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Type 2 diabetes in children

Type 2 diabetes in children is a chronic condition that affects the way your child's body metabolizes sugar (glucose).

Type 2 diabetes is a disease more commonly associated with adults. In fact, it used to be called adult-onset diabetes. But type 2 diabetes in children is on the rise, fueled largely by the obesity epidemic.

There's plenty you can do to help manage or prevent type 2 diabetes in children. Encourage your child to eat healthy foods, get plenty of physical activity and maintain a healthy weight. If diet and exercise aren't enough to control type 2 diabetes in children, oral medication or insulin treatment may be needed.

Symptoms Causes Risk factors Complications Prevention

Type 2 diabetes in children may develop gradually. Some children who have type 2 diabetes have no signs or symptoms. Others experience:

  • Increased thirst and urination. As excess sugar builds up in your child's bloodstream, fluid is pulled from the tissues. This may leave your child thirsty. As a result, your child may drink — and urinate — more than usual.
  • Increased hunger. Without enough insulin to move sugar into your child's cells, your child's muscles and organs become depleted of energy. This triggers hunger.
  • Weight loss. Despite eating more than usual to relieve hunger, your child may lose weight. Without the energy that sugar supplies to your cells, muscle tissues and fat stores simply shrink.
  • Fatigue. If your child's cells are deprived of sugar, he or she may become tired and irritable.
  • Blurred vision. If your child's blood sugar is too high, fluid may be pulled from the lenses of your child's eyes. This may affect your child's ability to focus clearly.
  • Slow-healing sores or frequent infections. Type 2 diabetes affects your child's ability to heal and resist infections.
  • Areas of darkened skin. Areas of darkened skin (acanthosis nigricans) may be a sign of insulin resistance. These dark patches often occur in the armpits or neck.

When to see a doctor

See your child's doctor if your child is at high risk of type 2 diabetes. To diagnose type 2 diabetes before it does serious damage, diabetes screening is recommended for all children and adolescents at high risk, even if they have no signs or symptoms of the condition. Your child may be at high risk if he or she:

  • Has a body mass index (BMI) above the 85th percentile
  • Has a sibling, parent, grandparent, aunt, uncle or cousin with type 2 diabetes
  • Is black, Hispanic, Native American, Asian-American or Pacific Islander, as these racial groups have a higher incidence of type 2 diabetes
  • Has signs of insulin resistance, such as darkened skin on the neck or armpits

Talk to your child's doctor if you're concerned about diabetes or if you notice any of the signs or symptoms of type 2 diabetes — increased thirst and urination, increased hunger, weight loss, fatigue, blurred vision, slow-healing sores, or frequent infections.

Type 2 diabetes develops when the body becomes resistant to insulin or when the pancreas stops producing enough insulin. Exactly why this happens is unknown, although excess weight, inactivity and genetic factors seem to be important.

Insulin: The key for sugar

Insulin is a hormone that comes from the pancreas, a gland located just behind the stomach. When your child eats, the pancreas secretes insulin into the bloodstream. As insulin circulates, it acts like a key by unlocking microscopic doors that allow sugar to enter your child's cells. Insulin lowers the amount of sugar in your child's bloodstream. As your child's blood sugar level drops, so does the secretion of insulin from the pancreas.

Glucose: The energy source

Glucose — sugar — is a major source of energy for the cells that make up muscles and other tissues. Glucose comes from two main sources: the food your child eats and your child's liver. During digestion, sugar is absorbed into the bloodstream. Normally, sugar then enters cells with the help of insulin.

Liver: Production and storage

The liver acts as a glucose storage and manufacturing center. When your child's insulin levels are low — when your child hasn't eaten in a while, for example — the liver releases the stored glucose to keep your child's glucose level within a normal range.

In type 2 diabetes, this process doesn't work well. Instead of moving into your child's cells, sugar builds up in his or her bloodstream. This occurs when your child's pancreas doesn't make enough insulin or your child's cells become resistant to the effect of insulin.

Researchers don't fully understand why some children develop type 2 diabetes and others don't, even if they have similar risk factors. However, it's clear that certain factors increase the risk, including:

  • Weight. Being overweight is a primary risk factor for type 2 diabetes in children. The more fatty tissue a child has, the more resistant his or her cells become to insulin. However, weight isn't the only factor in developing type 2 diabetes.
  • Inactivity. The less active your child is, the greater his or her risk of type 2 diabetes. Physical activity helps your child control his or her weight, uses glucose as energy, and makes your child's cells more responsive to insulin.
  • Family history. The risk of type 2 diabetes significantly increases if a parent or sibling has type 2 diabetes — but it's difficult to tell if this is related to lifestyle, genetics or both.
  • Race. Although it's unclear why, children of certain races — especially blacks, Hispanics, Native Americans, Asian-Americans and Pacific Islanders — are more likely to develop type 2 diabetes.

Type 2 diabetes can be easy to ignore, especially in the early stages when your child is feeling fine. But type 2 diabetes must be taken seriously. The condition can affect nearly every major organ in your child's body, including the heart, blood vessels, nerves, eyes and kidneys. Keeping your child's blood sugar level close to normal most of the time can dramatically reduce the risk of these complications.

The long-term complications of type 2 diabetes develop gradually. But eventually, diabetes complications may be disabling or even life-threatening.

  • Heart and blood vessel disease. Diabetes dramatically increases your child's risk of various cardiovascular problems, including heart disease, stroke, high cholesterol and high blood pressure.
  • Nerve damage (neuropathy). Excess sugar can injure the walls of the tiny blood vessels (capillaries) that nourish your child's nerves, especially in the legs. This can cause tingling, numbness, burning or pain.
  • Kidney damage (nephropathy). Diabetes can damage the numerous tiny blood vessel clusters in the kidneys that normally filter waste from your child's blood. The earlier diabetes develops, the greater the concern. Severe damage can lead to kidney failure or irreversible end-stage kidney disease, requiring dialysis or a kidney transplant.
  • Eye damage. Diabetes can damage the blood vessels of the retina (diabetic retinopathy). Diabetes can also lead to cataracts and a greater risk of glaucoma.
  • Foot damage. Nerve damage in the feet or poor blood flow to the feet increases the risk of various foot complications. Left untreated, cuts and blisters can become serious infections.
  • Skin conditions. Diabetes may leave your child more susceptible to skin problems, including bacterial infections, fungal infections and itching.

Healthy lifestyle choices can help prevent type 2 diabetes in children and its complications. And if your child already has type 2 diabetes, lifestyle changes can reduce the need for medications. Encourage your child to:

  • Eat healthy foods. Offer your child foods low in fat and calories. Focus on fruits, vegetables and whole grains. Strive for variety to prevent boredom.
  • Get more physical activity. Encourage your child to get active. Sign up for a sports team or dance lessons, or look for active things to do together.
  • Lose excess pounds. Help your child make permanent changes in his or her eating and exercise habits.

Better yet, make it a family affair. The same lifestyle choices that can help prevent type 2 diabetes in children can do the same for adults. The best diet for a child with diabetes is also the best diet for the whole family.

Keeping your child's eyes healthy

If your child already has type 2 diabetes, be sure to schedule an annual eye exam to look for early signs of eye disease.

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