What’s It Like For Teens With Type 2 Diabetes
Sometimes people who have diabetes feel different from their friends because they need to think about how they eat and how to control their blood sugar levels every day.
Some teens with diabetes want to deny that they even have it. They might hope that if they ignore diabetes, it will just go away. They may feel angry, depressed, or helpless, or think that their parents are constantly worrying about their diabetes management.
If you’ve been diagnosed with type 2 diabetes, it’s normal to feel like your world has been turned upside down. Your diabetes care team is there to provide answers and support. Don’t hesitate to ask your doctors, dietitian, and other treatment professionals for advice and tips. It also can help to find support groups where you can talk about your feelings and find out how other teens cope.
Diabetes brings challenges, but teens who have it play sports, travel, date, go to school, and work just like their friends.
Pathophysiology Of Type 2 Diabetes Mellitus In Children And Adolescents
Type 2 diabetes mellitus is a complex metabolic disorder of heterogeneous etiology with social, behavioral, and environmental risk factors unmasking the effects of genetic susceptibility. There is a strong hereditary component to the disease, with the role of genetic determinants illustrated when differences in the prevalence of type 2 diabetes mellitus in various racial groups are considered. Although substantial progress in our knowledge of the genetic basis of type 2 diabetes mellitus is taking place, these new discoveries represent but a small proportion of the genetic variation underlying the susceptibility to this disorder. Furthermore, the recent increases observed in diabetes mellitus prevalence are too quickly to be the result of increased gene frequency and altered gene pool, emphasizing the importance of environmental factors.
For diabetes mellitus to develop insulin resistance alone is not sufficient and inadequate -cell insulin secretion is necessary. In patients with type 2 diabetes mellitus, impaired insulin action and insulin secretory failure are both present. It has been proposed that hyperglycemia may worsen both insulin resistance and insulin secretory abnormalities, thus enhancing the transition from impaired glucose tolerance to diabetes mellitus.
Can You Get Diabetes From Eating Too Much Sugar
One of the most common misconceptions about diabetes is that it is caused by sugar.
Every time we see a child with a new diagnosis, parents ask if it is because of something they did, says Dr. Choudhary. Was it too much sugar? Was it the soda?
Dr. Choudhary says when it comes to type 1 diabetes, many people don’t know that its cause is not related to nutrition and sugar intake. Type 1 diabetes is an autoimmune condition where the body loses its ability to make insulin. The exact cause is unknown, and there is no way to prevent it no matter how much sugar is or is not consumed.
While type 2 diabetes can be related to gaining too much weight, it’s not eating sugar alone that causes the condition. Any child who doesn’t get enough activity and eats too many unhealthy foods, sugary or not, may be at a higher risk for type 2 diabetes, especially if they gain weight. However, some children who have a healthy weight may also be at risk for type 2 diabetes due to their genetics.
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Speaking To Your Child About Diabetes
Here are some recommended tips for discussing diabetes with your child:
- discuss how foods fit into a healthy lifestyle
- describe blood sugar levels as in target, high, or low
- talk to your child about other important things that are happening in their life such as school, sports and social events
- remember that diabetes is only one part of your childs life
Try not to describe food as bad or junk and avoid describing blood sugar levels as good or bad,.
Causes Of High Blood Sugar
High blood sugar can happen if you:
- Skip a dose of your type 2 diabetes medicine or skip a required dose of insulin.
- Eat too much.
- Exercise less than what you are used to doing.
- Are taking medicines that raise blood sugar as a side effect, such as sleeping pills, some anti-inflammatory medicines , and some decongestants.
- Are stressed or ill, especially if you aren’t eating or drinking enough. Plan ahead with your doctor and write down sick-day guidelines, which may include testing for ketones.
Being pregnant can also make your blood sugar levels go up.
If you take insulin, you may have some mornings when your blood sugar level is very high, even if it was low when you went to bed. This could be caused by the dawn phenomenon or the Somogyi effect. Talk with your doctor if this happens. You may need to check your blood sugar during the night to find out why your levels are high in the morning.
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How Is Type 2 Diabetes Managed
Theres no cure for Type 2 diabetes. But you can manage the condition by maintaining a healthy lifestyle and taking medication if needed. Work with your healthcare provider to manage your:
- Blood sugar: A blood glucose meter or continuous glucose monitoring can help you meet your blood sugar target. Your healthcare provider may also recommend regular A1c tests, oral medications , insulin therapy or injectable non-insulin diabetes medications.
- Blood pressure: Lower your blood pressure by not smoking, exercising regularly and eating a healthy diet. Your healthcare provider may recommend blood pressure medication such as beta blockers or ACE inhibitors.
- Cholesterol: Follow a meal plan low in saturated fats, trans fat, salt and sugar. Your healthcare provider may recommendstatins, which are a type of drug to lower cholesterol.
Can Children Develop Type 2 Diabetes
While Type 2 diabetes is more common in older adults, an increasing number of children have been diagnosed with the disease. Childhood obesity is on the rise and is a major factor in this increase.
Type 2 diabetes is a chronic disease affecting the way the body processes glucose. It develops over a long period of time because there is too much sugar, or glucose, circulating in the blood stream. With Type 2 diabetes, a child’s pancreas produces insulin, but the child’s cells do not respond to insulin and the uptake of glucose from the bloodstream. This also is referred to as insulin resistance and causes elevated blood sugar levels. This differs from Type 1 diabetes in which the pancreas produces little or no insulin.
Diabetes risk factors
Researchers don’t fully understand why some children develop diabetes and others do not, even if they have similar risk factors.
However, some known risk factors that increase incidence among children include:
- Obesity Being overweight is the primary risk for developing Type 2 diabetes. Fat tissue contributes to insulin resistance.
- Sex
- Type 2 diabetes is more likely to present in a childs early teens.
- Family history A risk of Type 2 diabetes increases if a child has a parent or sibling with diabetes or a mother who had gestational diabetes while pregnant.
- Inactivity Physical activity helps children control their weight and helps cells be more responsive to insulin.
Preventing diabetes in children
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What Are The Signs & Symptoms Of Type 2 Diabetes
The symptoms of type 2 diabetes aren’t always obvious and they can take a long time to develop. Sometimes, there are no symptoms. It’s important to remember that not everyone with insulin resistance or type 2 diabetes develops these warning signs, and not everyone who has these symptoms necessarily has type 2 diabetes.
But kids or teens who develop type 2 diabetes may:
- Need to pee a lot. The kidneys respond to high levels of glucose in the blood by flushing out the extra glucose in urine . Kids with high blood sugar levels need to pee more often and make more pee.
- Drink a lot of liquids. Because they’re peeing so often and losing so much fluid, they can become very thirsty and drink a lot in an attempt to keep the levels of body water normal.
- Feel tired often. This is because the body can’t use glucose for energy properly.
What Health Problems Can People With Diabetes Develop
Following a good diabetes care plan can help protect against many diabetes-related health problems. However, if not managed, diabetes can lead to problems such as
- heart disease and stroke
- gum disease and other dental problems
- sexual and bladder problems
Many people with type 2 diabetes also have nonalcoholic fatty liver disease . Losing weight if you are overweight or obese can improve NAFLD. Diabetes is also linked to other health problems such as sleep apnea, depression, some types of cancer, and dementia.
You can take steps to lower your chances of developing these diabetes-related health problems.
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How To Prevent Type 2 Diabetes In Children
You can help children avoid diabetes by encouraging them to take the following steps:
- Practice healthy habits. Children who eat well-balanced meals and limit their intake of sugar and refined carbs are less likely to become overweight and develop diabetes.
- Get moving.Regular exercise is important for preventing diabetes. Organized sports or neighborhood pick-up games are great ways to get kids moving and active. Limit screen time and encourage outside play instead.
- Maintain a healthy weight. Healthy diet and exercise habits can help children maintain a healthy weight.
Its also important to set a good example for children. Be active with your child and encourage good habits by demonstrating them yourself.
Taking Care Of Yourself In Other Ways
Be aware of other things you can do to help yourself stay healthy.
- Wear medical identification at all times. You can buy medical identification such as bracelets, necklaces, or other kinds of jewellery at your local drugstore.
- Take precautions when you are driving and do not drive if your blood sugar is low.
- Be prepared so that you can prevent problems while you are travelling. You can do things to be prepared, such as taking extra medical supplies with you.
- Get a influenza vaccine every year. When you have the flu, it can be harder to manage your blood sugar. It’s a good idea to get a pneumococcal vaccine too.
- Use vision aids if you have trouble with your eyesight.
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Symptoms May Be Hard To See
âPatients may have no clue,â says Berhane Seyoum, MD, chief of endocrinology at DMC Harper University Hospital. Thatâs why his team is trying to find an early way to screen for signs of an unhealthy metabolism and diabetes.
But you could start to pee more than normal or get thirsty. If youâre at a healthy weight, your doctor may not think your symptoms are from diabetes. Thatâs why âitâs always good to get a physical once a year to see what your blood sugar looks like,â says Seyoum.
What Causes Type 1 Diabetes
Type 1 diabetes occurs when your immune system, the bodys system for fighting infection, attacks and destroys the insulin-producing beta cells of the pancreas. Scientists think type 1 diabetes is caused by genes and environmental factors, such as viruses, that might trigger the disease. Studies such as TrialNet are working to pinpoint causes of type 1 diabetes and possible ways to prevent or slow the disease.
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Can You Reverse Or Cure Diabetes
Unfortunately, there is no cure for type 1 diabetes. Physicians and researchers are still learning why the condition occurs, so no cure is available yet though current studies are underway to find the cause.
However, type 2 diabetes can be reversed and stopped with healthy lifestyle changes.
“If kids with type 2 diabetes eat healthy foods and lose weight, we can stop using insulin to treat them,” says Dr. Choudhary. “Sometimes we can even take them off medication completely. Type 2 diabetes can be reversed if the family is on board with healthy eating and exercise changes.”
However, Dr. Choudhary warns that not all cases of type 2 diabetes can be reversed. If the pancreas is too damaged, the child will live a life with diabetes. That’s why early diagnosis and diet and exercise are so important.
Stay At A Healthy Weight
A healthy weight is one that is right for your body type and height and is based on your body mass index and the size of your waist . Losing just 5% of your body weight can help reduce your risk for type 2 diabetes.footnote 8If you are age 20 or older, use the Interactive Tool: Is Your BMI Increasing Your Health Risks? to check your BMI. To use the tool, you’ll need to know your height, weight, and waist circumference.
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Why Are Bipoc Youth Especially At Risk Of Developing Obesity And Type 2 Diabetes
Perez-Colon says economic status may play a role in the racial and ethnic disparities. Black and Hispanic households have higher poverty rates and lower average incomes than white households in the United States. In 2018, the median Black household earned just 59 cents for every dollar of income that the median white household earned, and the median Hispanic household earned 73 cents, according to a 2019 Economic Policy Institute analysis of U.S. Census Data.
If children are of low socioeconomic status then that can trigger a whole chain of factors leading to higher risk for diabetes for example, factors that prevent them from getting healthy diets, Perez-Colon says. Eating more lean protein and more vegetables in a healthy diet is costly, versus eating an unhealthy diet of fast food that is much cheaper. According to a previous analysis of diet studies across the globe, the healthiest diets cost on average $1.48 per day more than the least-healthy diets.
Cultural factors can play a role too, says Perez-Colon. Im Hispanic, and I know even in my own family that years ago my grandmother would tell us, You are too thin, you look unhealthy. They believe gaining weight is healthy. We need to change that cultural belief, to say, No, thats not correct.
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A Final Thought On Type 2 Diabetes In Children And Teens
Remember that type 2 diabetes and its complications are modifiable in young people, says Perez-Colon. Just because you have a risk factor for diabetes doesnt mean necessarily that you need to develop it or that you will have it uncontrolled. Its up to the child and their family to switch that risk around and implement those healthy habits.
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Differential Diagnosis Of Type 2 Diabetes Mellitus In Children And Adolescents
Individuals with type 2 diabetes mellitus may have clinical presentations indistinguishable from those of patients with other types of diabetes mellitus. This is relevant because as the number of children with type 2 diabetes mellitus increases, it becomes increasingly important to classify their diabetes mellitus correctly so that appropriate therapy may be instituted.
Typically, children with type 1 diabetes mellitus are not overweight and have recent weight loss, polydipsia, and polyuria . They have a short duration of symptoms and frequently have ketoacidosis at presentation. After metabolic stabilization, they may have an initial period of diminished insulin requirement, after which they require insulin for survival.
What Are The Symptoms Of Type 2 Diabetes In Children And Teens
Many of the signs of type 2 diabetes are the same in children as they are in adults. The ADA lists these as common symptoms:
- Feeling very hungry even if you are eating well
- Fatigue
Perez-Colon also looks for weight gain around the middle. In addition, she is watchful for acanthosis nigricans: a velvety darkening and thickening of the skin that usually happens around the neck and skin folds and which can be a sign of type 2 diabetes, according to the ADA. Research indicates that it is more common among Native American, Black, and Hispanic people in the United States.
A big tipoff for her that a child is at risk of obesity, and perhaps type 2 diabetes, comes from lifestyle. Most of the time they have a sedentary lifestyle and barely do physical activities. Diet-wise, they are drinking an increased amount of juice or sweetened drinks. They are not eating much in the way of fruit or vegetables. They are eating a lot of salty foods, such as chips. They may be eating very late at night, which can predispose you to putting on weight. And they eat large portions, getting seconds and sometimes even thirds.
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Screening For Type 2 Diabetes Mellitus In Children And Adolescents
Most of the European Caucasian children and adolescents with type 2 diabetes mellitus and one third of the American children were asymptomatically at diagnosis. According to this, the prevalence in screening studies in Europe of obese children was much higher than the prevalence rate reported in the standardised documentation system of diabetes mellitus for example in Germany. Therefore it is likely that, as with adults, undiagnosed type 2 diabetes mellitus is a common condition in childhood. In conclusion, a screening of type 2 diabetes mellitus seems necessary since unrecognised hyperglycaemia would undoubtedly contribute to both microvascular and macrovascular risk in later life.