Under normal circumstances, rising glucose levels (a type of sugar) in the blood cause the pancreas to produce the hormone insulin. Insulin allows the glucose in the blood to enter the cells of the body and be converted into energy. Type 2 diabetes develops when the body loses its ability to respond properly to insulin.
In type 2 diabetes, the body’s cells become progressively less sensitive to insulin and, therefore, very large amounts are required for glucose control. Unfortunately, the pancreas cannot maintain this elevated level of insulin production indefinitely, and eventually the body loses the ability to produce all the insulin it needs. At this point, blood sugar levels rise. Despite these high blood sugar levels, symptoms of diabetes may either be absent or so mild as to escape attention.
type 1 diabetes, occurs only after the pancreas is severely damaged by the body’s immune system. The damaged pancreas can no longer produce adequate amounts of insulin. Therefore, instead of the high levels of insulin and insulin resistance seen in type 2 diabetes, very low levels of insulin occur in type 1 diabetes. As a result, sudden serious illness requiring emergency insulin treatment is quite common in type 1 diabetes.
Finding the Causes and Risk Factors
Obesity is the major cause of most type 2 diabetes because the tissue of overweight people frequently become resistant to insulin. Since physical activity improves tissue sensitivity to insulin, physically inactive people also have tissues that are more insulin resistant.
The short-term effects of type 2 diabetes include:
Possible long-term effects of type 2 diabetes include:
Eye disease and vision problems
Heart disease and circulatory problems
According to the American Diabetes Association (ADA), doctors should begin to screen children for diabetes at age 10 or puberty, whichever comes first, if they are overweight and have at least two other risk factors for diabetes. Screening should be repeated every 1-3 years. In addition to obesity, the risk factors for type 2 diabetes include:
Family history: a close relative with type 2 diabetes (including mother having diabetes or gestational diabetes)
Ethnicity: African American, Hispanic/Latino, Asian American, Native American, and Pacific Islander descent
Conditions associated with insulin resistance, such as:
A blood test is done for screening and diagnosis. The most commonly used test is the fasting plasma glucose, a blood test done after a person has fasted for eight hours. A fasting plasma glucose (blood sugar) level of 126 milligrams per deciliter or greater on two separate occasions is diagnostic of diabetes. Other tests, like a hemoglobin A1c (HbA1c)
test or a two-hour glucose tolerance test, can also be done to diagnose diabetes.
Making Lifestyle Changes
Managing their blood sugar levels requires major lifestyle changes for children. To succeed, children need adult supervision and support. The entire family should work with a diabetes team (doctor, nurse, social worker, dietician, and exercise counselor) to develop a healthy lifestyle.
Children living with type 2 diabetes need daily strategies to maintaining normal blood sugar levels. These include:
Planning healthy meals
Eliminate regular sodas, limit carbohydrates and fruit juice, and have your child eat whole grains and vegetables.
Count grams of carbohydrates and read food labels.
Increasing physical activity
Encourage your child to get plenty of active play time every day.
Plan for periods of low blood sugar by carrying short-acting glucose or carbohydrates.
Monitoring and taking medicines
Check your child's blood sugar levels throughout the day if directed. There are different ways to check blood sugar levels. Some methods involve pricking the finger or arm and applying a drop of blood to a meter with a glucose-sensitive strip.
Schedule regular eye and foot exams to detect and treat early vision and circulatory problems.
If instructed by the doctor, monitor your child's blood pressure and cholesterol levels.
To control blood sugar, have your child take medicines and/or insulin injections as prescribed.
Preventing Type 2 Diabetes in Children
The primary preventive measures for type 2 diabetes are maintaining a healthy weight and getting regular exercise. A diet with age appropriate calorie intake and plenty of fruits and vegetables is ideal for diabetes prevention. Vigorous daily play should also be encouraged in school and at home. Rather than spending time online, watching TV, or playing video games, children should have fun exercising.
2/15/2010 DynaMed's Systematic Literature Surveillance
DynaMed's Systematic Literature Surveillance: American Diabetes Association. Diagnosis and classification of diabetes mellitus. Diabetes Care. 2010;33(suppl 1:S62-69).
8/27/2010 DynaMed's Systematic Literature Surveillance
DynaMed's Systematic Literature Surveillance: Lobelo F, Liese AD, Liu J, et al. Physical activity and electronic media use in the SEARCH for diabetes in youth case-control study. Pediatrics. 2010;125(6):e1364-71. Epub 2010 May 10.
Please be aware that this information is provided to supplement the care
provided by your physician. It is neither intended nor implied to be a
substitute for professional medical advice. CALL YOUR HEALTHCARE PROVIDER
IMMEDIATELY IF YOU THINK YOU MAY HAVE A MEDICAL EMERGENCY. Always seek the
advice of your physician or other qualified health provider prior to
starting any new treatment or with any questions you may have regarding a