Treatment Overview
Treatment of
type 2 diabetes in children focuses on keeping blood
sugar levels within a
target range. Children may need higher blood sugar
goals than adults because their bodies are still developing; also, they may not
be able to recognize symptoms of low blood sugar. To reach his or her target
blood sugar, your child needs to eat healthy meals of appropriate portion size
and get daily exercise. Treatment also may include medicine.
Healthy eating
A healthy diet with the right amount
of calories will help your child achieve target blood sugar levels and maintain
a healthy weight. The meal plan designed for your child will spread
carbohydrate (starches and sugary foods) throughout
the day. This helps prevent high blood sugar after meals as well as weight
gain. A registered dietitian can design a meal plan that fits your child's
needs. For more information, see the topic
Healthy Eating for Children.
Being physically active
Physical activity is
extremely important. It helps the body use insulin correctly and helps control
weight. Your child does not have to start a rigorous exercise program, but
being more active can help control blood sugar. For example, your child could
play outside with friends, take brisk walks with family members, and
participate in individual or team sports. Children and teens need to get at
least 60 minutes of moderate-intensity physical activity most days of the week,
preferably daily.7 Limiting TV and video or computer
games may encourage activity.
Medicines
Your child may need medicines if 3
months of eating healthy meals and getting regular physical activity have not
lowered your child's blood sugar to his or her target level.
- Oral medicines for diabetes help the body
produce more insulin, decrease the body's
resistance to insulin, or slow the absorption of
carbohydrate from the intestine. Your child may need one medicine at some times
and more than one at other times.
- Some children need daily insulin
shots—alone or with oral medicines. Even if your health professional does not
prescribe daily insulin, your child may need to take insulin temporarily when
first diagnosed or during illness or surgery. If the progression of diabetes
cannot be stopped, your child eventually may need to take insulin daily.
Checking blood sugar, blood pressure, and cholesterol
Your child's blood sugar level needs to be checked regularly. Your child
will probably have to test before breakfast and 2 hours after meals.
If your child has high blood pressure or high cholesterol, those
conditions need to be treated.
- High blood pressure is usually treated with
angiotensin-converting enzyme (ACE) inhibitors because
these medicines also protect the circulatory system and the kidneys from damage
caused by diabetes. Sexually active teens should be warned that ACE inhibitors
should not be taken during pregnancy.
- Weight loss and
well-controlled blood sugar can help lower your child's cholesterol. Your
child's health professional may recommend medicine if these lifestyle changes
do not lower cholesterol. Sexually active teens should be warned against
becoming pregnant while taking these medicines.
What To Think About
Some children have very high blood
sugar levels when they are diagnosed with type 2 diabetes. A child with a very
high blood sugar level may develop the serious chemical imbalance
diabetic ketoacidosis and need to be treated with
insulin in a hospital. After blood sugar returns to a target level, the child
usually no longer needs insulin. His or her own body may start making enough
insulin again.
Treating diabetes with insulin or some oral
medicines (or both) increases the risk for low blood sugar episodes. Your
health professional will determine the range for your child's blood sugar that
will prevent damage from diabetes while causing as few low blood sugar episodes
as possible.
The lifestyle changes necessary to control diabetes
can be especially difficult for a child or teen. Your child will have a better
chance of being successful if the whole family participates. Eating a healthy
diet and getting regular exercise may help other family members avoid
developing diabetes.
Teens who have
depression or an
eating disorder may have difficulty keeping their
blood sugar at a healthy level. In addition, teens who smoke or use alcohol or
other drugs have problems with blood sugar control. Support groups may help
teens deal with diabetes management issues, which can improve the teens'
perception of diabetes care and blood sugar control.