Type 2 Diabetes| Diagnosis & Treatment

How is type 2 diabetes diagnosed?

If your child has the symptoms of type 2 diabetes or is at risk, their doctor may order blood and urine tests, including:

  • hemoglobin (A1C) test: indicates average blood sugar level for the past two to three months
  • random blood sugar test
  • fasting blood sugar test: taken after an overnight fast
  • oral glucose tolerance test: a two-hour test that includes checking blood sugar before and after your child drinks a prescribed sugar drink
  • checking the blood for autoantibodies, which are found in type 1 diabetes
  • checking for the presence of ketones (byproducts from the breakdown of fat in children with low levels of insulin) in the urine or blood

Your child may need to have blood drawn more than once so the test results can be confirmed with a second test on a different day. Distinguishing between type 1 and type 2 diabetes in children can sometimes be difficult. Your child's doctor may need to do additional testing or monitor your child for some time before the type of diabetes can be confirmed.

How is type 2 diabetes treated?

Because type 2 diabetes is a chronic condition, treatment is an ongoing process. Your child will need routine health care and frequent blood-sugar checks. After stabilizing your child’s condition, the goal of treatment will be to keep their blood sugar level as close to normal as possible.

Control of type 2 diabetes can be improved through healthy eating habits, losing weight, and becoming more physically active. Your child will have a diabetes team to help with the following:

  • choosing healthy foods, controlling portions and reducing unhealthy snacks
  • managing their weight
  • adding more physical activity to their daily routine

Your child’s doctor may also prescribe oral or injectable medications.

The role of food in diabetes management

It is important to understand how food impacts blood glucose for children with diabetes.

Food causes blood glucose to go up. Insulin causes blood glucose to go down. Too much food with not enough insulin can cause blood glucose to go too high. Not enough food with too much insulin can cause blood glucose to go too low. Further, the type and amount of food will affect how much and how quickly the blood glucose goes up. Balancing food and insulin together can help keep blood glucose in a normal range.

Carbohydrates, also known as carbs, are an important source of energy. They are also the main nutrient the body turns into blood glucose, also known as blood sugar. Everyone needs to eat some carbohydrates to stay healthy. Common carbohydrate foods include: bread, crackers, cereal, pasta, rice, fruit, and milk.

  • Carbohydrates that are high in fiber such as whole grains, fruits, and vegetables slow digestion and contribute to a feeling of fullness. High-fiber food can also reduce spikes in blood glucose after eating.
  • Processed carbohydrates that are low in fiber can raise blood sugars too high. Eating fewer process carbohydrates helps manage type 2 diabetes.

A dietitian can help determine the right amount of carbohydrates and types for your child. 

Proteins and fats help kids feel full and have less impact on blood glucose levels than carbohydrates. Because of this, children with diabetes are encouraged to include protein and healthy fats at meals and snacks. Examples of healthy proteins include poultry, fish, beef, pork, peanut butter, cheese and eggs. Healthy fats include avocados, olive oil, eggs, nuts and cheese. While these foods can be a part of a healthy diet, appropriate portion sizes are important.

A healthy diet can mean different things to different people. A dietitian is very important to help with meal planning and understanding the right balance of foods for your child.

What are the possible complications of type 2 diabetes?

Even with careful management, type 2 diabetes can put your child at risk of some serious complications that require prompt medical attention. These include hypoglycemia, hyperglycemia and diabetic ketoacidosis.

Hypoglycemia, also known as low blood sugar, is a risk if your child is on insulin. Hypoglycemia can result from too high an insulin dose, a missed meal or snack, more physical activity than usual, or illness that causes vomiting and/or diarrhea.

  • Symptoms of hypoglycemia include shakiness, sweating, weakness, blurry vision and rapid heartbeat.
  • If left unchecked, hypoglycemia can result in a medical emergency. Your child could lose consciousness or have a seizure.
  • If your child has any of these symptoms, measure their blood glucose level (if possible) and give them a fast-acting carbohydrate, such as fruit juice, hard candy or raisins if they are awake and able to swallow food safely. If not, call 911 and administer glucagon if your child has been prescribed this medication. Seek medical attention right away.

Hyperglycemia, also known as high blood sugar, happens when blood sugar is too high and builds up in the blood stream. It can be caused by not having enough insulin, eating too much food or the wrong kinds of food, too little physical activity, or illness.

  • Symptoms of hyperglycemia can include: excessive urination, bedwetting, weight loss, thirst, yeast infections, nausea and vomiting.
  • If your child has signs or symptoms of hyperglycemia, measure their blood sugar and check their urine for ketones. If ketones are elevated, call your diabetes team for further guidance.

Diabetic ketoacidosis is a life-threatening condition that can result from low insulin and high blood sugar. It is more common in children with type 1 diabetes but can occur with type 2 diabetes.

Without insulin, the body is deprived of glucose for energy and starts breaking down fat for fuel. This releases toxins into the blood faster than the kidneys can get rid of them. Diabetic ketoacidosis can cause fluid to build up in the brain, lead to a loss of consciousness, cardiac arrest or kidney failure.

Your child should receive medical attention right away if they have any of these symptoms:

  • confusion or trouble paying attention
  • sweet or fruity-smelling breath
  • trouble breathing
  • nausea or vomiting