Diabetes mellitus type 2 in adolescents
What is it?
Diabetes (di-ah-BE-tez) is also called diabetes mellitus (MEL-uh-tus). There are three main types of diabetes. Your child or teenager has type 2 diabetes. It may be called non-insulin dependent or adult onset diabetes. With type 2 diabetes, your child's body has trouble using insulin or may not make enough insulin. Type 2 diabetes is more common in overweight people who are older than 40 years and are not active. Type 2 diabetes has recently become more common in overweight children and teenagers. It usually starts during puberty but has also been found in younger children. There is no cure for diabetes, but your teenager can have a long and active life if his diabetes is controlled.
How did my child get type 2 diabetes?
- Insulin is a hormone (a special body chemical) made by the pancreas. The pancreas is an organ that lies behind the stomach. Much of the food we eat is turned into sugar. This sugar goes into the blood and travels to the cells of your child's body to be used for energy. Insulin acts as a "key" to help sugar enter the cells.
- With type 2 diabetes, your child's body has trouble using insulin. Your child's body may also not make enough insulin. When this happens, sugar will build up in his blood. The right diet and amount of exercise will help your child control his diabetes. Your child may need to take medicine to help his body make more insulin or use insulin better.
- No one knows for sure what causes type 2 diabetes. Type 2 diabetes runs in families. Your child is more likely to get it if someone else in your family has type 2 diabetes.
- Your child is also more likely to get type 2 diabetes if he is overweight. Being overweight makes it harder for his body to use the insulin it makes. This is called insulin resistance. In insulin resistance, your child's pancreas will keep making insulin to try to control his blood sugar but his body will not use the insulin correctly. After many years, his pancreas may just stop working and stop making insulin.
Signs and Symptoms:
Your child may or may not experience signs and symptoms of type 2 diabetes. Your child may have one or more of the following symptoms of hyperglycemia (hi-per-gli-SE-me-ah) or high blood sugar:
- More thirsty than usual.
- Urinating more than usual.
- More hungry than usual.
- Abdominal (belly) pains.
- Nausea (upset stomach) or vomiting (throwing up).
- Problems seeing clearly.
- Losing weight for no reason.
What is hypoglycemia? Hypoglycemia (hi-po-gli-SE-me-ah) happens when your child's blood sugar level falls too low. It can be caused by taking too much diabetes medicine (insulin or pills). It may also be caused by skipping a meal, eating too little food, or exercising more than usual. Ask your child's caregiver for more information about diabetic hypoglycemia.
If your child has the following symptoms of low blood sugar, immediately give him a food or drink that contains sugar. Good choices for treating low blood sugar are four ounces (one-half cup) of orange juice, five to six pieces of hard candy, or glucose tablets. The following are signs and symptoms of hypoglycemia:
- Becoming confused or having trouble paying attention.
- Becoming crabby or grumpy.
- Becoming sweaty.
- Feeling faint (lightheaded).
- Feeling hungry.
- Feeling tired.
- Feeling like his heart is beating very fast.
- Feeling shaky.
What is ketoacidosis? Ketoacidosis happens when blood sugar stays too high for too long without being treated. This can cause your child's body to start breaking down body fats for energy, instead of blood sugar. Wastes called ketones are left behind. This may happen when your child is sick or under a lot of stress. It can also happen if your child has eaten too much or has not taken enough medicine. Ketoacidosis can be very serious and needs to be treated right away. Ask caregivers for more information about ketoacidosis.
The following are signs and symptoms of ketoacidosis:
- More thirsty than usual.
- Urinating more than usual.
- Confusion, or trouble thinking clearly.
- Fatigue (feeling tired).
- Fast deep breathing at rest.
- Fruity-smelling breath.
- Nausea (upset stomach) and vomiting (throwing up).
- Stomach pain.
- So sleepy your child cannot be awakened.
Can diabetes cause other health problems? High blood sugar levels may damage other body tissue and organs over time. Diabetes can even cause death without treatment. If your child's blood sugar is well controlled, other health problems may not happen. Having uncontrolled diabetes for a long time can damage your child's nerves and arteries (blood vessels). This can increase your child's chance of having a heart attack or stroke. It also increases his chances of having problems with his eyes, kidneys, nerves, and of getting infections.
The most important thing you must do is help control your child's blood sugar. Caregivers will work with you and your teenager to help keep blood sugar levels within a "target range." This means that the blood sugar is not too high or too low. To do this, your child has to find the right balance of diabetes medicine, food intake, and physical activity. Food puts sugar in your child's body and raises blood sugar levels. Diabetes medicine and physical activity lower blood sugar levels.
You can help control your teenager's blood sugar by helping them eat the right food. A diabetes nurse or a dietitian will help you learn what they should eat and how food affects diabetes. A diet high in fiber is helpful in diabetes.
- Your teenager should not drink alcohol.
- Exercising helps your teenager's body better use sugar and insulin. This helps keep their blood sugar level under control. It also makes the heart stronger, lowers blood pressure, and helps keep an ideal body weight. Your teenager may also feel less anxious about their diabetes and feel better about themselves if they exercise. Ask caregivers to help plan the best exercise program for your teenager. Start exercising when their caregiver says it is OK.
Your teenager may need to take medicine to control his blood sugar. They may need to go into the hospital for more tests and treatments.
- A vegetarian diet and/or a high fiber diet will decrease blood sugars and help your teenager lose weight. It will also help prevent or control diabetes.
Herbs and Supplements:
Before your teenager takes any herbs or supplements, ask his caregiver if it is OK. Talk to your teenager's caregiver about how much he should take. If your teenager is using this medicine without instructions from his caregiver, follow the directions on the label. Your teenager should not take more medicine or take it more often than the directions tell him to.
The herbs and supplements listed may or may not help treat your condition.
- American ginseng (Panax quinquefolium) may be helpful and has been studied in people with diabetes.
- Bitter melon (Momordica charantia) may be helpful and has been studied in people with diabetes.
- Chinese ginseng (Panex ginseng) may be helpful and has been studied in people with diabetes.
- Cinnamon (Cinnamomum cassia) may be helpful and has been studied in people with diabetes, type 2.
- Fenugreek (Trigonella foenum-graecum) is helpful for diabetes and has been studied in people.
- Gymnema (Gymnema sylvestre) may be helpful and has been studied in people with diabetes.
- Prickly pear cactus (Opuntia fulginosa) may be helpful and has been studied in people with diabetes.
- Psyllium (Plantago isphagula) may be helpful and has been studied in people with diabetes.
- Alpha lipoic acid may be helpful for diabetes and has been studied in people.
- B vitamins B1 (thiamine), B6 (pyridoxine), and B12 (cyanocobalamin)) may be helpful for diabetes and diabetic nerve problems.
- Biotin has been used, but has not been studied in people who have diabetes.
- Chromium may be helpful for diabetes and has been studied in people.
- Fish oil (DHA, EPA) may be helpful and has been studied in people with diabetes.
- Glucomannan may be helpful for diabetes and has been studied in people.
- Guar gum may be helpful for diabetes and has been studied in people.
- Magnesium may be helpful for diabetes and has been studied in people.
- Vanadium is helpful for diabetes and has been studied in people.
- Vitamin E may be helpful for diabetes and has been studied in people.
- Zinc may be helpful for diabetes and has been studied in people.
- Traditional Chinese Medicine (TCM), which combines acupuncture and herbs, has been used to treat diabetes.
- Stress may affect diabetes.
Other ways of treating your teenager's symptoms:
Talk to your caregiver if:
You would like medicine to treat your teenager's diabetes.
Your teenager's symptoms have not gone away or improved by these self-help measures.
You have questions about what you have read in this document.
Your teenager has burning or stinging when he urinates or is urinating small amounts often. These may be signs that he has a bladder infection.
Your teenager has one or more of the following symptoms of high blood sugar:
- Blurry vision.
- Fatigue (feeling very tired).
- Hungry all of the time.
- Sores that take a long time to heal.
- Urinating often or bedwetting.
- Very thirsty and drinking a lot of liquids.
- Irritability (grumpy).
Your teenager has one or more of the following symptoms of low blood sugar:
- Confused or acting "spacey" or drunk.
- Crabby or grumpy.
- Faint (lightheaded).
- Feeling like his heart is beating very fast.
SEEK CARE IMMEDIATELY IF:
- Your teenager has trouble thinking clearly.
- Your teenager is so sleepy he cannot be awakened.
- Your teenager is feeling worse even though you are following the caregiver's directions.
You have the right to help plan your care. To help with this plan, you must learn about your teenager's health condition and how it may be treated. You can then discuss treatment options with your caregivers. Work with them to decide what care may be used to treat your teenager. You always have the right to refuse treatment.
1. Abbas ZG & Swai ABM: Evaluation of the efficacy of thiamine and pyridoxine in the treatment of symptomatic diabetic peripheral neuropathy. East Afr Med J 1997; 74(12):803-808.
2. Anderson RA, Cheng N, Bryden NA et al: Elevated intakes of supplemental chromium improve glucose and insulin variables in individuals with type 2 diabetes. Diabetes 1997; 46(11):1786-1791.
3. Boden G, Chen X, Ruiz J et al: Effects of vanadyl sulfate on carbohydrate and lipid metabolism in patients with non-insulin-dependent diabetes mellitus. Metabolism 1996; 45(9):1130-1135.
4. Dierkx RI, van de Hoek W, Hoekstra JB et al: Smoking and diabetes mellitus Neth J Med 1996; 48(4):150-162.
5. Faure P, Benhamou PY, Perard A et al: Lipid peroxidation in insulin-dependent diabetic patients with early retina degenerative lesions: effects of an oral zinc supplementation. Eur J Clin Nutr 1995; 49(4):282-288.
6. Frati AC, Jimenez E & Ariza CR: Hypoglycemic effect of Opuntia ficus indica in non insulin-dependent diabetes mellitus patients. Phytother Res 1990b; 4(5):195-197.
7. Gatenby SJ, Ellis PR, Morgan LM et al: Effect of partially depolymerized guar gum on acute metabolic variable in patients with non-insulin-dependent diabetes. Diabetic Med 1996; 13(4):358-364.
8. Jain SK, McVie R, Jaramillo JJ et al: Effect of modest vitamin E supplementation on blood glycated hemoglobin and triglyceride levels and red cell indices in type 1 diabetic patients. J Am Coll Nutr 1996; 15(5):458-461.
9. Jiang ZS, Zhang SL & Yan H: Study on syndrome-type in TCM and its correlation with superoxide dismutase and malonyldialdehyde in patients with non-insulin dependent diabetes mellitus. Chung Kuo Chung Hsi I Chieh Ho Tsa Chih 1997; 17(10):597-598.
10. Keen H, Payan J, Allawi J et al: Treatment of diabetic neuropathy with gamma-linolenic acid. Diabetes Care 1993; 16(1):8-15.
11. Khan A, Khattak KN, Safdar M et al: Cinnamon improves glucose and lipids of people with type 2 diabetes. Diabetes Care 2003; 26(12):3215-3218.
12. Konrad T, Vicini P, Kusterer K et al: alpha-lipoic acid treatment decreases serum lactate and pyruvate concentrations and improves glucose effectiveness in lean and obese patients with type 2 diabetes. Diabetes Care 1999; 22(2):280-287.
13. Lehmann R & Spinas GA: Role of physical activity in the therapy and prevention of type II diabetes mellitus. Ther Umsch 1996; 53(12):925-933.
14. Lima M, Cruz T, Pousada JC et al: The effect of magnesium supplementation in increasing doses on the control of type 2 diabetes. Diabetes Care 1998; 21:682-686.
15. Nicholson AS, Sklar M, Barnard ND et al: Toward improved management of NIDDM: A randomized, controlled, pilot intervention using a lowfat, vegetarian diet. Prev Med 1999; 29(2):87-91.
16. Okada S, Hamada H, Ishii K et al: Factors related to stress in patients with non-insulin-dependent diabetes mellitus. J Int Med Res 1995; 23(6):449-457.
17. Passariello N, Fici F, Giugliano D et al: Effects of pyridoxine alpha-ketoglutarate on blood glucose and lactate in type I and II diabetics. Int J Clin Pharmacol Ther Toxicol 1983; 21(5):252-256.
18. Pick ME, Hawrysh ZJ, Gee MI et al: Oat bran concentrate bread products improve long-term control of diabetes: a pilot study. J Am Diet Assoc 1996; 96(12):1254-1261.
19. Shanmugasundaram ER, Rajeswari G, Baskaran K et al: Use of Gymnema sylvestre leaf extracts in the control of blood glucose in insulin-dependent diabetes mellitus. J Ethnopharmacol 1990a; 30(3):281-284.
20. Sharma RD, Sarkar A, Hazra DK et al: Use of fenugreek seed powder in the management of non-insulin dependent diabetes mellitus. Nutr Res 1996c; 16(8):1331-1339.
21. Sotaniemi E, Haapakoski E & Rautio A: Ginseng therapy in non-insulin dependent diabetic patients. Diabetes Care 1995; 18:1373-1375.
22. Tandan R, Lewis GA, Krusinski PB et al: Topical capsaicin in painful diabetic neuropathy: controlled study with long-term follow-up. Diabetes Care 1992; 15(1):8-14.
23. Urooj A, Vinutha S, Shashikala P et al: Effect of barley incorporation in bread on its quality and glycemic responses in diabetics. Int J Food Sci Nutr 1998; 49(4):265-270.
24. Vuksan V, Jenkins D, Spadafora P et al: Konjac-glucomannan (glucomannan) improves glycemia and other associated risk factors for coronary heart disease in type 2 diabetes. Diabetes Care 1999; 22:913-919.
25. Vuksan V, Sievenpiper JL, Koo VYY et al: American Ginseng (Panax quinquefolius) reduces postprandial glycemia in nondiabetic subjects and subjects with Type 2 diabetes mellitus. Arch Intern Med 2000; 160(7):1009-1013.
26. Welihinda J, Karunanayake EH, Sheriff MHR et al: Effect of Momordica charantia on the glucose tolerance in maturity onset diabetes. J Ethnopharmacol 1986; 17(3):277-282.
Last Updated: 11/4/2014