RICHMOND, VA (WWBT) - Before the obesity epidemic in the United States, type 2 diabetes was practically unheard of in people under 30 years of age, which explains the former name for the disease: “adult-onset diabetes”. Fast forward to the 21st century and the rate of diabetes is rising around the world, with studies showing children are at greater risk of developing the disease. Type 2 diabetes mellitus (T2DM) now accounts for 15 to 45 percent of all newly diagnosed cases of diabetes in children and adolescents. By comparison, in the early 1990s, T2DM represented about 3 percent of pediatric diabetes in the United States.
Now classified by the health care community as an epidemic, the exact cause of T2DM is unknown, however, the rise is closely associated with the increase of overweight and obesity cases. Since the 1970s, obesity in American children and adolescents has more than tripled. While this does not guarantee a diagnosis of T2DM, overweight children have an increased likelihood of insulin resistance. As the body struggles to regulate insulin, high blood sugar leads to a number of potentially serious health problems.
Genetics, ethnicity, and maternal history of gestational diabetes also play a role in children having an increased risk for developing T2DM.
The symptoms of T2DM are not always easy to spot. In most cases, the disease develops gradually and many people, including children, don’t feel any symptoms. Still, it pays to be cautious, especially if your child is at high risk for the disease. Watch for these signs: increased urination, extreme thirst, increased appetite, and rapid weight loss.
Another likely sign of T2DM is a skin condition called acanthosis nigricans. As many as 70 percent of children with T2DM have this condition, which is characterized by a patch of darkened, velvety, and rippled skin, most often on an underarm, the back of the neck, or between the fingers and toes.
While the development of T2DM in adults is often a slow and gradual process, a diagnosis in children can present with immediate life threatening conditions including diabetes ketoacidosis and hyperglycemic hyperosmolar syndrome. The young age at which children are developing T2DM also puts them at greater risk for developing serious long-term complications later in life. These include increased risk of blindness, kidney disease, heart disease, and amputations. Early adoption of healthy lifestyle changes, regularly monitoring blood glucose levels, and following your physician’s recommendations for taking medications is essential in helping to prevent these complications.
Kids with diabetes benefit from a healthy, balanced diet and do not have to follow a special “diabetes diet”. However, they may need to pay more attention to when they eat and how much is on their plates in order to promote healthy weight management and control blood glucose levels.
People of all ages function well by having routines and following a schedule. The same is true when it comes to the timing of meals and snacks for children. Generally, having a balanced meal or snack every three to four hours seems to be effective in preventing too much hunger and overeating in children. This is important when it comes to healthy weight management in T2DM.
What doesn’t work well is unpredictability when it comes to eating meals and snacks. The emotional response from a child who is unsure about when meals or snacks will be happening can build into insecurity about food and eating. This can be seen in rapid eating, preoccupation with food, frequent questioning about when and what is being served for meals, and “sneak eating”. A routine and rhythm will build predictability and security around food and eating, and help keep undesirable behaviors, such as overeating, at bay.
A balanced eating plan includes a variety of foods. Using the Balanced Plate Method is a basic blueprint to help us all make healthy choices. This promotes filling your plate with colorful vegetables and fruits and then splitting the other half between whole grains and healthy protein.
Physical activity is also important. The American Academy of Pediatrics recommends that children and adolescents participate in 60 minutes or more of physical activity daily and to limit nonacademic screen time to less than 2 hours per day.
Parents often ask, “What’s the first thing I should be doing to reduce the risk of my child developing type 2 diabetes?” There are a number of simple changes that can be added gradually to improve the health of the entire family, but nutritionally speaking, a great place to start would be to check around the home for obvious sources of concentrated sweets, “junk foods”, or sugary beverages. Keeping these types of foods and beverages out of the house makes them easier to resist – out of sight, out of mind! However, this is not to say these choices are now totally off limits. Instead opt for a small, portioned amount once per week to satisfy cravings.
At Bon Secours Pediatric Endocrinology & Diabetes Associates, we use a team approach to treating children with T2DM. Care is managed by a physician, dietitian, diabetes educator, and behavioral health clinician to ensure that holistic care is provided in order set families up for success. Each visit provides the opportunity to meet with our care team specialists alongside the provider to address questions or concerns and to work together in creating individualized treatment plans.
- Reiter, A. (2017, April 13). Rates of new diagnosed cases of type 1 and type 2 diabetes on the rise among children, teens.
- Mayer-Davis E.J., Lawrence J.M., Dabelea D. (2017, April 13). Incidence Trends of Type 1 and Type 2 Diabetes among Youths, 2002-2012. New England Journal of Medicine.
- Stanford Children’s Health. (2018). Type 2 Diabetes in Children.
- American Diabetes Association. (2016, November 21). Children and Type 2 Diabetes.
- American Academy of Pediatrics. (2018). Childhood Nutrition.