While referring diabetes in children it was an understood fact that type 1 was the culprit. However, the case scenario is changing in this respect and type 2 diabetes is becoming a public health issue in some recent years. It is an example of the growth of diabetes as a chronic health dilemma owing to the increasing prevalence of obesity and physical inactivity around the globe.
Type 2 diabetes in children is most prevalent in the US, Canada, Hong Kong, Japan, Australia, New Zealand and Bangladesh. About 8% of the recently diagnosed cases of diabetes in the US are of type 2 in children. The mean age at which this diagnosis is made in the US is about 12-14 years and is more prevalent in girls corresponding to their puberty.
While it is important to effectively manage the disease in children because of its long-term consequences, Diabetes type 2 has different implications as far as children are concerned regarding the diagnosis, treatment options, medications, etc. let us have a look at the causes which predispose a child to develop diabetes at such an early age.
Causes of Type 2 Diabetes in Children
The subject is still being studied devotedly to uncover the predisposing and risk factors leading to type 2 diabetes in children, however, some of the obvious reasons in this regard are
Growing obesity epidemic
About one-third of children in the US are obese and apart from diabetes, this number continues to rise at an alarming rate. Many factors are attributed to being overweight as family history, lack of physical inactivity and unhealthy eating patterns. Having a BMI above the 85th percentile is a serious issue with children. Very rarely, the cause of obesity lies with hormonal disorders.
Today children are spending more time in front of televisions, and other electronic gadgets rather than playing outside on regular basis. Coupled with unhealthy eating patterns, if you find a combination of factors in your child who spends more than four hours of screen time, it is time to make some interventions.
A family history of type 2 diabetes
A child with a sibling or one of the grandparents with diagnosed diabetes is more at risk of developing the disease.
Race and ethnicity
Some of the races that are at risk of developing diabetes in adults are also the risk factors in children; African-Americans, Hispanics, Native Americans, Asian-Americans and Pacific Islanders.
Age and sex
Type 2 diabetes is often diagnosed at puberty and this incidence is seen more in girls than in boys.
A low weight at birth predisposes an individual to develop diabetes as a child and later in life.
Born to a mother with type 2 diabetes
A mother who was exposed to gestational diabetes during her pregnancy or was already diabetic adds to the chances of her child becoming a diabetic later in life.
Signs and symptoms of insulin resistance
The signs of insulin resistance in children are acanthosis nigricans (a darkened and thickened skin around the skin folds), fatigue, brain fog, inability to focus, increased hunger, sleepiness especially after meals and intestinal bloating.
Management of Type 2 Diabetes in Children
Even before diagnosis, if as a parent you know that your child is predisposed towards type 2 diabetes, you should take proactive measures in your household in which children are encouraged to have more of physical activity. Set a trend of healthy eating practices so that the children follow them voluntarily.
A proper diagnosis and differentiation of type 1 and 2 should be made because often diabetes is diagnosed while routine testing in children. Some of the signs and symptoms to look for in children are
- Increased thirst and frequent urination
- Weight loss
- Blurred vision
- Slow healing of injuries
- Random sugar levels are elevated calling for a fasting blood sugar profile.
- The hbA1C levels give precise information on the blood sugar levels over few months.
- Insulin and peptide C is raised with absent antibodies that help to differentiate type 1 from 2.
- The child may present with weight loss, ketosis, and acidosis in extreme cases.
The management protocol for children may vary from case to case because the medications for blood sugar and lipid control for adults are not approved for use in children. The medications and therapeutic approach also change with the growth of the child.
The treatment includes monitoring the child’s blood sugar levels, lifestyle changes, sometimes insulin and other medications. The overall goal would be to improve the insulin sensitivity and prevent the complications.