Glucose is a type of sugar. Under normal conditions, rising glucose levels in the blood cause the pancreas to produce a hormone known as insulin. Insulin allows the glucose in the blood to enter the cells of the body and be converted into energy. Type 2 diabetes develops when the body loses its ability to respond properly to insulin.
In type 2 diabetes, the body’s cells become less sensitive to insulin. As a result, large amounts are required for glucose control. Unfortunately, the pancreas cannot maintain this high level of insulin production indefinitely, and eventually the body loses the ability to produce all the insulin it needs. At this point, blood sugar levels rise. Despite these high blood sugar levels, symptoms of diabetes may either be absent or mild.
In contrast, type 1 diabetes occurs only after the pancreas is severely damaged by the body’s immune system. The damaged pancreas can no longer produce enough insulin. Instead of the high levels of insulin and insulin resistance seen in type 2 diabetes, very low levels of insulin occur in type 1 diabetes. As a result, sudden serious illness requiring emergency insulin treatment is common in type 1 diabetes.
Obesity is the major cause of most type 2 diabetes. The tissue of overweight people often becomes resistant to insulin. Since physical activity improves tissue sensitivity to insulin, physically inactive people may also have tissues that are more insulin resistant.
The short-term effects of type 2 diabetes include:
Possible long-term effects of type 2 diabetes include:
According to the American Diabetes Association (ADA), doctors should begin to screen children for diabetes at age 10 or onset of puberty if they are overweight and have at least 2 other risk factors for diabetes. Screening should be repeated every 3 years. In addition to obesity, other risk factors for type 2 diabetes include:
The risk of type 2 diabetes is higher in children of African American, Asian American, Native American, and Pacific Islander descent.
A blood test is done for screening and diagnosis. The most commonly used test is the fasting plasma glucose, a blood test done after a person has fasted for 8 hours. A fasting plasma glucose (blood sugar) level of 126 milligrams per deciliter or greater on 2 separate occasions is diagnostic of diabetes. Other tests, like a hemoglobin A1c (HbA1c) test or a 2-hour glucose tolerance test, can also be done to screen for or diagnose diabetes.
Managing blood sugar levels requires major lifestyle changes for children. To succeed, children need adult supervision and support. The entire family should work with a diabetes team (doctor, nurse, social worker, dietitian, and exercise counselor) to develop a healthy lifestyle.
Children living with type 2 diabetes need daily strategies to maintain normal blood sugar levels. These include:
The primary preventive measures for type 2 diabetes are maintaining a healthy weight and getting regular exercise. A diet with age appropriate calorie intake and plenty of fruits and vegetables is ideal for diabetes prevention. Active daily play should also be encouraged in school and at home. Children should have fun exercising instead of spending a lot of time online, watching TV, or playing video games.
American Diabetes Association
Healthy Children—American Academy of Pediatrics
Canadian Diabetes Association
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Last reviewed January 2018 by EBSCO Medical Review Board Michael Woods, MD, FAAP Last Updated: 4/14/2014