What all parents should know about Type 2 Diabetes

Type 2 diabetes is no longer a disorder that is only diagnosed in adulthood. In recent years, there has been a significant increase in the diagnosis of type 2 diabetes in kids. At Le Bonheur Children’s Hospital, 1 in every 5^th child diagnosed with diabetes has type 2 diabetes. In 2020, hospitalizations due to complications with type 2 diabetes more than doubled compared to the previous year.

We spoke with Le Bonheur endocrinologist Dr. Amit Lahoti about what every parent needs to know about type 2 diabetes in children. He is also an Associate Professor of Pediatrics at University of Tennessee Health Science Center and Medical Director of Le Bonheur’s EMPOWER clinic.

What is Type 2 Diabetes?

In patients with type 2 diabetes, the body does not produce adequate amount of insulin compared to the body’s needs and has decreased response to insulin (insulin resistance). Insulin is a hormone produced by the pancreas and it helps our body to use the sugar from sugary or starchy foods and maintain blood sugar levels in a normal range. The combination of inadequate amounts of insulin and insulin resistance in type 2 diabetes results in high blood glucose levels, or hyperglycemia.

Risk Factors for Type 2 Diabetes

There is not one single risk factor that causes type 2 diabetes, but rather a combination of risk factors. Below is a list of prominent risk factors for type 2 diabetes:

• Family history of type 2 diabetes
• African American, Hispanic American or Native American descent
• Overweight or obesity
• Not exercising regularly

Symptoms to Look For

The major symptoms parents need to look for as possible indicators of type 2 diabetes are:

• Frequent urination
• Bedwetting after previously being dry at nights
• Increased thirst during the day or getting up in the night for a drink.
• Unintentional weight loss
• Darkness around the neck and under arm area — this is a sign of insulin resistance

Type 2 diabetes progresses slower than type 1 diabetes, so signs and symptoms can go unnoticed for several weeks. The best things a parent can do is to know the risk of developing type 2 diabetes in your child and pay close attention to any possible symptoms. If you do have concerns, call your child’s pediatrician for a checkup.

Complications of Diabetes

A diagnosis of diabetes increases the risk of many other health complications. Some of the major complications that can follow a type 2 diabetes diagnosis include, but are not limited to:

• Diabetic kidney disease progressing up to kidney failure
• Neuropathy or nerve damage
• Diabetic Eye Disease including vision loss
• High cholesterol levels
• Stroke
• Heart Attack
• Sudden Death

Kids with type 2 diabetes are at risk of progression to these complications faster than adults with type 2 diabetes. Kids diagnosed with type 2 diabetes in their early teen years, if not managed well, can develop some of these complications before they turn 18.

Diabetes Prevention

Diabetes can be prevented in children by encouraging them to eat healthy balanced meals and limit sugary foods and drinks (like regular sodas, fruit juices, sweet tea, sports drinks). A healthy diet that includes nutrient‐rich, low‐fat foods including whole grain cereals and breads, dairy products, lean proteins, fresh fruits and vegetables can greatly decrease the risk of becoming overweight and the development of diabetes.

The disease can also be prevented by limiting screen time and increasing the time your child spends physically active every day. This can be anything from participating in an after school sport to walking the family dog every day.

After Diagnosis Care

The parent's role after their child is diagnosed is very important. The child, even in their teen years, will need help managing their medication and insulin. They will also need help learning how to test their glucose levels. It is extremely important to supervise and help the child in diabetes care until the child demonstrates readiness to manage diabetes on their own. Their diabetes care team can help with this very important transition.

Lifestyle changes will be necessary not only for the child but for the whole family. It is always more successful for the child when the whole family adapts a healthier lifestyle centered on balanced meals and exercise. A child with diabetes needs to exercise at least 30‐60 minutes for 5 days out of the week. This is more effective if family members actively participate in the activities with them.

If your child is diagnosed with type 2 diabetes, it is helpful to seek out assistance and care from a multi‐specialty clinic with a focus on type 2 diabetes management. At Le Bonheur, we have recently created our EMPOWER clinic – a clinic focused on providing care for children with type 2 diabetes, based on best practices in the field. In the clinic, your child will receive help from a pediatric endocrinologist, clinical psychologist, registered dietitians, diabetes educators, nursing staff and a social worker.

While a type 2 diabetes diagnosis can be scary, with the help of trained professionals it can be managed, and a child can have a long and fulfilling life free from diabetic complications.