An alarming number of children are being diagnosed with type 2 diabetes. A generation ago it was rare to hear about a child having type 2 diabetes—it used to be only adults who got this disease. Not anymore. Over the past 15 years, there has been a 10- to 30-fold increase in American children with type 2 diabetes, due in great part to higher rates of obesity and lower rates of physical exercise among children. Most of the affected children and youth are between the ages of 10 and 19, and more girls are affected than boys. Most are also from ethnic groups at high risk for the disease, such as those of African, Hispanic, and Asian descent. Type 2 diabetes is being diagnosed in Canadian First Nations children as young as eight years of age, and the incidence in this group is increasing rapidly. In the next generation, it is estimated that the global incidence of type 2 diabetes in kids will increase by a whopping 50%.
The growing incidence of type 2 diabetes in children is especially concerning, because complications such as blindness, kidney failure, heart disease, and nerve damage appear to develop earlier and more rapidly in children than in adults.
What can be done about this growing health threat? How can you prevent your child from getting type 2 diabetes? And what steps do you need to take if your child is diagnosed?
Who is at risk?
Being overweight is the single greatest risk factor for type 2 diabetes. In Canada, 26% of children—that’s 1.6 million kids!—are overweight or obese due to unhealthy eating habits, lack of exercise, an inherited tendency to be heavier, or, in rare cases, a hormone problem or other medical condition. Ninety-five percent of children with type 2 diabetes are overweight when they are diagnosed. When you consider that the number of overweight children in this country has tripled over the past 30 years, it’s not surprising that the incidence of type 2 diabetes in this population continues to rise so dramatically.
In addition to obesity, other risk factors include being a member of a high-risk ethnic group; having a family history of diabetes; having dark, velvety patches in the skin folds (a condition known as acanthosis nigricans); having high levels of fat in the blood (dyslipidemia), having high blood pressure (hypertension); and having polycystic ovarian syndrome (PCOS) (a disorder in females marked by irregular periods or a lack of menstrual periods, unusual hair growth, and excess weight).
What to look for
About half of all children with type 2 diabetes don’t have any symptoms, which makes diagnosing the disease challenging. When symptoms do occur, they tend to develop slowly and can include increased hunger or thirst, dry mouth, frequent urination, fatigue, blurred vision, slow healing of sores or cuts, itchy skin, and numbness or tingling in the hands or feet. Some overweight children may lose weight unexpectedly and without changes to their eating habits or activity levels. The Canadian Diabetes Association recommends screening for type 2 diabetes in obese children age ten and older (or at puberty if it starts earlier than age ten) who have at least two of the risk factors noted above and in very obese children without other risk factors.
How type 2 diabetes is treated in your child
You and your child can work with your doctor and other healthcare professionals—such as a certified diabetes educator, nurse, dietitian, and pharmacist—to learn how to manage type 2 diabetes. The goal is to reach and maintain normal blood sugar levels and weight. This can be accomplished by making healthy food choices, increasing physical activity, and sometimes by taking medication.
It is important to be aware that teenagers may face special challenges when it comes to managing their diabetes, since they may become more concerned about body image (especially girls, who are susceptible to eating disorders), and this is a time when they may begin experimenting with tobacco, drugs, and alcohol, all of which have a negative impact on diabetes.
If your child is diagnosed
An important part of managing diabetes involves preventing diabetes-related complications. The Canadian Diabetes Association recommends children and youths with type 2 diabetes be screened for high blood pressure at every clinical visit and that they be screened for other complications and coexisting conditions including high cholesterol (every one to three years) as well as non-alcoholic fatty liver disease, PCOS in high-risk females, and kidney, nerve, and eye disease (every year).
It’s a good idea to make lifestyle changes around food and exercise gradually and to remember that it takes time to achieve better health. Instead of singling out your child for special treatment, try to get the whole family involved in making positive lifestyle changes regarding food and activity levels. Set goals and offer rewards when your child meets those goals and work with your healthcare team to develop a plan for keeping your child on track.
7 Tips to help prevent type 2 diabetes in your child
Parents can play an important role in their child’s health, especially when the child is young. This can help set up the child for a lifetime of healthy habits. Follow these tips to help ensure nutritious mealtimes, an active lifestyle and less time plugged in to electronic gadgets:
- Switch from regular pop to sugar-free pop or water.
- Choose lower-fat dairy products.
- Offer healthy snack choices, such as fresh fruit and cut-up veggies.
- Model healthy eating and activity habits.
- Walk or bike instead of driving whenever possible.
- Reduce TV and computer screen time and replace it with family activities.
- Follow Eating Well with Canada’s Food Guide and Canada’s Physical Activity Guides for Children and Youth
Type 1 & type 2 diabetes in kids: What’s the difference?
About 90% of kids with diabetes in Canada have type 1 and 10% have type 2, according to the Public Health Agency of Canada. However, as noted earlier, type 2 diabetes is on the increase.
With type 1, most cases are diagnosed in child-hood and adolescence. It can occur as early as during the first year of life, but generally the onset is between the ages of 10 and 14. The causes of type 1 diabetes are believed to be genetic factors and environmental triggers.
Type 2 diabetes tends to occur later in children, between the ages of 10 and 19. Risk factors include being overweight or obese, physical inactivity, a family history of the disease, certain ethnicities, maternal gestational diabetes, and insulin resistance.
Type 1 or type 2: It may not be easy to tell
Type 2 diabetes in children was first brought to the attention of the Canadian medical community when a study was published in 1992 describing 12 Aboriginal children in Manitoba who were diagnosed with the condition.
But it remains challenging to determine if a child has type 2 diabetes, because the condition can go undiagnosed for a long time. Children may have no symptoms or very mild symptoms. Also, criteria for differentiating between types 1 and 2 diabetes in children can be confusing. In this age group, signs and symptoms of one type can appear in the other type. For example, children with type 2 diabetes can develop ketoacidosis (acid buildup in the blood), which is usually associated with type 1, and children with type 1 diabetes can be overweight, which is usually associated with type 2. A blood test called a C-peptide test can tell how much insulin is being made by the pancreas, and that can help doctors determine whether a child has type 1 or type 2 diabetes.
Since type 1 diabetes remains the main type of diabetes in children, cases of type 2 diabetes are sometimes misclassified, according to the Public Health Agency of Canada. This means there may be a large number of children whose type 2 diabetes remains undiagnosed or who have been misdiagnosed with type 1 diabetes.
Since both type 1 and type 2 diabetes are lifelong diseases, the early onset of either type increases the risk of related complications later in life. Currently it’s only possible to prevent or delay the onset of type 2 diabetes, but good management of both type 1 and type 2 is extremely important in order to prevent negative consequences of either form of the disease.
London Drugs’ commitment to your health
London Drugs is committed to providing the very best healthcare to our clients. As part of this commitment, we offer the following services to assist our patients with diabetes:
- Certified Diabetes Educators to help educate
you about blood glucose testing, administrating insulin, medication management, preventing low blood sugar, healthy eating, physical activity, foot care, and helping to determine if you are a candidate for insulin pump therapy - Diabetes Device Trainers to help you learn to
use your diabetes devices, such as blood glucose monitors and insulin pens - Needle Disposal Program to safely dispose of your used lancets and needles
- Personal Consultation Booths ensure privacy between you and your pharmacist
- Travel Health Clinics to prepare people for international travel, develop an immunization schedule, and provide information on how to travel safely
- Compression Stocking Fitting assists people with circulation problems
- Diabetes Management Logbook helps people with diabetes monitor their blood sugar and reduce their risk of complications
- Diabetes Journal to provide you with important information about diabetes and help you manage your health
- Fitness Journal to make it easier for you to achieve and maintain an active lifestyle
