What is type 2 diabetes? 

Type 2 diabetes 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 type 2 diabetes?

 Your child has a higher risk for type 2 diabetes if he or she 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 type 2 diabetes? 

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 type 2 diabetes diagnosed? 

Your child may need tests to check for type 2 diabetes by the time he or she is 10 years old: 

•     An A1c test shows the average amount of sugar in your child's blood over the past 2 to 3 months. Your child's healthcare provider will tell you the level that is right for your child. The goal is usually below 7.5%. Your provider can help you make changes if a check shows your child's A1c is too high

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

•     A random glucose test can be done any time of day, no matter how long ago your child ate

•     An oral glucose tolerance test starts with a fasting blood sugar level check. He or she is then given a glucose drink. His or her 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

•     Genetic testing may be done to check for genes that may cause diabetes 

How is type 2 diabetes treated? 

Type 2 diabetes can be controlled. The goal is to help keep your child's blood sugar at a normal level. He or she must eat healthy foods, and exercise regularly. Your child may also need medicine by mouth or insulin if blood sugar levels cannot be controlled 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 the level is higher than directed. Write down the results and show them to your child's healthcare provider. Your provider may use the results to make changes to your child's medicine, food, or exercise schedules. 

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 or her blood sugar level may drop too low if he or she 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 or she eats too many carbohydrates. Your child's dietitian will help you plan meals and snacks that have the right amount of carbohydrates

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

What else can I do to help my child manage type 2 diabetes? 

•     Go to all follow-up appointments. Your child may need to return to have his or her A1c checked at least twice a year. Your child may also need tests to check his or her blood pressure, cholesterol, eyes, and feet

•     Have your child exercise as directed. Exercise can help keep your child's blood sugar level steady. Encourage your child to exercise for at least 60 minutes on most days of the week. Help your child include activities 3 days each week that strengthen his or her muscles and bones. Work with your child's healthcare provider to create an exercise plan:

  ○   Check your child's blood sugar level before and after exercise. Healthcare providers may tell you to change the amount of insulin your child takes or food he or she eats. If the blood sugar level is high, check your child's blood or urine for ketones before you exercise. Do not let your child exercise if the blood sugar level is high and your child has ketones

  ○   If your child's blood sugar level is less than 100 mg/dL, have him or her eat a carbohydrate snack before exercise. Examples are 4 to 6 crackers, ½ banana, 8 ounces (1 cup) of milk, or 4 ounces (½ cup) of juice. Have your child drink water or liquids that do not contain sugar before, during, and after exercise. Ask your dietitian or healthcare provider which liquids your child should drink when he or she exercises

 •     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 or she is overweight. The provider can help your child set manageable weight loss goals

•     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 or her diabetes is not controlled. Make sure his or her 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 type 2 diabetes? 

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

•     Give instructions to your child's school. Make sure your child's teachers know he or she 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 around your child.Do not let others smoke around him or her. 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 or she 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 type 2 diabetes in children? 

Uncontrolled diabetes can damage your child's nerves and arteries. Long-term high blood sugar levels can damage his or her eyes and kidneys. Diabetes is life-threatening if it is not controlled. Control your child's blood glucose levels to prevent complications.

When should I seek immediate care? 

•     Your child has a low blood sugar level and it does not improve with treatment

•     Your child's blood sugar level is above 240 mg/dL and does not come down after a dose of insulin

•     Your child has ketones

•     Your child has a fever

•     Your child has nausea or is vomiting and cannot keep any food or liquid down

•     Your child has symptoms of a low blood sugar level, such as trouble thinking, sweating, or a pounding heartbeat

•     Your child has blurred or double vision

•     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's blood sugar levels are higher than his or her target goals

•     Your child often has low blood sugar levels

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

•     Your child has numbness in his or her arms or legs

•     Your child has warm, red patches of skin or a wound that does not heal

•     Your child gets easily irritated

•     Your child is anxious or depressed

•     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.

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