Type 2 diabetes

Type 2 diabetes is the most common type of diabetes in adults, accounting for 90 to 95 percent of all diabetes cases. The risk for type 2 diabetes increases with age.

Although type 2 diabetes typically occurs in older adults, we have seen a rise in type 2 diabetes cases occurring in teens and young adults over the past 2 decades. The rise in type 2 diabetes in youth may be related to the increased incidence of obesity and decreased physical activity among children. A study done in 2006 found that type 2 diabetes accounted for approximately 20% of all cases of diabetes diagnosed between 10 and 19 years of age. Type 2 diabetes is very uncommon in children before 10 years of age.

What causes type 2 diabetes?
Type 2 diabetes is caused by a process known as insulin resistance. In type 2 diabetes, the insulin produced by the body has a weak effect and cannot transport as much sugar into the cells as is needed. This usually results in the release of very large amounts of insulin from the pancreas in an attempt to cause the desired effect on blood sugar levels. People get type 2 diabetes when they are unable to compensate for insulin resistance by increasing insulin levels as much as needed. Once the body is unable to compensate for insulin resistance by releasing enough insulin, sugar begins to accumulate in the blood, causing high blood sugars and type 2 diabetes. Diabetes Ketoacidosis or DKA is not common in type 2 diabetes.

Prevention or delay of onset of type 2 diabetes:
Type 2 diabetes may be prevented or delayed by following a program to eliminate or reduce risk factors - particularly losing weight and increasing exercise. Information gathered by the Diabetes Prevention Program, sponsored by the National Institutes of Health and the American Diabetes Association, continues to study this possibility.

What are the symptoms of type 2 diabetes?
The following are the most common symptoms for type 2 diabetes. However, each child may experience symptoms differently. Symptoms may include:

• Frequent infections that are not easily healed
• Frequent urination
• Extreme hunger but loss of weight
• Unusual thirst
• Blurred vision
• Extreme weakness and fatigue
• Irritability and mood changes
• Nausea and vomiting
• High levels of sugar in the blood when tested
• High levels of sugar in the urine when tested
• Dry, itchy skin
• Tingling or loss of feeling in the hands or feet

Some people who have type 2 diabetes exhibit no symptoms. Half of all persons with diabetes do not know they have the disease.

The symptoms of type 2 diabetes may resemble other problems or medical conditions. Always consult your child's physician for a diagnosis.

What are the risk factors for type 2 diabetes?
Risk factors for type 2 diabetes include the following:

• Age (incidence increases with age)
• Family history of diabetes
• Being overweight
• Not exercising regularly
• Being a member of certain racial and ethnic groups, such as African Americans, Hispanic Americans, and Native Americans
• A low level HDL (high density lipoprotein, the "good" cholesterol)
• A high triglyceride level

Treatment for type 2 diabetes:
Type 2 diabetes can be treated with diet, exercise, pills or injections. In the early stage of the disease, weight loss and insulin-sensitizing medications can help control the high blood sugars. However, as the disease progresses over time, pills stop working as well and sometimes multiple pills or insulin are needed to maintain normal blood sugar levels. Type 2 diabetes progresses faster in young people than in older people. Therefore, it is important to achieve good control quickly after diagnosis to protect the beta cells from failing.

Specific treatment for type 2 diabetes will be determined by your child's physician based on:

• Your child's age, overall health, and medical history
• Extent of the disease
• Your child's tolerance for specific medications, procedures, or therapies
• Expectations for the course of the disease
• Your opinion or preference

The goal of treatment is to keep blood-sugar levels as close to normal as possible. Emphasis is on control of blood sugar (glucose) by monitoring the levels, regular physical activity, meal planning, and routine healthcare. Treatment of diabetes is an ongoing process of management and education that includes not only the child with diabetes, but also family members.

Often type 2 diabetes can be controlled through losing weight, improved nutrition, and exercise. However, sometimes, these are not enough and either oral medications and/or insulin must be used. Treatment may include:

• proper diet
• weight control
• an appropriate exercise program
• insulin replacement therapy (under the direction of your child's physician)