(LifeWire) - Type 2 diabetes currently accounts for up to 50% of all new cases of diabetes in kids. This is a significant increase from even a decade ago, when the majority of cases for pediatric diabetes were type 1 diabetes.
People who have type 2 diabetes either do not produce enough insulin or do not use insulin effectively. Insulin, a hormone produced by the pancreas, helps glucose (sugar) move from the bloodstream to the cells, where it is used as an energy source. If sugar does not get into the cells, they lack the fuel needed for the body to function. Over time, excess sugar in the blood can damage the body's organs. Reducing insulin resistance combats type 2 diabetes by helping the body to better metabolize sugar.
One of the main causes of type 2 diabetes is obesity, which contributes to both insulin resistance and cardiovascular problems. Since the 1970s, the rate of obesity in children has more than doubled. Many attribute this to an increasingly sedentary lifestyle, as well as poor nutritional habits.
Often diet, exercise and lifestyle changes can help children manage type 2 diabetes or prevent it from developing, but sometimes medications may be needed as well.
The Growing Epidemic
One significant study of adolescents in a large Midwestern city found that the rate of type 2 diabetes increased 10-fold from 1982 to 1994, representing 33% of all adolescent cases of diabetes. Nationally, it is estimated that 29% of adolescent patients with diabetes have type 2 diabetes, resulting in an estimated 2.8 million adolescents in the U.S. with prediabetes or type 2 diabetes.
Given the rise of childhood obesity, it is estimated that more than one third of all children who were born in 2000 will eventually develop diabetes, either during childhood or after adolescence.
With only a minority of the people who ultimately develop type 2 diabetes being diagnosed before the age of 20, the rise in childhood type 2 diabetes is expected to be accompanied by a similar increase in the number of adults who develop type 2 diabetes.
Some ethnic groups are more prone to diabetes. For example, 50% of Hispanics in the U.S. are projected to develop childhood or adult diabetes. This rise in diabetes also leads to a reduction in projected lifespan -- as much as 22 years for some individuals.
Goals of Managing Type 2 Diabetes in Children
Managing type 2 diabetes in children involves several goals. These goals are: to keep blood sugar levels normal; to improve insulin sensitivity, which helps control blood sugar levels; to treat cardiovascular issues and fatty liver disease; and to prevent complications associated with diabetes, such as nephropathy (kidney disorder), neuropathy (nerve damage, especially to the feet and legs) and retinopathy (eye disease).
Underlying all of these goals is the essential challenge to instill lifestyle changes to combat obesity, which will help people achieve all the other treatment goals for type 2 diabetes.
Exercise and Diet for Children and Adolescents
For children younger than 2 years old, high dietary fat intake is essential to optimize development of the nervous system. However, most children older than 2 years of age should adhere to a lower-fat diet in keeping with the recommendations outlined in the USDA's "My Pyramid for Kids," which is specifically geared for children and adolescents who are 6 to 11 years old.
Dietary recommendations for children with type 2 diabetes or prediabetes include consuming more fresh fruits and vegetables, eating fewer high-fat and processed foods, and eliminating sweetened beverages, such as soft drinks, entirely from the diet.
In addition to adopting healthy eating habits, children and adolescents should make a habit of engaging in physical activity for at least 60 minutes daily, whether by getting involved in organized sports or informal activities. Exercise is known to reduce insulin resistance in children, even if children remain overweight.
The National Institutes of Health recommends limiting television and video game viewing to no more than one hour per day. Instead of sedentary entertainment, experts recommend active playing and/or participation in organized sports, dance or other activities.
Special Challenges for Children and Families
It can be socially and emotionally challenging for a child or adolescent who is diagnosed with type 2 diabetes or prediabetes. He or she may feel "singled out" among family members and peers. The most successful approach is often for the entire family to be supportive by adopting healthy diet and exercise practices together, rather than establishing an alternate diabetic diet and exercise routine for the diabetic family member alone.
This concept can be carried out into the classroom, extracurricular activities and camp settings as well. Parents of diabetic and prediabetic children can work with teachers and other classroom parents to suggest healthy snacks for classroom celebrations, including birthdays. Not only will this help the diabetic and prediabetic children not to feel singled out, but all of the children will benefit from eating healthy nutritious snacks.
Medications and Other Treatment Considerations for Children and Adolescents
The first, and most important factor in combating diabetes for children is by making lifestyle modifications with diet and exercise. Ideally, a diabetes healthcare team for children and adolescents will include nutritionists and activity leaders to help patients and families incorporate healthy changes into their lives.
Even if no diabetic symptoms, such as increased thirst or urination are present, healthcare providers may prescribe antidiabetic medications if lifestyle changes are not successful in modifying the risks involved with diabetes.
Children and adolescents who have symptoms of diabetes might be started on medications right away, concurrent with diet and exercise changes. Healthcare providers may also prescribe oral medications such as Glucophage (metformin) to some patients with prediabetes to prevent type 2 diabetes from developing. Glucophage helps lower blood sugar levels.
In formulating treatment plans, healthcare providers may consider a wide range of medications, including insulin and oral agents. At this time, only insulin and Glucophage are approved by the FDA for pediatric use. However, pediatric diabetologists may use other antidiabetic medications on an individual basis.
