Type 2 Diabetes In Children - An Overview

Type 2 diabetes is a lifelong condition. You can minimise the long-term risks and complications for your child.

Key points about type 2 diabetes in children

the medical name for diabetes is diabetes mellitus
diabetes is a condition that happens when the level of glucose in the blood is too high for a long time
type 2 diabetes is more common in adults but can happen in tamariki (children) and rangatahi (young people)
type 2 diabetes is a lifelong condition - once your child is diagnosed with diabetes, they will always have it
diabetes can lead to serious complications but you can minimise the risk by maintaining blood glucose levels within a healthy range as much as possible, keeping physically and mentally healthy and following your treatment plan
the treatment for type 2 diabetes includes weight management, healthy diet, regular daily exercise and medicines

What is type 2 diabetes?

You might find it helpful to watch the animated video about diabetes and the body at the top of the page.

Type 2 diabetes is a lifelong condition where the level of glucose in the blood is too high. This happens because of a combination of 2 factors.

Insulin resistance

The pancreas is producing insulin but it cannot work properly because the body if 'resistant' to it. This means the body needs more and more insulin to achieve the same effect.

Insulin resistance is more likely in people:

who have family members with insulin resistance
who are overweight
who don't get enough exercise

Reduced insulin production

After a period of producing more and more insulin, the pancreas becomes exhausted and cannot make enough insulin.

Glucose and insulin

Glucose is the main source of energy in our bodies. It is mostly made when our bodies break down the carbohydrates that we eat or drink.

Glucose is absorbed from the gut into the blood stream.

Insulin is a hormone produced by special cells called beta cells in the pancreas. The pancreas is an organ in the abdomen, behind the stomach.

Insulin allows the glucose from the bloodstream to move to the cells in the body. From there it's used as fuel for energy.

What are the risk factors for type 2 diabetes?

There are known risk factors for having type 2 diabetes.

Family members with diabetes

You are more likely to develop type 2 diabetes if other members of your whānau have type 2 diabetes.

Environmental factors

being above a healthy weight
not getting enough exercise - the recommendation is for tamariki to have 60 minutes of 'huff and puff' activity every day
eating too much food, especially fats, takeaways, fast foods and sugar

Can you prevent or delay type 2 diabetes?

You can prevent or delay type 2 diabetes by making changes to the environmental risk factors.

The risk of getting type 2 diabetes lessens by becoming physically active and eating a healthy diet.

How long does diabetes last?

Type 2 diabetes is a lifelong condition. But the symptoms may lessen and the treatment may reduce if a person:

becomes physically active
eats a healthy diet
doesn't gain weight

What are the symptoms of type 2 diabetes?

Symptoms usually develop gradually.

Some people with type 2 diabetes have few or no symptoms but a lot of tamariki and rangatahi will have the following symptoms:

being very thirsty and drinking a lot
weeing a lot
having new or more wet accidents
having new or increased bedwetting
weight loss despite being hungrier and eating more
being tired and having low energy
mood changes
fungal infections (thrush)
dark skin patches in certain areas of the body (the medical name is acanthosis nigricans )

What should I do if I think my child may have type 2 diabetes?

If you suspect your child has diabetes, please seek medical attention as soon as possible.

Diabetes is diagnosed by assessing the risk factors and symptoms, and doing a blood test. If your child has risk factors for type 2 diabetes, your doctor may want to do blood tests for diabetes even when there are few symptoms.

Your child might need a test called an oral glucose tolerance test. This involves drinking a sweet liquid, and then checking glucose levels in the blood.

What is the treatment for my child with type 2 diabetes?

The goal of the treatment for type 2 diabates is to stabilise blood glucose levels as much as possible. The aim of treatment is to make your child feel better and to prevent health complications later in life.

The treatment of type 2 diabetes is about a balance between:

Healthy lifestyle, which includes healthy eating and physical activity.
Diabetes medicine.

Make healthy changes

It's very important to involve all the family and whānau in supporting your child or young person to make healthy changes.

They can do this by:

eating a healthy diet centred on whole foods and less processed foods where possible
being active and doing regular physical activities
continuing to live the same type of lifestyle throughout their teens and into adulthood

Consider food choices

See the KidsHealth page on type 2 diabetes in children - general guidelines on nutritional management.

See the KidsHealth page on healthy eating for children with diabetes.

Encourage your child to be active

All tamariki and rangatahi should aim to get 60 minutes of moderate to vigorous activity every day. This should include muscle-strengthening exercises 3 days a week.

See the KidsHealth page on encouraging children and young people with diabetes to be active.

If your child is using insulin, they may need to do the following around activity, to avoid hypoglycaemia:

have extra carbohydrate
adjust insulin dosing

Your diabetes team will discuss this with you.

Aim to limit recreational screen time to a maximum of 2 hours a day. Avoid things that involve sitting for long periods of time.

Please talk with your diabetes team about specific recommendations for your child.

Achieve and maintain a healthy weight

Achieving and maintaining a healthy weight is an important part of diabetes management. It helps prevent health problems later in life.

Check further down the page for some resources to help you with healthy choices.

Medicines

Most tamariki with type 2 diabetes need medicines:

tablets (such as metformin) which help the body to use insulin more effectively and lower blood glucose levels
injection medicines (such as insulin) if the body is not making enough insulin

Some tamariki may also need medicines to help with blood pressure, kidney health or cholesterol level.

Why is it important to monitor blood glucose levels?

It's important to monitor blood glucose levels and try to keep them within target range (4 to 8 mmol/L) even if your child is feeling 'OK' at the moment.

High blood glucose levels over a long period of time leads to serious complications. Screening is important to find any possible developing complications early.

Possible complications include:

eye problems (retinopathy, cataracts)
kidney problems (nephropathy)
nerve problems (neuropathy)
foot problems
heart and blood vessel problems leading to heart attack and stroke

Tamariki with type 2 diabetes and obesity are also at a higher risk of:

obstructive sleep apnoea
fatty liver disease
polycystic ovary syndrome

See KidsHealth's page on possible complications in children with diabetes.

You can minimise long-term risks and complications by:

keeping blood glucose levels in target range as much as possible
staying healthy with a healthy diet and more exercise
learning as much as you can about diabetes

Learning about diabetes

There is a lot to learn about how to care for a child or young person with diabetes.

This learning involves the whole family, whānau, and other people that are involved in the life of a child or young person - school staff, friends, neighbours, sports coaches, etc.