Children's Hospital Colorado

Type 2 Diabetes

What is type 2 diabetes?

Diabetes refers to a medical condition in which the body's blood glucose (sugar) levels are high. This occurs because the body resists the effects of insulin and doesn't produce enough insulin to maintain a normal blood glucose level.

Insulin is a hormone that our bodies need to convert sugar, starches and other food into the energy we need for daily life. The body needs insulin to allow glucose into its cells. Without it, glucose builds up in the bloodstream. Over time, high blood glucose levels can cause health problems.

What causes type 2 diabetes?

In children, the most significant cause of type 2 diabetes is a family history of the disease and being at an unhealthy weight.

There are also specific risk factors that put a child at a higher risk for developing type 2 diabetes, including:

  • A poor diet with high fat and carbohydrate intake
  • High levels of fat in the blood
  • Low physical activity levels
  • Puberty (children almost never get type 2 diabetes before puberty starts)

Who gets type 2 diabetes?

People can develop type 2 diabetes at any age, even during childhood. Type 2 diabetes generally occurs during adolescence due to the increased insulin resistance associated with puberty. Children who are obese and have a strong family history of type 2 diabetes or whose mothers had diabetes during their pregnancy are at a higher risk for developing type 2 diabetes.

What's the difference between type 1 and type 2 diabetes?

Both types of diabetes are chronic conditions that affect the way the body regulates blood sugar (glucose). Insulin is the key that allows glucose (the body's fuel) to enter its cells. For type 1 diabetes, kids don't produce insulin, so their bodies are missing the key they need.

Type 2 diabetes is different from type 1 diabetes because their pancreas still makes insulin, but it can't produce enough insulin to overcome the body's insulin resistance. When it comes to type 2 diabetes in children, this key is broken; their bodies can't use insulin properly (a condition known as insulin resistance) or they can't produce enough insulin.

Another major difference between type 1 and type 2 diabetes is that type 1 diabetes is not preventable, while type 2 diabetes can be prevented or delayed by adhering to a healthy lifestyle.

What are the signs and symptoms of type 2 diabetes?

Type 2 diabetes tends to come on gradually, so people often won't show signs of the disease or have any symptoms for years. In fact, type 2 diabetes in children is often discovered by laboratory testing. The following are some of the signs and symptoms your child may have:

  • Frequent urination
  • Excessive thirst
  • Feeling very tired
  • Weakness
  • Extreme hunger
  • Blurred or decreased vision
  • Obesity
  • Recent weight gain or unexplained weight loss
  • Numbness and tingling in the hands or feet
  • Darkening of the skin around the neck and in the armpits
  • Dry mouth
  • Headaches
  • Wounds that don't heal

What tests are used to diagnose diabetes in children?

Your child should be tested for diabetes if they have symptoms of diabetes, or if you think they may be at risk for developing diabetes. Your doctor can diagnose diabetes using:

  • A glucometer: A hand-held device that tests your blood sugar levels using a small drop of blood from the tip of the finger.
  • A urine sample: A simple urine collection that your doctor will use to test for the presence of sugar in the urine.
    • For patients with very high blood sugar levels, it's important to evaluate the acid levels in blood and urine.
  • An oral glucose tolerance test (OGTT): A test that's similar to what doctors do to test for diabetes during pregnancy that tests for type 2 diabetes.
  • Hemoglobin A1c: This blood test looks for blood sugar levels that have been high over for a long period.

How is type 2 diabetes treated?

Type 2 diabetes treatment in children always involves a combination of medicines and healthy lifestyle choices. When used with medicines that help the body's insulin work better, lifestyle changes can help manage type 2 diabetes and prevent its complications. Lifestyle changes may even slow or stop the progression of the disease from prediabetes to diabetes.

If your child is diagnosed with type 2 diabetes, your child needs to make positive lifestyle changes, including:

  • Eating healthy foods
  • Losing extra weight
  • Increasing the daily level of physical activity

Children diagnosed with type 2 diabetes may be referred to the Weight Management Specialty Clinic at Children's Hospital Colorado. This specialized clinic provides evaluation and treatment for conditions like type 2 diabetes that are associated with weight.

Even with healthy lifestyle choices, most children diagnosed with type 2 diabetes will also need to take a medicine called metformin. This medicine is generally given twice a day as the dosage is increased over several weeks. Some children will also need daily insulin injections to help control their blood sugar.

Currently, there are newer medicines used to treat type 2 diabetes in adults. We are one of the few centers with experience using these medicines in children. Another effective way to treat type 2 diabetes is weight loss surgery. Many children with type 2 diabetes qualify for this treatment.

Why choose Children's Colorado for your child's diabetes treatment?

For kids with type 2 diabetes, we have every specialist, program, clinic and referral they may need to manage their diabetes right here at our hospital. By taking a multidisciplinary approach to diabetes care, we're able to give kids the support, tools, care and resources they need to build a healthier future.

Our care team provides comprehensive care for every aspect of your child's condition because the team has pediatric experts from various specialties and disciplines. The team members treating your child may include an endocrinologist, psychologist, gastroenterologist, cardiologist, nutritionist, dietitian, exercise physiologist, recreational therapist, bariatric surgeon and other specialists your child needs.

Our multidisciplinary team of experts will walk you through the process – from testing and diagnosis to goal setting and treatment. We take an individualized, family-centered approach every step of the way.

The following resources are available to help parents learn more about their child's diabetes diagnosis:

  • The American Diabetes Association provides detailed information about signs and symptoms, diagnosis and treatment of type 2 diabetes.
  • The Family Health Library provides health education materials that come from trusted medical sources. The library is located on Anschutz Medical Campus in Aurora.