Updated January 11, 2006

Treating Type 2 Diabetes in Children

by Jill A. Goldfarb, M.D.

Blood lipid control. Some children with Type 2 diabetes also have high blood lipid levels. Your child can control his blood lipid levels primarily through weight loss, increased activity, and improvement in blood glucose control. Medicines may also be necessary in some cases.

Regular checkups. Also important are regular visits to your physician and other members of your child’s diabetes team for routine health exams. These exams should include an annual dilated eye exam, foot exams at every medical visit, and annual urine tests for albuminuria (albumin in the urine, a sign of diabetic kidney disease).

A family approach
When it comes to making lifestyle changes, it’s often helpful to have the entire family involved in making those changes together. This might include stocking the kitchen and preparing meals with more healthful foods for everyone, not just for the child with diabetes. It could include incorporating more physical activity—such as outdoor games, bike rides, hikes, or even yardwork—into family time and setting limits on TV watching and computer use for everyone in the home, adults and children alike. Having family support is also important for kids who participate in team sports or wish to pursue active interests such as dance or in-line skating.

Although lifestyle and dietary changes may seem burdensome at first, family members may grow to appreciate their benefits over time. Eating a more healthful diet and becoming more aware of the amounts of carbohydrate, fat, and protein one eats often contributes to weight loss for a person who is overweight. It can also lower blood pressure and blood lipid levels. For a person with diabetes who is overweight, weight loss can reduce insulin or other medicine needs—sometimes to the point where insulin or drug therapy can be discontinued altogether.

Getting more physical activity can also lead to improved fitness levels and weight loss, but more important, it can be fun if it is approached with a positive attitude. Both parents and children may discover new interests and skills as they explore new activities.

Dealing with feelings
Your child may express feelings of being different from other kids because of his diabetes. Just like many other kids with chronic diseases, children who have Type 2 diabetes may have feelings of anger, depression, isolation, or denial. Feelings like these can cause a child to not take care of his diabetes as well as he otherwise would.

How you and other adults in your child’s life respond to his diagnosis and treatment can have a big effect on how he feels and behaves. A child can pick up on parental anxiety, anger, and grief over his illness, but he also responds to a parent’s ability to stay calm and use problem-solving techniques when things don’t go exactly as planned. For this reason, finding support for parents and other family members is often as important as finding support for the child who has diabetes. Visit the ADA’s Web site at www.diabetes.org (click on “Community Programs & Local Events” then “What’s Happening Locally”) or check with your diabetes team to find a support group for families in your area. If you are unable to find local support groups, online support groups can also provide answers and a sense of community when you need it.

Summer camps for kids with diabetes are often a great way to expose your child to others who share the same challenges and to lessen his feelings of isolation. For a list of camps, visit the ADA’s Web site at www.diabetes.org (click on “Community Programs & Local Events” then “Diabetes Camps”).

Dr. Goldfarb is a third-year general pediatrics resident at Children’s Medical Center, University of Texas Southwestern Dallas. She will be starting her fellowship in pediatric endocrinology in July 2005. This column is edited by Jean Betschart Roemer, a Pediatric Nurse Practitioner at the Children’s Hospital of Pittsburgh and the author of Type 2 Diabetes in Teens: Secrets for Success, which is available through www.Learningdiabetes.com.

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