Symptoms, And Causes, Of Type 2 Diabetes Mellitus (T2DM) In Children

Diabetes type 2 (T2DM) occurs by resistant glucose metabolism in the body cells. The absence of appropriate management could result in long- or short-term complications for this chronic condition.

Growing numbers of children are being diagnosed with type 2 diabetes mellitus. A decline in physical activity and obesity could explain this trend. In case your child shows any sign or symptom of diabetes, contact your pediatrician. By incorporating lifestyle modifications earlier in the disease process, not only can severe complications be avoided, but also prediabetes can be delayed from turning into diabetes mellitus.

What Are The Causes Of Type 2 Diabetes Mellitus In Children?

Type 2 diabetes is yet to be identified as having an exact cause. The risk for developing type 2 diabetes may be increased by genetics and lifestyle factors, such as physical inactivity and excessive energy consumption, which lead to being overweight or obese.

The body of a child with type 2 diabetes mellitus has little ability to use insulin to metabolize glucose because insulin is resistant. High blood sugar levels can result from this accumulation of sugar in the bloodstream. In comparison to their peers without diabetes, children with T2DM are more likely to suffer from conditions like hypertension, hyperlipidemia, polycystic ovarian disease, and fatty liver.

Related: How To Detect Diabetes 1 In Children

Factors that Increase the Risk of Type 2 Diabetes Mellitus in Children

Below are some factors that may make one more susceptible to type 2 diabetes mellitus.

  • Insulin resistance may increase with excessive weight or obesity. Type 2 diabetes is associated with abdominal fat.
  • Insulin response is reduced by physical inactivity. Because glucose cannot enter the cells for energy production, it builds up in the blood.
  • Diabetes mellitus type 2 is more likely to occur when there is a positive family history of diabetes.
  • There is evidence that certain genes may increase type 2 diabetes risk in some ethnic groups.
  • Diabetes type 2 may be increased by low birth weight and preterm birth.
  • It has been shown that gestational diabetes during pregnancy increases the risk of diabetes in children.

Diabetes type 2 can affect children and teens of all ages. Before puberty, diabetes mellitus of type 2 is rare. Female adolescents have a higher risk of diabetes than male adolescents.

Symptoms Of Type 2 Diabetes In Children

Often, type 2 diabetes is not symptomatic in children and is only discovered during routine medical treatment. Symptoms and signs may appear gradually for some patients, including:

  • Increased thirst
  • Urinating frequently
  • Bedwetting
  • Tiredness
  • Blurred vision
  • Darkening of the skin around the armpits or neck
  • Weight loss
  • Infections with recurrence
  • Wounds that do not heal quickly
  • Neuropathy and numbness

A high blood glucose level is responsible for these signs and symptoms. Type 1 diabetes mellitus leads to more weight loss in children than type 2 diabetes mellitus.

Diabetes Mellitus Type 2 Complications in Children

Dietary changes, medications, and physical activity are among the factors that can cause a child with diabetes mellitus to suffer short-term complications. Despite being short-term, these complications can be fatal and require emergency treatment. Here are a few risks to watch out for:

A regular glucose check, a healthy diet and exercise regimen, and the use of medications under the recommendations could reduce these complications.

Diabetes mellitus is considered to be a part of the insulin resistance syndrome, a spectrum of disease conditions grouped in medicine. Thus, children with T2DM may also have the following conditions in addition to diabetes mellitus:

  • High blood pressure
  • Hypertriglycerides and hypercholesterolemia
  • Injuries to blood vessels, especially kidneys, hearts, and retinas
  • The liver and muscles are fattier (fatty liver)
  • Sleep-disordered breathing

Children with T2DM may be afflicted with these disorders in addition to DM, unlike those with type 1 DM who may only suffer from poor glucose control. In controlling blood sugar levels, you may be able to prevent these complications, but they may not fully disappear as they coexist with diabetes and aren’t caused directly by it.

The problem is that poorly managed type 2 diabetes mellitus may accelerate the overall development of the disease, leading to major adverse health outcomes, including life-threatening complications:

Maintaining an appropriate blood glucose level can reduce the likelihood of developing these complications. Regular screening for comorbidities is also necessary. Hence, seeking early medical attention is key to preventing serious complications.

The Right Time To See A Doctor

When you notice signs or symptoms of diabetes in your child, seek medical treatment. Although the same symptoms in other conditions can also be seen, blood sugar testing can help diagnose and treat diabetes mellitus type 2 at its earliest stages.

Type 2 Diabetes Mellitus Diagnosis in Children

When your doctor suspects that your child has diabetes, we can order a variety of screening tests to rule out the disease.

  • During a visit, a random blood glucose test determines blood sugar levels, and blood sugar levels greater than 200mg/dL or 11.1mmol/L are indicative of diabetes.
  • When your blood glucose level is higher than 126mg/dL or 7 mmol/L, you have diabetes. A fasting blood glucose test is performed after an overnight fast or a minimum eight-hour fast.
  • Glycated or glycosylated hemoglobin (A1C test) indicates a patient has diabetes if it has less than 6.5 percent of their average blood glucose levels over the past three months.
  • A special sugar drink is given to the child two hours after an OGTT (oral glucose tolerance test) is conducted.

Obtaining two abnormal test results on separate days is sufficient for diagnosing diabetes. In addition to checking for symptoms of type 1 diabetes and type 2 diabetes, pediatricians order additional tests.

Diabetes Mellitus Type 2 Treatment for Children

Diabetes type 2 needs to be managed for the rest of one’s life. To maintain optimal sugar levels, your child’s treatment plan may change as they grow. By maintaining normal blood sugar levels, complications can be avoided.

Plan for managing diabetes may consist of the following:

Education for diabetes self-management

As soon as all of your questions have been resolved, you should consult two sources – first your treating doctor and anyone else they suggest, and second, reliable internet resources (after checking that their sources are reliable with your doctor). Make sure the child is actively involved in the process as well as their doubts are clarified.

Healthy diet

Blood sugar levels are maintained with low fat, low-calorie diets (low carbohydrates). You may be able to keep your blood sugar levels stable by substituting high-calorie soft drinks, refined sugars, and carbohydrates with protein- and low-calorie vegetable and fruit foods. Use as few packaged and processed foods as possible. Every person should become familiar with reading and interpreting nutrition labels.

Adults must provide healthy food choices and eat on schedule by becoming role models rather than simply speaking about it. Keeping a food log will also prove useful.

Regular exercise

It is recommended that you engage in aerobic physical activity for at least an hour a day. Maintaining a healthy blood sugar level can be achieved through regular exercise. Having a parent or friend participate in the child’s exercise routine can make this process easier. You can read these articles for more to encourage physical activity in your children:

Adequate sleep

Improved metabolic disorders (such as type 2 diabetes mellitus) and good health can be achieved with a good night’s sleep.

No smoking and alcohol

Diabetics can suffer devastating complications from bad habits such as smoking and alcohol. Be a good role model to your children by not indulging yourself. For more you can read our article: 21 Tips to be a good parent and educate well.

Blood sugar monitoring

Your pediatrician will recommend that you measure blood glucose levels regularly using glucometers to decide the appropriate amount of insulin, diet, and physical activity to maintain a healthy blood glucose level. Recent times have seen the development of several apps that are very useful in managing diabetes mellitus on a day-to-day basis.

Medications

The three medications approved for treating diabetes mellitus type 2 in children are metformin (Glumetza) pills, insulin injections, and liraglutide injections.

Metformin works by decreasing liver glucose release between meals, thereby increasing insulin use by cells. In most cases, it does not cause hypoglycemia on its own. Initially, nausea and diarrhea may occur, but these side effects rapidly disappear. In chronic use, it can cause B12 deficiency, which should be monitored periodically.

After eating, liraglutide stimulates pancreatic insulin production. It cannot be used in diabetic ketoacidosis or Type 1 diabetes.

Controlling high blood sugar levels is done with insulin, usually long-acting insulin (glargine). Injections or insulin pumps are both available for delivering insulin.

Weight loss surgery

If no other means are available to control type 2 diabetes in obese teens with a BMI over 35, weight loss surgery may be a necessary option.

Management of comorbidities

In addition to insulin resistance syndrome, the children are screened at the time of diagnosis and regular intervals for other features of insulin resistance syndrome, including hypertension, renal damage, hyperlipidemia, and hypertriglyceridemia.

A pediatrician needs to advise on stopping insulin treatment if other treatment options can lower blood sugar. Whether he or she takes medication or not, encourage your child to follow a healthy diet and be physically active.

Despite claims that herbal treatments and alternative approaches can prevent diabetes, there is no scientific evidence to suggest that they are effective. Some medication interactions or side effects may occur. To avoid complications, you should always speak with your child’s doctor before beginning any therapy.

How Can You Help Your Child Deal With Diabetes?

For diabetics to follow their treatment plans, parents and caregivers must be consistently committed. For your child to cope with the challenges caused by the disease, you may try the following.

  • Outline the symptoms and treatments for the illness.
  • Encourage physical activity in your children.
  • Healthy eating is something you should teach them to do.
  • Calculate insulin doses based on activities, diet, and glucose levels with your child.
  • Teach them how to use insulin injections and glucometers.
  • Maintain a friendly relationship between your child and their diabetes treatment
  • Explain to them the symptoms and how to call emergency assistance for hypoglycemia, hyperglycemia, or diabetic ketoacidosis.

It is important to tell your child’s teachers and school nurse about diabetes so that they can take immediate action should the child’s blood sugar level become low or high during class time.

Type 2 diabetes prevention in children

It is very possible to prevent type 2 diabetes mellitus in children with a healthy diet and regular exercise.

Fruits, vegetables, and whole grains, which are low in calories and fat, are good food choices. Sports training and dance are examples of physical activities that can be beneficial. The child can learn the importance of healthy eating habits and exercise if all family members follow a healthy lifestyle.

Diabetics can face many challenges, but when they receive the right support and encouragement the process can be made much easier. The management of the condition may make some children feel stressed. Stay on the lookout for any warning signs, such as depression, poor sleep, or poor academic achievement. You can obtain a quick resolution by consulting your physician or psychologist.

Children and their families can also benefit from joining local or online diabetic support groups.


References

[1]. Diabetes: Differences Between Type 1 and 2: Mottchildren.org