Across the United States, the rate of children diagnosed with type 2 diabetes is rising sharply, largely due to childhood obesity, unhealthy eating habits and a lack of physical activity. This is a change from the past, as type 2 diabetes occurred more commonly in adults; it was referred to as adult-onset diabetes, in contrast to type 1, which is usually diagnosed in young children and teens.

Childhood diabetes is poised to become a major public health challenge, as diabetes often leads to serious health problems like heart disease, high blood pressure, fatty liver disease, high cholesterol, stroke, kidney damage, vision problems and nerve damage. These conditions can develop at a younger age and progress faster in children than adults with diabetes, especially if not diagnosed and treated.

The main difference between type 1 and type 2 diabetes is how the body produces and uses insulin. Type 1 is considered an autoimmune disease where the body attacks its own insulin-producing cells. People with type 1 can’t produce their own insulin and must take insulin injections to manage their blood sugar level. With type 2, the body’s cells become resistant to insulin and are unable to absorb glucose or sugar from the blood stream to be used for energy. Lifestyle factors play a key role in developing type 2 diabetes.

Obesity is a major risk factor for developing type 2 diabetes at any age, but during the last three decades, the rate of childhood obesity has more than doubled in children and tripled in adolescents. According to data from the CDC, more than one third of U.S. children are overweight or obese. Childhood obesity is a complex condition with many contributing factors.

The standard U.S. diet often means larger portions, high calorie, nutrient poor foods that are ultra-processed, and sometimes a lack of healthier choices. Kids are more sedentary, spending far more time in front of screens such as phones, computers, TV or video games than outside playing games or sports. A family history of obesity and poor eating patterns contributes, as does not getting enough sleep, which can disrupt hormones that control appetite.

Overweight children may have prediabetes; their blood sugar levels are higher than normal but not yet high enough to meet criteria for diabetes. This is a critical warning sign that the child may develop type 2 diabetes if ignored. The good news is that prediabetes is reversible; most children can be cured at this point with lifestyle changes.

Other risk factors or warning signs for developing childhood type 2 diabetes besides obesity and family history are having high blood pressure, high cholesterol or having dark patches of skin around the neck, armpit or groin. Also, children of Latino, African American or Asian American descent are more at risk for developing diabetes. Children with a parent or grandparent with diabetes are far more likely to have diabetes than those who don’t have the same family history. This is a good reason why the whole family should exercise, eat a healthier diet and support each other.
Symptoms of diabetes can vary in children or be very subtle; some may not experience symptoms at all.
Some of the signs of diabetes in children include:

• Increased thirst or drinking more than usual over a period of time

• Frequent urination

• Increased hunger despite eating a normal amount

• Unexplained weight loss or gain that seems significant

• Unusual fatigue or feeling tired

• Blurred vision

• Slow healing wounds or infections

• Persistent dry mouth

• Strange smelling breath, especially a fruity smell

• Tingling or numbness in hands or feet

• Frequent yeast or urinary tract infections in girls

• Excessive moodiness or irritability

Parents can help prevent their children from getting type 2 diabetes by encouraging their child to get at least 60 minutes of physical activity a day, providing healthy foods and setting a good example when it comes to eating. Go for a walk or bike ride together as a family. Allow your child to participate in sports, dance or gymnastics. Make playing outside fun by providing balls, jump ropes or going to the park.

Tips parents can use to improve their child’s diet include:

• Don’t drink your calories. Limit sugary beverages like soda, coffees and sports drinks, and even fruit juices like orange juice.
• Avoid processed foods in favor of whole, fresh foods prepared at home. Skip fast food restaurants and anything from the grocery store that has a long list of unpronounceable ingredients (also known as ultra-processed foods).

• Limit portion sizes. Don’t eat from the bag or frequent all-you-can-eat restaurants or go back for seconds and thirds.

• Limit snacks between meals. Focus on eating nutritious foods that include healthy fats, a good amount of protein and fiber at mealtime.
• Learn the difference between a snack and a treat or dessert. For example, most granola bars contain lots of sugar and not much in the way of nutrition.

• Limit restaurant meals. The portion sizes are often distorted, and the food is often higher in calories than foods cooked at home.

For those with concerns about their child’s health, make an appointment with a pediatrician as soon as possible. A healthcare provider can perform tests to diagnose diabetes such as a random blood sugar test, a fasting blood sugar test, an A1C test or an oral glucose tolerance test. If the tests are positive, a treatment plan will be made.