Type 2 Diabetes in Children
Exams and Tests
Many children have had no symptoms before they are diagnosed with type 2 diabetes. Usually, the illness is discovered when a blood or urine test taken for another reason shows diabetes.
A doctor may want to assess your child for type 2 diabetes if he or she has a body mass index (BMI) or weight above the 85th percentile for his or her age and gender or weighs more than 120% of ideal and has any two of these risk factors:5
- Family history of type 2 diabetes
- Being a Native American, African-American, Latino, Asian-American, or Pacific Islander
- Signs of not being able to use insulin properly (insulin resistance) or conditions associated with it, such as:
- The skin problem acanthosis nigricans
- High blood pressure
- High cholesterol
- Higher-than-normal liver enzymes, a sign of inflammation from fat deposited in the liver
- Polycystic ovary syndrome, a hormone problem that interferes with ovulation
Some children have very high blood sugar levels at the time of diagnosis. A child with very high blood sugar can become confused, sleepy, or unconscious, and may develop diabetic ketoacidosis (DKA), which is an emergency. DKA is most common in people with type 1 diabetes and in some African-American people who have type 2 diabetes.
If a doctor suspects that your child may have type 2 diabetes, he or she will do a medical history, physical examination, and blood glucose testing. If the results of these tests meet the criteria for diagnosing diabetes established by the American Diabetes Association (ADA), your child has diabetes.
If a child has no diabetes symptoms, two blood tests done on separate days are needed to confirm the diagnosis. Two types of tests used to diagnose diabetes are:
- A blood glucose test. A fasting blood sugar test (done after not eating or drinking for 8 hours) is preferred.
- A glucose tolerance test. The child has a fasting blood sugar test and then drinks a sweet liquid with a certain amount of glucose in it. The child's blood sugar is tested two hours later.
Other possible tests
If it is hard to tell whether your child has type 2 or type 1 diabetes, your doctor may do a C-peptide test or an autoantibodies test. (Autoantibodies are produced when the body's immune system does not work right.) These tests may not be able to distinguish the type of diabetes your child has. Getting a definite diagnosis may take months or years. In either case, your child's sugar levels will need to be controlled right away.
Sometimes a doctor will do a quick home blood sugar test or a urine test for sugar to see whether a child may have diabetes. Although these tests are simple and can indicate possible diabetes, additional testing is needed to make sure your child actually has the disease.
Monitoring tests if diagnosed with diabetes
Because your child is at risk for diabetes complications (eye, heart, kidney, nerve, liver, and blood vessel problems), he or she needs to see a doctor regularly throughout life.5
Kinds and frequency of tests and examinations for type 2 diabetes5 Frequency
Exams and tests
Every 3–6 months
- Have a medical checkup to review blood sugar levels since the last checkup and evaluate whether your child's treatment plan needs to be changed. Bring your child's home blood sugar records to this appointment. Keep a record with notes of special issues such as changes in diet, in activity, and when your child has low blood sugar problems. Bring this record to the appointment too. During each visit, the doctor will check your child's blood pressure.
- Have a hemoglobin A1c or similar blood test (glycosylated hemoglobin or glycohemoglobin) to estimate your child's average blood sugar level over the previous 2 to 3 months. This test may be done every 3 to 6 months.
- Your child may need to have a blood sugar test (blood glucose test). If so, you may want to run a home blood sugar test when your doctor draws blood for the test. This is a good way to check the accuracy of your home meter.
Every 6 months
- Have a dental exam to check for gum problems.
Every year
- See an eye specialist (ophthalmologist) for an exam, including ophthalmoscopy. If your child is at low risk for vision problems, your doctor may consider follow-up exams every 2 years.
- Have a screening test for kidney function. Urine tests look for the amount of protein in the urine (proteinuria), an indicator of kidney damage. Usually, you give a single urine sample, to test for an albumin-to-creatinine ratio. Some doctors do a urine test for protein that estimates protein but does not provide a ratio. Another way to test kidney function is to do a 24-hour urine collection. This may be better because protein levels can be different at different times of the day. Home urine collection kits are available.
- Your child may need a thorough medical examination of his or her feet at least once a year. Yearly foot exams are recommended for all people with diabetes, and it may help your child understand the importance of proper foot care.6
- At the time of diagnosis and as needed
- After blood sugar levels are under control
- Every year if the child has blood sugar levels above a target range and high LDL cholesterol
- Every 5 years if the child has low risk and does not have a family history of the disease
- Have a cholesterol and triglyceride level test to see whether diabetes may be raising the cholesterol level in your child's bloodstream.
- Have liver enzymes tested to see whether diabetes and obesity may be harming liver function.
Early Detection
Starting at age 10 or at the beginning of puberty, a child who has a body mass index (BMI) in the 85th percentile or higher for his or her age or whose weight is more than 120% of ideal and has two of the following risk factors needs to be tested for diabetes every 2 years:5
- Family history of type 2 diabetes
- Being a Native American, African-American, Latino, Asian-American, or Pacific Islander
- Signs of not being able to use insulin properly (insulin resistance) or conditions associated with it, such as:
- The skin problem acanthosis nigricans
- High blood pressure
- High cholesterol
- Higher-than-normal liver enzymes, a sign of inflammation from fat deposited in the liver
- Polycystic ovary syndrome, a hormone problem that interferes with ovulation
If the results of a glucose test show that your child's blood sugar is higher than normal but not yet at the level of diabetes (prediabetes), the test should be repeated 3 months later to see whether your child has developed diabetes.4 If your child eats a healthy diet and gets regular exercise, he or she may not develop diabetes.
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| Author: | Caroline Rea, RN, BS, MS | Last Updated: July 28, 2008 |
| Medical Review: | Michael J. Sexton, MD - Pediatrics Stephen LaFranchi, MD - Pediatrics and Pediatric Endocrinology | |
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