days of the week. Exercise can help keep your child's blood sugar level steady. Work with your child's healthcare provider to create an exercise plan. You may need to check your child's blood sugar level before and after he exercises. He may need a carbohydrate snack before, during, or after exercise. If your child's blood sugar level is high, check his blood or urine for ketones before he exercises. Do not let him exercise if his blood sugar level is high and he has ketones in his urine or blood. If your child's blood sugar level is lower than 100 mg/dL, give him a carbohydrate snack before he exercises. Examples are 4 to 6 crackers, ½ banana, 8 ounces (1 cup) of milk, or 4 ounces (½ cup) of juice.

  • Help your child maintain a healthy weight. Ask your child's healthcare provider how much your child should weigh. A healthy weight can help control your child's diabetes. Ask your child's healthcare provider to help you create a weight loss plan for your child if he is overweight.

  • Check your child's feet each day for sores. Have your child's feet checked at least once each year for problems that may develop if his diabetes is not controlled. Make sure his shoes and socks fit correctly. Ask your child's healthcare provider for more details about foot care.

What other care will my child need for diabetes mellitus type 2?

  • Make sure your child always wears medical alert jewelry or carries a card that says he has diabetes. Ask your child's healthcare provider where to get these items.
    Medical alert ID bracelet


  • Give instructions to your child's school. Make sure your child's teachers know he has diabetes. Provide written instructions about what to do if your child has symptoms of high or low blood sugar levels at school.

  • Do not smoke. Do not smoke around your child, and do not let others smoke around him. Do not let your older child smoke. Nicotine and other chemicals in cigarettes and cigars can cause lung and heart damage. Cigarette smoke can worsen the problems that occur with diabetes. Ask your healthcare provider for information if you or child currently smoke and need help to quit. E-cigarettes or smokeless tobacco still contain nicotine. Talk to your healthcare provider before you or your child use these products.

  • Ask about vaccines. Your child has a higher risk for serious illness if he gets the flu or pneumonia. Ask your child's healthcare provider if your child should get a flu or pneumonia vaccine, and when to get the vaccine.

What are the risks of diabetes mellitus type 2 in children? Uncontrolled diabetes can damage your child's nerves and arteries. Long-term high blood sugar levels can damage his eyes and kidneys. Diabetes is life-threatening if it is not controlled.

When should I seek immediate care?

  • Your child's blood sugar level is lower than directed and does not improve with treatment.

  • Your child has blurred or double vision.

  • Your child is having trouble staying awake or focusing.

  • Your child is shaking or sweating.

  • Your child's breath has a fruity, sweet smell, or his breathing is deep and labored.

  • Your child's heartbeat is fast and weak.

When should I contact my child's healthcare provider?

  • Your child has a fever.

  • Your child has abdominal pain, diarrhea, or is vomiting.

  • Your child feels dizzy or has headaches.

  • Your child feels weak or more tired than usual.

  • Your child has numbness in his arms or legs.

  • Your child has warm, red patches of skin.

  • Your child gets easily irritated.

  • You have questions or concerns about your child's condition or care.

CARE AGREEMENT:

You have the right to help plan your child's care. Learn about your child's health condition and how it may be treated. Discuss treatment options with your child's caregivers to decide what care you want for your child.