This Issue

Type 2 diabetes: More children at risk for “adult” disease

Rising obesity rates partly to blame

Type 2 Diabetes in children: It’s a family affair

Is your child at risk for type 2 diabetes?

Q & A

A closer look

Signs and symptoms

Some children have no symptoms of type 2 diabetes, while others may experience:

• Increased thirst

• Frequent urination

• Increased hunger but loss of weight

• Blurred vision

• Fatigue

• Frequent infections or slow-healing sores

• Tingling in hands and feet

• High blood pressure or high cholesterol

• Areas of darkened skin

Signs & Symptoms

Need more information?

• Take Charge of Your Health!
A Teenager’s Guide to Better Health

• National Diabetes Education Program

• American Diabetes Association Planet D

Is it a dirty neck or a sign of diabetes?

The Disparities of Diabetes

Need More Information?

Is it a dirty neck or a sign of diabetes?

One of the signs of type 2 diabetes is increased pigmentation (acanthosis nigricans) in body folds and creases.

Common sites are armpits, groin and neck.

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A closer look

The pancreas, a tapered seven-inch long gland situated beneath the stomach, secretes a hormone called insulin, which plays a major role in the absorption of glucose into the cells of the body.

Glucose is a simple sugar that is released into the bloodstream after we eat and digest certain foods, particularly carbohydrates. Glucose provides fuel for the body. Just as cars run on gas, our bodies run on glucose. We are able to walk and run because glucose fuels our muscles. However, glucose cannot enter the cells without the assistance of insulin.

In type 2 diabetes, the body either does not make enough insulin or does not effectively use the insulin it produces. Sugar builds up in the blood, starving the cells of their much-needed energy, and causing potentially serious health complications.

Click here for a closer look at insulin

Type 2 Diabetes in children:
It’s a family affair


What is type 2 diabetes?

Diabetes keeps the body from making, or effectively using, the hormone insulin. Our cells rely on a simple sugar called glucose for fuel. Insulin made by the pancreas unlocks cells so that sugar circulating in the blood can slip inside.

Often, insulin resistance is the first step toward type 2 diabetes. Type 2 diabetes affects 90 to 95 percent of people with diabetes. In this disorder the pancreas must crank out increasing amounts of insulin just to make normal deliveries of sugar to the cells. When the pancreas can’t keep up, sugar builds up in the blood. A build-up in sugar can lead to all kinds of short- and long-term medical problems.

Once, type 2 diabetes affected mainly inactive, overweight, middle-aged adults. “Now we’re seeing a worrisome rise in this illness in children over age 10,” says Dr. Jan Cook, medical director of Blue Cross Blue Shield of Massachusetts. “We know how to turn that around. Eating well, exercising daily and keeping a normal body weight are important treatments for type 2 diabetes. For children with type 2 diabetes, these healthy choices plus medicine, if needed, can help prevent complications.”

Season with love

Eating well helps keep a child’s blood sugar within a healthy range — that is, not too high or too low. All children need carbohydrates and fats to give them enough energy to zip around all day, plus protein to build strong muscles and bones. These nutrients are broken down inside the body into glucose, which fuels activities or winds up stored as body fat.

Not all foods are equally healthy. Most kids love sugary drinks, fried foods and high-calorie sweets and snacks. Encouraging your child to eat a balance of healthy carbohydrates, fats and protein (see below) and substitute water for sweet liquids will help keep blood sugar as close to normal as possible.


High-fiber carbs slow the release of glucose. Eating sweets, refined grains (white flour, white bread), or too many carbs at once causes blood sugar spikes.

Healthy choices:

• Whole grains (oatmeal, brown rice, whole wheat pasta, bread, crackers or whole grain cereals)

• Lentils and dried peas or beans (black-eyed pea, split green peas, black, white or navy beans)

• Fresh or frozen vegetables and fruits in rainbow colors

Why Exercise?

Inactivity contributes to weight problems and insulin resistance, according to the American Diabetes Association. Both start the ball rolling toward type 2 diabetes. Reverse these unhealthy trends by encouraging children to be active 60 minutes a day:

• Walking
• Running
• Skipping rope
• Dancing
• Jumping
• Skateboarding
• Biking
• Playing basketball
• Soccer
• And other active games

Important note:
Be aware that exercise can cause dips in blood sugar. If your child has diabetes, talk to your medical team about how to be active safely by checking blood sugar and carefully balancing food, medication and exercise.

Adults need to reinforce healthy lifestyles for type 2 diabetic children. Eating right and exercising are vital to managing diabetes and staying healthy. Contact your doctor if you have any questions about your child’s diet or exercise routine



Satisfies hunger without causing blood sugar spikes.

Healthy choices:

• Beans or tofu

• Fish

• Poultry (preferably with skin removed) or lean meat

• Peanut butter


Won’t make blood sugar rise, but can prompt weight gain.

Healthy choices:

• Small portions of liquid oils (olive oil, canola oil)

• Small amounts of nuts

• Omega-3 fatty acids (in oily fish like salmon, walnuts, flaxseed)

• Limit saturated fat (butter, red meat), choose low-fat dairy, avoid fried foods and trans fats (hydrogenated oils)

Create a family plan

Children with type 2 diabetes have different medical needs and food preferences, so a one-size meal plan doesn’t fit all. Work with your child’s medical team or care management program to decide on the right plan. Fortunately, healthy meals and snacks for children with diabetes are good for the whole family.

Hundreds of great recipes appear on the American Diabetes Association website ( You’ll also find Planet D, a portion of the website aimed at children and teens with diabetes, plus tools for balancing meals and snacks, personalizing recipes, and searching out healthy substitutes. Ask your medical team for recipe suggestions, too.

Stick with it

It’s hard to be different. Teens, particularly, want to fit in. Try these tips to help your child stick with the plan:

• Make it a family effort.

Children with diabetes do best when the entire family gets involved. Stock up on healthy foods and downplay chips, sweets, soda and fast foods. Launch weekly family taste tests to try a new vegetable, whole grain or fruit. Cooking simple recipes together can help, too, since children enjoy eating food they’ve prepared.

• Identify hurdles.

Sit down with your child nightly for a week to write down healthy eating hurdles that made it hard for each of you to stick to the plan. Obvious culprits are birthday parties, pizza nights, school lunches, sleepovers, sideline snacks at sports events, fast food cravings and lack of time to shop for or cook healthy foods.

• Tackle easy problems first.

Brainstorm solutions together. Go slow: Pick one easy problem for each of you to tackle so you won’t feel overwhelmed. Success builds confidence. Next week, tackle another. Example: Decide on a snack your child could take to a sleepover.

• Reward success.

Let your child choose non-food rewards for sticking to the plan. Extra points for active rewards! Examples: Challenge you to a game of basketball or Wii Sports? Read together? Pass on a detested chore? Extra gaming time?

• Try, try again.

Don’t let discouragement derail your child. Make a pact to try, try again. Every day offers another chance to succeed.