Type 2 Diabetes and Insulin Resistance

Pediatric Diabetes and Endocrinology

Type 2 Diabetes and Insulin Resistance

The pediatric diabetes and endocrinology staff at American Family Children's Hospital in Madison, Wisconsin, provides comprehensive care for children with type 2 diabetes and insulin resistance.

Topics:

What is insulin resistance?

Insulin is a hormone (chemical messenger) that your body makes from the pancreas. It is released in response to glucose (sugar) in your body.

Insulin acts as a “key” to “open up the door” and allow sugar into cells to be used for energy. Being insulin resistant means your body's cells (mostly the muscle, liver and fat cells) don't respond normally to the insulin your body produces. The key is there, but it does not unlock the door.

With that, the sugar does not as easily get into the cells. In response, the pancreas releases more insulin, leading to higher insulin levels (hyperinsulinemia). High levels of insulin can lead to darkening of the skin, called acanthosis nigricans. People with insulin resistance may or may not go on to develop type 2 diabetes.

What is type 2 diabetes?

Without insulin to move the sugar into the cells of the body, sugar builds up in the blood and rises to unhealthy levels. The cells that produce insulin (called beta cells) can no longer make enough insulin to overcome the body's resistance. When this happens, blood sugars rise and type 2 diabetes develops.

The diagnosis of type 2 diabetes is becoming increasingly common in U.S. kids and teens, especially in those who are overweight. Some studies report that between 8 and 45 percent of children who've been newly diagnosed with diabetes have the form known as type 2. Diabetes is a chronic condition that needs close attention, but with some practical knowledge, you can take charge in learning to live with the disease.

From Kids Health: Type 2 Diabetes - What is it?

What are risk factors for insulin resistance and type 2 diabetes?

Although no one knows for certain what causes type 2 diabetes, there seems to be a genetic risk. In fact, it's estimated that 45 to 80 percent of affected kids have at least one parent with diabetes and may have a significant family history of the disease. In some cases, a parent may be diagnosed with type 2 diabetes at the same time as the child.

Type 2 diabetes is strongly associated with obesity. Lifestyle choices and activity play a large role. Eating unhealthy, taking in excess calories and fat, and not being physically active are all factors that can contribute to the development of type 2 diabetes. Poor sleep is a risk factor, as well. Certain ethnic groups also tend to be more prone to developing type 2 diabetes, including people of Native American, African American, Hispanic/Latino and Asian/Pacific Island descent.

What are treatment options for type 2 diabetes in children?

The goal of treatment is keep blood sugar levels close to normal. This can be achieved by increasing the body’s response to insulin, preferably by decreasing but also sometimes by providing more insulin. Diet and exercise are the first line of therapy. Often a medication, called metformin, is also prescribed. This medication, a pill taken daily, helps the body to use insulin more effectively.

Patients learn to check their blood sugars using a blood glucose meter, which is a computerized device that measures the amount of glucose in a sample of your blood and displays it on a screen. To get a sample of your blood, a small needle called a lancet is used to poke the skin (usually on a finger or on your arm) to get one drop of blood. The drop of blood is placed on a testing strip that goes into the blood glucose meter. Within a few seconds, the blood glucose reading appears on a screen.

Helping kids with type 2 diabetes switch to healthier habits is a key part of treatment. Because most kids are overweight when they're diagnosed, it's important to promote healthy eating and physical activity to prevent further weight gain or to encourage weight loss while making sure they grow and develop properly.

What can I do to prevent type 2 diabetes?

Getting to a healthy weight is one way. That's because a lot of extra weight makes it harder for the body to respond to insulin properly. Making healthy food choices and getting enough exercise are other good steps to take to help prevent diabetes.

Taking Steps to Prevent Type 2 Diabetes

  • Chow down on good-for-you foods: Try to eat foods that are low in fat but high in other nutrients. Here are some good choices: whole-grain cereals and breads, fruits, vegetables, milk, yogurt, cheese, lean meats and other sources of protein.
  • Limit fast food and sugary sodas: Eating too much fat and sugar can make you overweight, and being overweight can make you more likely to develop type 2 diabetes. Try to cut back on fatty fast foods and sugary drinks like sodas, juices and iced teas.
  • Get up and get moving: Staying active is a better choice than watching TV or playing video or computer games when it comes to preventing diabetes and staying healthy. Moving around a lot helps prevent diabetes and helps keep your weight in a healthy range for your height. Being active can be as simple as walking the dog, running around your yard or playing soccer with friends. Try to do something that gets you moving every day.
  • If you have questions about your weight, ask: If you're concerned about your weight, ask your mom or dad to take you to talk to your doctor. A doctor can help you find out if your weight is healthy and how to keep it (or get it) that way.

Are there other health risks associated with insulin resistance and type 2 diabetes?

  • High cholesterol: Cholesterol is a type of fat found in the blood. Too much cholesterol can block the blood vessels and damage important areas of the body, including the brain and heart. Learn more about cholesterol 
  • High blood pressure: Blood pressure is the pressure the blood exerts against the blood vessel walls as the heart pumps. The pressure increases when the heart contracts and pushes blood into the vessels and lowers when the heart relaxes, but there's always a certain amount of pressure in the arteries. When someone has high blood pressure, the heart and arteries have a much heavier workload. The heart must pump harder and the arteries are under greater strain as they carry blood. If high blood pressure continues for a long time, the heart and arteries may no longer work as well as they should. Other organs that are receiving the blood, like the kidneys and brain, may also be affected. Having high blood pressure puts someone at a higher risk for stroke, heart attack, kidney failure, loss of vision and atherosclerosis (hardening of the arteries). While high blood pressure doesn't always cause symptoms, it still affects the body and puts a person at risk for those long-term health problems. In rare cases, severe hypertension can cause headaches, visual changes, dizziness, nosebleeds, heart palpitations, and nausea.



  • Fatty liver: When fat accumulates in the liver, it can cause inflammation, scarring, and permanent liver damage, leading to the need for a liver transplant.
  • Sleep apnea: This sleep disorder causes a person to stop breathing temporarily during sleep. One common cause of obstructive sleep apnea is enlarged tonsils or adenoids (tissues located in the passage that connects the nose and throat). Being overweight or obese also can lead someone to develop obstructive sleep apnea. Teens with obstructive sleep apnea might snore, have difficulty breathing and even sweat heavily during sleep. Because it disrupts sleep, someone with sleep apnea may feel extremely sleepy or irritable during the day. Those who show signs of the condition, such as loud snoring or excessive daytime sleepiness, should be evaluated by a doctor. Learn more about sleep apnea at Wisconsin Sleep

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