A child with diabetes has trouble regulating blood glucose, or blood sugar. There are two major kinds of the disease: type 1 and type 2.
If a child has type 2 diabetes (T2D), the body doesn't produce enough insulin -- the hormone that turns food into energy -- or the cells ignore insulin altogether. With type 1 diabetes, or T1D, the pancreas simply stops producing insulin.
T2D is by far the most common form, according to the American Diabetes Association (ADA). Of the nearly 26 million Americans who have diabetes, between 90 and 95 percent of them have T2D. And in that group, 215,000 of them have diabetes (type 1 or type 2) and are under the age of 20, says the American Diabetes Association. Between 2002 and 2005, 3,600 youth were diagnosed with T2D each year.
More than 90 percent of kids with T2D have a family history of the disease, says Parents advisor Lori Laffel, M.D., M.P.H., chief of the Pediatric, Adolescent and Young Adult Section at the Joslin Diabetes Center in Boston. "Previously this was a disease of adults in their 40s, 50s, and 60s. Now we see kids getting type 2 diabetes at around the time of puberty," says Dr. Laffel. This is in large part due to the rise in childhood obesity.
But there is good news. In many cases of pre-diabetes, which is when a child shows some but not all of its symptoms, you can delay reliance on injected insulin by making sure your child is active and has a healthy diet. And if it's caught early enough, you can reverse the disease entirely.
While the signs of T1D are clear and can be severe (weight loss, sickness, vomiting), those for T2D are more subtle. Look for:
- excessive drinking and urination
- extreme fatigue
- repeated yeast infections in girls and fungal infection (jock itch) in boys
- a family history of T2D
Some groups have a higher risk for developing T2D, including African Americans, Latinos, Native Americans, and Asian Americans/Pacific Islanders, as well as people middle-aged and older. "If you have relatives with type 2 diabetes, tell your pediatrician," says JoAnn Ahern, APRN, manager of the pediatric diabetes program in Danbury Hospital, part of the Western Connecticut Health Network. If your child is above the 95th percentile for weight, have her tested annually so a diabetes diagnosis isn't missed. If T2D is untreated, the body's cells may be starved for energy, and over time, high blood glucose levels can damage the eyes, kidneys, nerves, or heart.
If your child is diagnosed, your doctor will refer you to an endocrinologist, a specialist in diseases like diabetes. Your team will also usually include a dietician, eye doctor, and diabetes educator.
T2D begins with insulin resistance. As the body's need for insulin rises, the pancreas gradually loses its ability to produce insulin. Because the progress is gradual, T2D treatment varies.
A child diagnosed with T2D or pre-diabetes will need blood glucose levels checked regularly. Your doctor will let you know how often, anywhere from a few times a day to several times a week. Doctors will usually try to lower blood sugar through diet and exercise first.
Because the cells that make insulin have essentially become worn out, eating a healthful diet (high-fiber grains, fruits and vegetables, avoiding sugary drinks and foods) gives those cells a rest.
"Every time you exercise, your muscles suck up glucose and you don't require as much insulin to get it into the muscles," explains Ahern. "When you eat high-fiber food, like brown rice or brown bread, it takes longer to digest and you don't need as much insulin to keep blood sugar normal."
Sometimes diet and exercise alone don't work, or families don't follow the treatment plan to eat well and exercise. In that case, medical intervention begins, usually with an oral medication called metformin, a pill to help control blood sugar. As the disease progresses, most kids with T2D will eventually become dependent on insulin, which usually needs to be injected. This generally happens within 5 to 10 years.
Many children are diagnosed with pre-diabetes, which means they have many of the markers of the disease -- including being overweight and inactive and having a high insulin level -- but not the disease itself yet. A healthy diet and activity level can stop it from developing into full-blown diabetes. That means:
- Keeping weight at a normal level for age
- Reducing or eliminating sugary foods and drinks from the diet
- Eating at least five servings of fruits and vegetables daily
- Being physically active for at least an hour each day
- Having less than two hours of screen time daily
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