Type 2 Diabetes Can Progress Faster in Kids, but the Warning Signs May Be Easy to Miss

(COLUMBUS, Ohio) - Type 2 diabetes is often thought of as an adult disease, but when it develops in children and teens, it can progress more aggressively and lead to serious health complications at younger ages. With approximately 8 million U.S. children and teens estimated to have prediabetes, experts at Nationwide Children's Hospital say early screening and family-centered lifestyle changes can play an important role in preventing progression to Type 2 diabetes and improving outcomes for those already diagnosed.

For 13-year-old Grace Cashion, the warning signs were not what she or her family expected. After months of stomach pain, a routine doctor's visit revealed high blood sugar levels and led to a diagnosis of Type 2 diabetes.

"Definitely a shock to hear that, going from stomach upset to that diagnosis," said Stephanie Cashion, Grace's mom.

Prediabetes is an early warning sign of possible future Type 2 diabetes. Prediabetes in children and teens means blood glucose levels are higher than normal and the body is showing a reduced ability to use insulin effectively.

Type 2 diabetes can behave differently in young people than it does in adults. Leena Mamilly, MD, pediatric endocrinologist at Nationwide Children's, explains that youth with Type 2 diabetes can experience a more severe decline in the function of the cells that produce insulin, along with increased resistance to insulin. That makes early identification and effective management especially important.

"Diabetes is a chronic condition. When it's diagnosed, it doesn't go away. It impacts people for life," said Leena Mamilly, MD, pediatric endocrinologist at Nationwide Children's. "It needs a lot of attention, not only in terms of taking medications, but also a lot of modifications to a person's daily schedule, their lifestyle and their diet in order to avoid complications and manage their disease appropriately."

Type 2 diabetes can be a serious condition that can lead to various long-term complications if not treated through lifestyle changes such as a healthy diet, exercise and medications. Grace's care team at Nationwide Children's diabetes clinic recommended working with a dietitian and changing habits at home to include more whole foods and walks after meals. Today, Grace has control of her diagnosis and no longer requires insulin.

"Grace really has taken it upon herself to check when she doesn't feel well. She'll check her blood sugar, and she knows what snack she needs to have," said Stephanie Cashion, Grace's mom. "If there's any time that she's not feeling well, she knows that she can go to the nurse. It has just been amazing watching her become so independent."

Experts stress the importance of creating healthy habits as a family to prevent complications late in life, and recommend the following practices for families to slow the progression of prediabetes and manage a Type 2 diabetes diagnosis:

• Move together. Aim for about an hour of movement every day. Start by finding practical ways to increase daily movement. This can be a walk after dinner as a family or some light stretching.
• Rethink snacks. Reduce sugary drinks and processed foods. Consider swapping sugary drinks with water and focusing on fruits and vegetables for snacks.
• Build balanced meals together. Eat more whole grains, vegetables and lean proteins. Work together as a family to create a weekly menu with foods the whole family is excited to have. Families can go grocery shopping or tackle a new recipe together.

"We need to help our children and teens get to a better state of health, especially as Type 2 diabetes in youth is becoming more common," said Dr. Mamilly. "It's important to screen for it, and it's important to also apply those lifestyle interventions, especially in the young pre-pubertal years."

To learn more about managing prediabetes and Type 2 diabetes, visit here.

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