Each year the number of children and young people being diagnosed with diabetes is increasing. Diabetes is essentially a disease where blood glucose levels remain elevated. Glucose is the main source of energy for the body.
In a healthy non-diabetic individual, glucose is regulated by the hormone called insulin. When the body does not produce enough insulin or the body’s cells do not respond to the insulin that is being produced, elevated levels of glucose persist, which when chronically present can lead to diabetes.
There are two most common types of diabetes, type I and type II. Other rarer types of diabetes do exist which can affect children and younger infants. Type I diabetes remains the most common type of diabetes affecting children. It tends to result in lifelong use of insulin due to an auto-immune disorder affecting the production of insulin.
Type II diabetes usually affects people aged 40 years and above. However, it is increasingly being seen in children and young people. This article will focus on type II diabetes affecting children and adolescents.
What is type II diabetes?
Type II diabetes is when insulin is being produced by the body but the cells in your body are not responding normally to the insulin. This is called insulin resistance.
Some risk factors predisposing children and adolescents to type II diabetes are:
- Being overweight / obese and being inactive
- Family members who have type II diabetes
- Certain ethnic backgrounds where type II diabetes is more prevalent
Typical symptoms of diabetes in children
Children and young adults with type I and type II diabetes tend to have similar symptoms. However, those with type II diabetes may develop symptoms more gradually.
Typical symptoms that children and young people may experience can be:
- Urinating more often. Children who may have previously been dry at night may start bedwetting again. Older children may be getting up at night to go to the toilet.
- Feeling very thirsty and not being able to quench their thirst.
- Feeling tired, having less energy. They may be playing outdoors less often or might cut back from their sports or physical activities due to fatigue.
- Losing weight
Why is early recognition of childhood type II diabetes important?
Although the overall number of children and adolescents affected by type II diabetes is lower than those with type I diabetes, the occurrence of complications with type II diabetes is higher than those suffering from type I diabetes.
Type II diabetes in children and young people is often a more severe and aggressive disease than type II diabetes in adults. Children and young people may have a greater degree of insulin resistance and a faster decline of cells that produce insulin. All these changes can lead to significant complications affecting nerves, blood vessels and several organ systems; i.e., diabetes related eye disease, kidney disease and nervous system changes.
Hence, it is vital to ensure early detection and start early management for children and young people with type II diabetes.
Diagnosing type II diabetes in children and young people
The diagnosis of diabetes in children and/or adults is through blood tests. If you are concerned your child may have symptoms of diabetes, please see you GP who can help you to arrange the appropriate blood tests.
Treatment for type II diabetes in children and young people
Much of the management of type II diabetes for children and young people is through early recognition of the disease.
Strategies to address appropriate healthy eating, exercise and weight loss are key in managing not only type II diabetes in children and adolescents who may be overweight or obese, but also several other diseases associated with cardio-metabolic health (such as, high cholesterol, high blood pressure). Some individuals may also require medications, e.g. metformin and/or insulin.
Dr Trisha Upadhyaya is a British trained GP based at Osler Health’s Star Vista clinic. For appointments please call: 6339 2727
References
- International Diabetes Federation.org.uk
- Dabelea D, Stafford JM, Mayer-Davis EJ, et al. Association of Type 1 Diabetes vs Type 2 Diabetes Diagnosed During Childhood and Adolescence With Complications During Teenage Years and Young Adulthood. 2017;317(8):825–835. doi:10.1001/jama.2017.0686
- Henderson M, Benedetti A, Barnett TA, Mathieu M, Deladoëy J, Gray-Donald K. Influence of Adiposity, Physical Activity, Fitness, and Screen Time on Insulin Dynamics Over 2 Years in Children. JAMA Pediatr.2016;170(3):227–235. doi:10.1001/jamapediatrics.2015.3909
- LacobucciG. Type 2 diabetes affects 7000 young people in England and Wales, analysis shows BMJ 2018; 363 :k4929 doi:10.1136/bmj.k4929
- WiseJ. Complications are more common in young people with type 2 diabetes than type 1 BMJ 2017; 356 :j1082 doi:10.1136/bmj.j1082
