Type 2 Diabetes

What is type 2 diabetes?

Type 2 diabetes is a metabolic disorder that develops when the body cannot properly use or produce enough insulin. It is a chronic disease with no known cure. Type 2 diabetes may be managed with healthy eating, exercise, and oral medication (medicine taken by mouth). In some cases, people with type 2 diabetes also need insulin.

Type 2 diabetes, formerly known as adult-onset diabetes, accounts for the majority of cases of diabetes in adults. Type 1 diabetes is more common among children, however, a growing number of children and adolescents are being diagnosed with type 2 diabetes. This may stem from the increase in childhood obesity. Type 2 diabetes is more common among children who are American Indian, African American, Hispanic/Latino American or Asian/Pacific Islander.

According to the Centers for Disease Control, more than 30 million Americans have diabetes and 90 percent to 95 percent have type 2 diabetes. An estimated 193,000 children younger than 20 years old have been diagnosed type 1 or type 2 diabetes.

What is insulin?

Insulin helps glucose (a form of sugar) enter the cells of the body. When glucose enters the cells, it can be used to produce energy, or it can be stored in the liver and muscles as glycogen for later use. Without insulin, glucose builds up in the bloodstream. This starves the body’s cells of energy and can cause long-term damage to many organs, including the eyes, kidneys, heart, and nerves.

Before developing type 2 diabetes, a child may become insulin resistant. This happens when their muscles, liver, and fat cells stop responding fully to insulin. At first, their insulin levels will be high, but eventually, their blood sugar levels will rise as well, leading to the onset of diabetes. Some people with type 2 diabetes have to take insulin injections and monitor their blood sugar to prevent complications. Insulin cannot be taken by mouth because the digestive system would destroy it.

What is the long-term impact of type 2 diabetes?

Over time, high blood sugar can damage nerves and major organs. Managing diabetes through diet, exercise and medications to keep blood sugar at a normal level can greatly reduce the risk of the following conditions later in life:

  • heart disease and stroke
  • nerve damage that can occur in the toes and fingers and may spread to other parts of the body
  • kidney damage
  • eye damage, possibly leading to blindness
  • infections that can lead to amputations

What is prediabetes?

Pre-diabetes is a condition in which blood glucose levels are higher than normal, but not high enough for a diagnosis of diabetes. Having pre-diabetes is a significant risk factor for development of diabetes.

If your child is diagnosed with prediabetes, losing weight and becoming more physically active may help delay or prevent the onset of type 2 diabetes. 

How we care for type 2 diabetes

The Diabetes Program at Boston Children’s Hospital is one of the largest pediatric diabetes centers in North America. We provide comprehensive services for infants, children, adolescents, and young adults with all types of diabetes. Our integrated team brings together pediatric endocrinologists, diabetes nurse educators, registered dietitians, and behavioral specialists who work with you and your child to develop an appropriate diabetes treatment or prevention plan. 

We are one of the few centers that offers a multidisciplinary program focused on the prevention and treatment of type 2 diabetes. This includes our Optimal Wellness for Life (OWL) Program, a multidisciplinary clinic dedicated to providing state-of-the-art care and developing innovative treatments for pediatric obesity and type 2 diabetes.

Our services include:

  • diagnostic evaluation
  • management of the acute complications of diabetes
  • long-term management and follow-up care, including nutritional support, exercise programming, and behavioral support