Type 2 diabetes is increasing in our teens and children at an alarming rate. It’s important to know who’s at risk and the steps you can take to protect your child.
Type 2 diabetes develops when your blood sugar is too high, which over time can damage your heart, kidneys, eyes and nerves. Type 2 diabetes is caused by building up a resistance to the hormone insulin. The pancreas makes insulin to allow sugar (glucose) to move into your cells where it is used as energy. Insulin resistance is when cells stop reacting to insulin properly.
The pancreas responds by making more insulin to keep blood sugar levels normal. However, the pancreas eventually grows tired of making extra insulin and can no longer keep up with the demand. Because the sugar cannot get into the cells, the blood sugar level rises and type 2 diabetes develops.
Some symptoms of type 2 diabetes include losing weight without trying, feeling more tired than usual and getting frequent infections. One sign of insulin resistance in some children is the development of thick, darkened skin on the back of the neck or in the armpits, called acanthosis nigricans. This is an outward sign of insulin resistance, but can fade or change once insulin resistance and blood sugar levels are corrected. Sometimes children with type 2 diabetes can have no symptoms at all, or sometimes these symptoms develop over time and end up going unnoticed. Because symptoms of type 2 diabetes can be difficult to spot, it’s important to know if your child is at risk.
Who’s at Risk?
According to the Centers for Disease Control and Prevention (CDC), the increase in type 2 diabetes is a problem closely related to the rise in childhood obesity. Kids who carry excess weight, especially in their bellies, are more likely to have insulin resistance. At your child’s well check, be sure to ask your healthcare provider if your child is at a healthy weight.
Other factors that put kids at higher risk for type 2 diabetes include having a family member with type 2 diabetes or being born to a mother who had diabetes while pregnant. Having another condition related to insulin resistance also increases your child’s risk of type 2 diabetes. These conditions include high cholesterol, increased blood pressure and polycystic ovarian syndrome.
Certain groups of children are also at risk for the disease. Because of growth hormones, teenagers have a small amount of insulin resistance already. This makes it especially important for teens to eat right, exercise regularly and get sufficient sleep. Race is also a factor, with those of African-American, Hispanic/Latino, Asian, Native American/Alaska Native and Pacific Islander descent all being more susceptible to developing type 2 diabetes.
Some risk factors can be modified or lessened by lifestyle changes. Try to focus on the risk factors your family can do something about instead of the ones you have no control over, such as family history. Some of the modifiable risk factors to focus your energy on are a lack of physical activity, a poor diet and not getting enough sleep.
Does your child get the recommended 60 minutes of physical activity a day or is he more of a couch potato? Children who get little or no exercise are more likely to have insulin resistance. Does your child eat the recommended five servings of fruits and veggies most days, or does he live on processed, sugary foods? Will your child drink water and milk or does he consume frequent juice, sports drinks and/or soda? Lastly, how is your child’s sleep? Both the amount and the quality of sleep a child gets are important in his growth and development and in preventing a variety if ailments, including insulin resistance and obesity.
Instilling Healthy Habits
Making healthy changes should be done as a family with no child being singled out. This allows you to be a role model of healthy behaviors for your kids. Whether your child is at risk of getting type 2 diabetes or not, making small changes to improve the health of your family is beneficial for everyone’s physical, mental and emotional health. Some small changes you can try that have a dramatic effect on health and insulin resistance follow.
* Avoid heavily processed foods, such as those containing high-fructose corn syrup.
* Eat dinner as a family at the table (not in front of the TV).
* Establish and stick to a bedtime routine with consistent sleep and wake times.
* Try a new vegetable each week as a family.
* Enjoy outdoor activities together.
* Save items such as sugary drinks, fast food, cookies and chips for special occasions.
* Switch from white bread, rice and pasta to whole grains.
* Limit screen time to no more than two hours a day.
* Allow your child to help pick healthy foods at the grocery store.
Diagnosis and Treatment
Several blood tests may be done if you and your provider have concern for type 2 diabetes in your child. A fasting glucose test is used to screen kids believed to be at risk for the disease. If your child’s fasting glucose is impaired, an oral glucose tolerance test may be ordered to make an official diagnosis of type 2 diabetes. A hemoglobin A1C (HgbA1C) test may also be ordered, which will provide an estimate of your child’s blood sugar for the past several months. The HgbA1C can tell how severe the diabetes is and is also used for patients already diagnosed with type 2 diabetes to make sure they are on the best treatment and their blood sugar levels are under control.
Sometimes these tests show prediabetes, which is when a child’s blood sugar is higher than normal and she is at an increased risk for getting type 2 diabetes. If a child is diagnosed with prediabetes, making lifestyle changes may delay or stop type 2 diabetes from developing. These lifestyle changes may include changes to the child’s nutrition, an increase in the amount and quality of physical activity and weight reduction.
Type 2 diabetes is a treatable, yet, lifelong, disease. Treatment for the condition may include diet and exercise alone or may require oral medications and/or insulin injections with frequent blood sugar checks. Once a child is diagnosed, she will see a specialist for the diabetes and possibly a diabetes educator or nutritionist as well. Because each child’s diabetes behaves differently and may have various factors causing the disease, each case may require slightly different treatment. The key to treating prediabetes and preventing diabetes is incorporating healthy habits into your family’s day-to-day activities.
With unhealthy foods being easier to access and a decrease in time for kids to exercise and sleep, it is no wonder diseases such as obesity and type 2 diabetes are on the rise. Thankfully, we can help our children avoid these diseases by encouraging and displaying healthy habits. Simple lifestyle changes related to diet, exercise and sleep can control insulin resistance and decrease your child’s risk of developing type 2 diabetes and obesity.
Christine McCaslin, MS, RN, CPNP, is dual certified in the acute and primary care of pediatrics. She is currently working as a locum tenens provider in Denver.