Type 2 diabetes used to be known as adult-onset diabetes. The disease was typically found in overweight adults over the age of 40 and very rarely in children. However, according to 2010 information from the Centers for Disease Control and Prevention (CDC), in the last 2 decades, type 2 diabetes has been reported among U.S. children and adolescents with increasing frequency. Obesity, sedentary lifestyle and being born to a diabetic mother are factors that contribute to the growing problem among youth. Treatment of type 2 diabetes in children, just as in adults, is complex, requiring visits to an endocrinologist, and instruction from nurses and dietitians.
Insulin
The Mayo Clinic reports that insulin administration is usually necessary to stabilize a child whose blood glucose is over 200, or whose hemoglobin A1c is greater than 8.5 percent. A short, thin needle is used to inject insulin below the skin. A combination of short- and long-acting insulin may be used, and careful monitoring is essential to prevent dangerous drops in blood sugar. Generally, doctors prescribe a sliding scale to help patients determine how much and what type of insulin to administer when glucose readings are within a certain range.
Metformin
Metformin was developed from properties of the French lilac. According to the Mayo Clinic, it is the only FDA-approved oral medication for lowering blood sugar in children age 10 and older. For kids with type 2 diabetes, it may be possible to wean off insulin and maintain glucose control with the help of this pill and lifestyle changes. Metformin improves the ability of muscle and liver cells to use insulin. Unlike other oral medications, metformin is not associated with weight gain, does not cause hypoglycemia and is known to prevent cardiovascular disease, a long-term complication of diabetes. A four-year study conducted at the M.D. Anderson Cancer Center in Texas found that insulin use in diabetic patients was associated with an increased risk of pancreatic cancer, while metformin use seemed to have protective effects. The study was published in the August 2009 issue of "Gastroenterology."
The most common side effect of metformin is gastric upset. Gas, diarrhea, stomach cramps, nausea and vomiting may occur when treatment is initiated, and subside with continued use. Side effects may be reduced by starting with a low dose and increasing gradually until a target dose is reached, or by the use of slow- or extended-release formulas.
Diet and Exercise
Diabetic children can have many of their favorite foods, but they may have to eat less and, if using insulin, administer medication accordingly. The National Institutes of Health recommends advance planning for special occasions like Halloween and birthdays. When sweets are on the menu, starchy foods, such as bread, pasta, rice and potatoes, should be restricted. High fiber, low carbohydrate and high protein foods are the best choices for meals and snacks. Fruit is healthy in limited portions and non starchy vegetables are virtually unrestricted. Exercise helps the cells in the muscles and the liver use insulin, making this the most important activity for children. Walking, biking, swimming, sports and outdoor games can aid in weight loss and improve overall health.
