Type 2 diabetes in children

Diagnosis

Children who are more likely to develop type 2 diabetes should be screened, which will be suggested by a doctor. Type 2 diabetes in children can be diagnosed using a variety of blood tests.

• Glycosylated hemoglobin (A1C) test: The results of this test reveal the child’s three-month average blood sugar level. Diabetes is identified by an A1C result of 6.5% or higher.
• Fasting blood sugar test: Blood sample is drawn from the child after they did not consume any food or water for at least 8 hours prior to the test. Diabetes is indicated by a fasting blood sugar level of 126 mg/dL (7.0 mmol/L) or greater.
• Random blood sugar test: This blood test is taken anytime even if the child had consumed food. Diabetes is suggested by a blood sugar level of 200 mg/dL, or 11.1 mmol/L, or higher, measured at random.
• Glucose tolerance test: The child will be refrain from eating or drinking anything after midnight. They will be given something to drink and after two hours, and blood sugar levels will be checked periodically. The child likely has diabetes if their blood sugar level is 200 mg/dL (11.1 mmol/L) or above.

Children who have been diagnosed with diabetes will undergo additional testing to determine if they have type 1 or type 2 diabetes, this will help the doctor to provide an appropriate treatment plan.

Treatment

The purpose of treatment is to maintain the child’s blood sugar levels within the target range, which should be as close as possible to the normal range.

The blood sugar target range of the child will be communicated to the parents by their healthcare provider, who may also establish an A1C target. As the child grows, these figures as well as the diabetes treatment program for the child may also change.

Type 2 diabetes requires ongoing care and may be treated with the following:

• Healthy eating: Children with type 2 diabetes would be recommended to undergo weight loss program to maintain a healthy weight, or to lose weight to improve the blood sugar level. It is recommended that the child or the family would take low fat and calories food, and high in nutritional value.

Fruits, vegetables, nuts, whole grains, and olive oil are all important components of a healthy diet. Make sure to choose fiber-rich, low-fat, low-calorie foods without sacrificing flavor or nutrients to aid in your child’s goals. The dietician for the child can assist in making a meal plan that considers the child’s dietary preferences and health objectives.

• Medication: The following medicines are approved for treating the type 2 diabetis in children:
  • Metformin: This medication improves how well the body’s cells use insulin and lowers the amount of sugar that a child’s liver releases into the circulation between meals.
  • Liraglutide: This medicine is administered by injection. Following meals, when blood sugar levels are greater, liraglutide aids in the body’s production of more insulin from the pancreas. The adverse effects of this drug on the digestive system could include nausea or diarrhea.
  • Insulin: If the child’s blood sugar levels are really high, insulin may occasionally be required. The blood sugar level is decreased by insulin by allowing sugar to enter the cells for energy.

Although there are many different types of insulin, type 2 diabetes in children is frequently treated with a long-acting insulin once daily and a short- or rapid-acting insulin with meals. A syringe or an insulin pen is commonly used to administer insulin.

• Physical activity: Physical activity should be included at the child’s everyday activity, even it is break-out into a smaller time, and it is not necessary to complete it all at once. Children with type 2 diabetes, like everyone else, should regularly engage in aerobic exercise. Children who engage in physical activity are better able to manage their weight, burn through sugar, and use insulin more efficiently. This may reduce blood sugar levels.
• Blood sugar monitoring: The frequency of blood sugar checking and recording for the child should be determined by the healthcare provider. Children taking insulin typically require more regular testing, potentially four times daily or more.

Continuous glucose monitoring may be a possibility, depending on the needs of the treatment. Only regular testing can guarantee that the child’s blood sugar level stays within the desired range.

• Weight loss surgery: Weight-loss surgery may result in better type 2 diabetes management for adolescents who are significantly obese, as measured by a body mass index (BMI) of 35 or above.
• Medical care: To ensure effective diabetes management, the child will require routine checkups. During appointments with the healthcare provider, they may be a discussion about the regular eating patterns of the child, physical activity levels, weight, and any medications the child may be on. Medication usage can be decreased with healthy lifestyle modifications.
• Signs of trouble: There are some type 2 diabetes complications that need to be treated right away, include low blood sugar, high blood sugar, diabetic ketoacidosis, and hyperosmolar hyperglycemia.
  • Low blood sugar (hypoglycemia): A blood sugar level below the target range in the child is known as hypoglycemia. Blood sugar levels might fall for a variety of causes, such as skipping a meal, consuming less carbohydrates than intended, engaging in greater physical activity than usual, or administering too much insulin. The risk of low blood sugar in children with type 2 diabetes is lower than that of type 1 diabetes in children.

If your child’s blood sugar level is low:

• • • Fast-acting carbohydrate: Give your child 15 to 20 grams of a fast-acting carbohydrate, such as fruit juice, glucose tablets, hard candies, regular (not diet) soda, or another sugar source.
    • Retesting blood sugar: In about 15 minutes, recheck your child’s blood sugar to be sure it has returned to the target range. If it isn’t, try again after 15 minutes with a fast-acting carbohydrate until you get a reading within the child’s target range.
  • High blood sugar (hyperglycemia): Blood sugar levels beyond the child’s target range are referred to as hyperglycemia. Numerous factors can cause blood sugar levels to increase, such as being ill, overeating, consuming particular foods, and not taking enough insulin or diabetes medicine.
  • Diabetes ketoacidosis: Because of a significant insulin deficiency, the child’s body produces some harmful acids (ketones). The child could develop the potentially fatal illness known as diabetic ketoacidosis (DKA), if there is an accumulation of excessive ketones. Children with type 1 diabetes have DKA more frequently, while it can also happen to kids with type 2 diabetes. Use an over-the-counter ketone test kit to examine the child’s urine for excessive ketones if they suspect DKA. Call the child’s healthcare provider or go to the emergency room if the ketone levels are high.
  • Hyperosmolar hyperglycemic state: Children with type 2 diabetes may experience hyperosmolar hyperglycemia state (HHS) over a few days. HHS’s abnormally high blood sugar levels, which can reach 600 mg/dL or greater, might arise from severe illnesses, infections, or other medical disorders. Severe dehydration follows from the body’s attempt to eliminate the excessive level of sugar by passing it in the urine. Patient with HHS needs immediate medical attention because the condition is life-threatening.