What are symptoms of type 2 diabetes in children? Type 2 diabetes is becoming increasingly common in children, and this is linked to a rise in obesity. However, the condition can be difficult to detect in children because it develops gradually. Symptoms, treatment, and prevention of type 2 diabetes are similar in children and adults. Learn more here. Read now
Glucagon is a hormone that causes the release of glucose from the liver (for example, it promotes gluconeogenesis). Glucagon can be lifesaving and every patient with diabetes who has a history of hypoglycemia (particularly those on insulin) should have a glucagon kit. Families and friends of those with diabetes need to be taught how to administer glucagon, since obviously the patients will not be able to do it themselves in an emergency situation. Another lifesaving device that should be mentioned is very simple; a medic-alert bracelet should be worn by all patients with diabetes.
2.Retinopathy - Diabetes may cause blood vessels in the retina (the light sensitive lining of the eye) to become leaky, blocked, or grow abnormally [Figure 1]. Retinopathy is rare before the age of 10 and the risk increases with the length of time a person has diabetes. Treatments such as laser, injections in the eye, or other procedures may be helpful to prevent visual loss or restore sight. The longer a patient has diabetes, the greater chance of developing an eye problem.  All patients with diabetes are at risk for developing retinopathy, but the risk is higher for patients with worse blood sugar control.  Early retinopathy may have no symptoms, but early treatment is essential to prevent any loss of vision.

A person of Asian origin aged 35 yr or more with two or more of the above risk factors, should undergo a screening test for diabetes. An oral glucose tolerance test (OGTT) is commonly used as the screening test10. Fasting and 2 h post glucose tests can identify impaired fasting glucose (IFG) (fasting glucose >110 - <125 mg/dl), impaired glucose tolerance (IGT) (2 h glucose >140-<200 mg/dl) and presence of diabetes (fasting > 126 and 2 h glucose >200 mg/dl). If a random blood glucose value is > 150 mg/dl, further confirmation by an OGTT is warranted. Recently, glycosylated haemoglobin (HbA1c) has been recommended as the test for diagnosis of diabetes (>6.5%). Presence of pre-diabetes is indicated by HbA1c values between 5.7 - 6.4 per cent11.

How is it treated? There is no uniform therapy for type 2 diabetes treatment, which depends on the individual person and his or her stage of type 2 diabetes. To learn more about individualization of therapy, please read our patient guide. That said, the ADA and EASD have created treatment recommendation guidelines for type 2 diabetes progression. In all cases, healthy eating, exercise, and weight management are key to effective type 2 diabetes management. As type 2 diabetes progresses, patients may need to add one or more drugs to their treatment regimen.
Type 1 diabetes is always treated with insulin, a life-saving treatment. Patients will need to take insulin several times a day for the rest of their lives. They will usually learn how to self-administer this. Insulin is usually given through injections under the skin, normally two to four times a day. An increasing number of patients with type 1 diabetes are being treated with ‘insulin pumps’, which provide a continuous supply of insulin. 
Talking to a counselor or therapist may help you cope with the lifestyle changes that come with a type 2 diabetes diagnosis. You may find encouragement and understanding in a type 2 diabetes support group. Although support groups aren't for everyone, they can be good sources of information. Group members often know about the latest treatments and tend to share their own experiences or helpful information, such as where to find carbohydrate counts for your favorite takeout restaurant. If you're interested, your doctor may be able to recommend a group in your area.

Insulin is only recommended for individuals for type 2 diabetics when they have not been able to get blood sugars low enough to prevent complications through other means. To avoid insulin, those with this health condition should work very hard to follow a healthy eating plan that includes a lot of vegetables and lean proteins, exercise every day, and keep stress in perspective. They also should take their oral drugs regularly. It can be difficult to follow these recommendations and the help of your doctor, nutritionist, diabetes educator, health coach, or integrative medicine practitioner may be helpful. If you who want to avoid taking medicine, work with health professionals who are knowledgeable about lifestyle medicine, and can help you understand how to fit the changes into your life.
A growing number of people in the U.S. and throughout the world are overweight and more prone to develop Type 2 diabetes, particularly if they have the genetics for it. "Type 2 diabetes can be caused by genetic inheritance, but by far the obesity epidemic has created massive increases in the occurrence of Type 2 diabetes. This is due to the major insulin resistance that is created by obesity," Gage says.
People with diabetes aim for a hemoglobin A1C level of less than 7%. Achieving this level is difficult, but the lower the hemoglobin A1C level, the less likely people are to have complications. Doctors may recommend a slightly higher or lower target for certain people depending on their particular health situation. However, levels above 9% show poor control, and levels above 12% show very poor control. Most doctors who specialize in diabetes care recommend that hemoglobin A1C be measured every 3 to 6 months.
A type 2 diabetes diet or a type 2 diabetic diet is important for blood sugar (glucose) control in people with diabetes to prevent complications of diabetes. There are a variety of type 2 diabetes diet eating plans such as the Mediterranean diet, Paleo diet, ADA Diabetes Diet, and vegetarian diets.Learn about low and high glycemic index foods, what foods to eat, and what foods to avoid if you have type 2 diabetes.
Impaired glucose tolerance (IGT) and impaired fasting glycaemia (IFG) refer to levels of blood glucose concentration above the normal range, but below those which are diagnostic for diabetes. Subjects with IGT and/or IFG are at substantially higher risk of developing diabetes and cardiovascular disease than those with normal glucose tolerance. The benefits of clinical intervention in subjects with moderate glucose intolerance is a topic of much current interest.
The body obtains glucose from three main sources: the intestinal absorption of food; the breakdown of glycogen (glycogenolysis), the storage form of glucose found in the liver; and gluconeogenesis, the generation of glucose from non-carbohydrate substrates in the body.[60] Insulin plays a critical role in balancing glucose levels in the body. Insulin can inhibit the breakdown of glycogen or the process of gluconeogenesis, it can stimulate the transport of glucose into fat and muscle cells, and it can stimulate the storage of glucose in the form of glycogen.[60]
^ Jump up to: a b c d Inzucchi, SE; Bergenstal, RM; Buse, JB; Diamant, M; Ferrannini, E; Nauck, M; Peters, AL; Tsapas, A; Wender, R; Matthews, DR (March 2015). "Management of hyperglycaemia in type 2 diabetes, 2015: a patient-centred approach. Update to a Position Statement of the American Diabetes Association and the European Association for the Study of Diabetes". Diabetologia. 58 (3): 429–42. doi:10.1007/s00125-014-3460-0. PMID 25583541.

Low testosterone (low-T) can be caused by conditions such as type 2 diabetes, obesity, liver or kidney disease, hormonal disorders, certain infections, and hypogonadism. Signs and symptoms that a person may have low-T include insomnia, increased body fat, weight gain, reduced muscle, infertility, decreased sex drive, depression, and worsening of congestive heart failure or sleep apnea.
Low blood sugar (hypoglycemia). If your blood sugar level drops below your target range, it's known as low blood sugar (hypoglycemia). Your blood sugar level can drop for many reasons, including skipping a meal, inadvertently taking more medication than usual or getting more physical activity than normal. Low blood sugar is most likely if you take glucose-lowering medications that promote the secretion of insulin or if you're taking insulin.
A study by Dabelea et al found that in teenagers and young adults in whom diabetes mellitus had been diagnosed during childhood or adolescence, diabetes-related complications and comorbidities—including diabetic kidney disease, retinopathy, and peripheral neuropathy (but not arterial stiffness or hypertension)—were more prevalent in those with type 2 diabetes than in those with type 1 disease. [44]
Most pediatric patients with diabetes have type 1 diabetes mellitus (T1DM) and a lifetime dependence on exogenous insulin. Diabetes mellitus (DM) is a chronic metabolic disorder caused by an absolute or relative deficiency of insulin, an anabolic hormone. Insulin is produced by the beta cells of the islets of Langerhans located in the pancreas, and the absence, destruction, or other loss of these cells results in type 1 diabetes (insulin-dependent diabetes mellitus [IDDM]). A possible mechanism for the development of type 1 diabetes is shown in the image below. (See Etiology.)
The classic presenting symptoms of type 1 diabetes mellitus are discussed below. For some children, the first symptoms of diabetes mellitus are those of diabetic ketoacidosis. This is a serious and life-threatening condition, requiring immediate treatment. Ketoacidosis occurs due to a severe disturbance in the body’s metabolism. Without insulin, glucose cannot be taken up into cells. Instead fats are broken down for energy which can have acid by-products.  

Jump up ^ Haw JS, Galaviz KI, Straus AN, Kowalski AJ, Magee MJ, Weber MB, Wei J, Narayan KM, Ali MK (December 2017). "Long-term Sustainability of Diabetes Prevention Approaches: A Systematic Review and Meta-analysis of Randomized Clinical Trials". JAMA Internal Medicine. 177 (12): 1808–1817. doi:10.1001/jamainternmed.2017.6040. PMC 5820728. PMID 29114778.


When the blood glucose level rises above 160 to 180 mg/dL, glucose spills into the urine. When the level of glucose in the urine rises even higher, the kidneys excrete additional water to dilute the large amount of glucose. Because the kidneys produce excessive urine, people with diabetes urinate large volumes frequently (polyuria). The excessive urination creates abnormal thirst (polydipsia). Because excessive calories are lost in the urine, people may lose weight. To compensate, people often feel excessively hungry.
The typical symptoms of diabetes mellitus are the three “polys:” polyuria, polydipsia, and polyphagia. Because of insulin deficiency, the assimilation and storage of glucose in muscle adipose tissues, and the liver is greatly diminished. This produces an accumulation of glucose in the blood and creates an increase in its osmolarity. In response to this increased osmotic pressure there is depletion of intracellular water and osmotic diuresis. The water loss creates intense thirst and increased urination. The increased appetite (polyphagia) is not as clearly understood. It may be the result of the body's effort to increase its supply of energy foods even though eating more carbohydrates in the absence of sufficient insulin does not meet the energy needs of the cells.
Jump up ^ O'Gara PT, Kushner FG, Ascheim DD, Casey DE, Chung MK, de Lemos JA, Ettinger SM, Fang JC, Fesmire FM, Franklin BA, Granger CB, Krumholz HM, Linderbaum JA, Morrow DA, Newby LK, Ornato JP, Ou N, Radford MJ, Tamis-Holland JE, Tommaso CL, Tracy CM, Woo YJ, Zhao DX, Anderson JL, Jacobs AK, Halperin JL, Albert NM, Brindis RG, Creager MA, DeMets D, Guyton RA, Hochman JS, Kovacs RJ, Kushner FG, Ohman EM, Stevenson WG, Yancy CW (January 2013). "2013 ACCF/AHA guideline for the management of ST-elevation myocardial infarction: a report of the American College of Cardiology Foundation/American Heart Association Task Force on Practice Guidelines". Circulation. 127 (4): e362–425. doi:10.1161/CIR.0b013e3182742cf6. PMID 23247304.
Adrenal Disease Chapter Anatomy Chapter Dermatology Chapter Diabetes Mellitus Chapter Examination Chapter Gastroenterology Chapter General Chapter Geriatric Medicine Chapter Growth Disorders Chapter Hematology and Oncology Chapter Hypoglycemic Disorders Chapter Infectious Disease Chapter Metabolic Disorders Chapter Neonatology Chapter Nephrology Chapter Neurology Chapter Obesity Chapter Obstetrics Chapter Ophthalmology Chapter Parathyroid Disease Chapter Pathology and Laboratory Medicine Chapter Pediatrics Chapter Pharmacology Chapter Pituitary Disease Chapter Prevention Chapter Radiology Chapter Sexual Development Chapter Sports Medicine Chapter Surgery Chapter Symptoms Chapter Thyroid Disease Chapter

Diabetes mellitus is a chronic disease, for which there is no known cure except in very specific situations.[75] Management concentrates on keeping blood sugar levels as close to normal, without causing low blood sugar. This can usually be accomplished with a healthy diet, exercise, weight loss, and use of appropriate medications (insulin in the case of type 1 diabetes; oral medications, as well as possibly insulin, in type 2 diabetes).[medical citation needed]
Awareness about the signs and symptoms and periodic screening especially in the presence of risk factors and warning signs of diabetes, would go a long way in preventing new cases of diabetes by providing an opportunity to intervene at the stage of prediabetes. It is evident that diabetes can be prevented among prediabetic individuals by improvements in physical activity and diet habits. Such strategies will also prevent development of diabetic complications to a great extent. Patient empowerment is vital in diabetes management. This can be done through patient education and sharing information on management and preventive aspects of diabetes.
Unlike many health conditions, diabetes is managed mostly by you, with support from your health care team (including your primary care doctor, foot doctor, dentist, eye doctor, registered dietitian nutritionist, diabetes educator, and pharmacist), family, and other important people in your life. Managing diabetes can be challenging, but everything you do to improve your health is worth it!
If eaten as part of a healthy meal plan, or combined with exercise, sweets and desserts can be eaten by people with diabetes. They are no more "off limits" to people with diabetes than they are to people without diabetes. The key to sweets is to have a very small portion and save them for special occasions so you focus your meal on more healthful foods.
There is strong evidence that the long-term complications are related to the degree and duration of metabolic disturbances.2 These considerations form the basis of standard and innovative therapeutic approaches to this disease that include newer pharmacologic formulations of insulin, delivery by traditional and more physiologic means, and evolving methods to continuously monitor blood glucose to maintain it within desired limits by linking these features to algorithm-driven insulin delivery pumps for an “artificial pancreas.”
Type 2 diabetes is a condition of blood sugar dysregulation. In general blood sugar is too high, but it also can be too low. This can happen if you take medications then skip a meal. Blood sugar also can rise very quickly after a high glycemic index meal, and then fall a few hours later, plummeting into hypoglycemia (low blood sugar). The signs and symptoms of hypoglycemia can include
Management. There is no cure for diabetes; the goal of treatment is to maintain blood glucose and lipid levels within normal limits and to prevent complications. In general, good control is achieved when the following occur: fasting plasma glucose is within a specific range (set by health care providers and the individual), glycosylated hemoglobin tests show that blood sugar levels have stayed within normal limits from one testing period to the next, the patient's weight is normal, blood lipids remain within normal limits, and the patient has a sense of health and well-being.
Patients who suffer from diabetes have a lifelong struggle to attain and maintain blood glucose levels as close to the normal range as possible. With appropriate blood sugar control, the risk of both microvascular (small blood vessel) and neuropathic (nerve) complications is decreased markedly. Additionally, if hypertension (high blood pressure) and hyperlipidemia (high cholesterol) are treated promptly and aggressively, the risk of cardiovascular complications should decrease as well.

Type 2 diabetes: Type 2 diabetes affects the way the body uses insulin. While the body still makes insulin, unlike in type I, the cells in the body do not respond to it as effectively as they once did. This is the most common type of diabetes, according to the National Institute of Diabetes and Digestive and Kidney Diseases, and it has strong links with obesity.
Type II is considered a milder form of diabetes because of its slow onset (sometimes developing over the course of several years) and because it usually can be controlled with diet and oral medication. The consequences of uncontrolled and untreated Type II diabetes, however, are the just as serious as those for Type I. This form is also called noninsulin-dependent diabetes, a term that is somewhat misleading. Many people with Type II diabetes can control the condition with diet and oral medications, however, insulin injections are sometimes necessary if treatment with diet and oral medication is not working.
Sugary breath isn’t as sweet as it seems.  Diabetics often notice that they’ve developed sweet or nail-polish-like breath before they’re diagnosed. However, if you’re dealing with this strange symptom, time is of the essence. Sweet breath is often a sign of diabetic ketoacidosis, a condition in which your body can’t effectively convert glucose into energy, keeping your blood sugar at dangerous—potentially fatal—levels if untreated.
The body will attempt to dilute the high level of glucose in the blood, a condition called hyperglycemia, by drawing water out of the cells and into the bloodstream in an effort to dilute the sugar and excrete it in the urine. It is not unusual for people with undiagnosed diabetes to be constantly thirsty, drink large quantities of water, and urinate frequently as their bodies try to get rid of the extra glucose. This creates high levels of glucose in the urine.
Autonomic changes involving cardiovascular control (eg, heart rate, postural responses) have been described in as many as 40% of children with diabetes. Cardiovascular control changes become more likely with increasing duration and worsening control. [18] In a study by 253 patients with type 1 diabetes (mean age at baseline 14.4 y), Cho et al reported that the prevalence of cardiac autonomic dysfunction increases in association with higher body mass index and central adiposity. [19]
When the blood glucose level rises above 160 to 180 mg/dL, glucose spills into the urine. When the level of glucose in the urine rises even higher, the kidneys excrete additional water to dilute the large amount of glucose. Because the kidneys produce excessive urine, people with diabetes urinate large volumes frequently (polyuria). The excessive urination creates abnormal thirst (polydipsia). Because excessive calories are lost in the urine, people may lose weight. To compensate, people often feel excessively hungry.
On behalf of the millions of Americans who live with or are at risk for diabetes, we are committed to helping you understand this chronic disease. Help us set the record straight and educate the world about diabetes and its risk factors by sharing the common questions and answers below. If you're new to type 2 diabetes, join our Living With Type 2 Diabetes program to get more facts.
Jump up ^ Rubino, F; Nathan, DM; Eckel, RH; Schauer, PR; Alberti, KG; Zimmet, PZ; Del Prato, S; Ji, L; Sadikot, SM; Herman, WH; Amiel, SA; Kaplan, LM; Taroncher-Oldenburg, G; Cummings, DE; Delegates of the 2nd Diabetes Surgery, Summit (June 2016). "Metabolic Surgery in the Treatment Algorithm for Type 2 Diabetes: A Joint Statement by International Diabetes Organizations". Diabetes Care. 39 (6): 861–77. doi:10.2337/dc16-0236. PMID 27222544.
Diabetes is a chronic condition, and it can last an entire lifetime. The goal of treating diabetes is to keep blood glucose levels as close to a normal range as possible. This prevents the symptoms of diabetes and the long-term complications of the condition. If you've been diagnosed with diabetes, your doctor – working with the members of your diabetes care team – will help you find your target blood glucose levels.
Clinical Manifestations. Diabetes mellitus can present a wide variety of symptoms, from none at all to profound ketosis and coma. If the disease manifests itself late in life, patients may not know they have it until it is discovered during a routine examination, or when the symptoms of chronic vascular disease, insidious renal failure, or impaired vision cause them to seek medical help.
If you’re getting a good night’s rest but still find yourself so tired you can barely function, it’s definitely worth mentioning to your doctor. Diabetes often wreaks havoc on a person’s normal blood sugar levels, causing fatigue in the process. In later stages, the tissue death associated with untreated diabetes can also limit circulation, meaning oxygenated blood isn’t being effectively transported to your vital organs, making your body work harder and tiring you out along the way.
George P Chrousos, MD, FAAP, MACP, MACE, FRCP(London) is a member of the following medical societies: American Academy of Pediatrics, American College of Physicians, American Pediatric Society, American Society for Clinical Investigation, Association of American Physicians, Endocrine Society, Pediatric Endocrine Society, Society for Pediatric Research, American College of Endocrinology
Diet, exercise, and education are the cornerstones of treatment of diabetes and often the first recommendations for people with mild diabetes. Weight loss is important for people who are overweight. People who continue to have elevated blood glucose levels despite lifestyle changes, or have very high blood glucose levels and people with type 1 diabetes (no matter their blood glucose levels) also require drugs.

Doctors, pharmacists, and other health-care professionals use abbreviations, acronyms, and other terminology for instructions and information in regard to a patient's health condition, prescription drugs they are to take, or medical procedures that have been ordered. There is no approved this list of common medical abbreviations, acronyms, and terminology used by doctors and other health- care professionals. You can use this list of medical abbreviations and acronyms written by our doctors the next time you can't understand what is on your prescription package, blood test results, or medical procedure orders. Examples include:

Insulin is a hormone produced by the beta cells within the pancreas in response to the intake of food. The role of insulin is to lower blood sugar (glucose) levels by allowing cells in the muscle, liver and fat to take up sugar from the bloodstream that has been absorbed from food, and store it away as energy. In type 1 diabetes (previously called insulin-dependent diabetes mellitus), the insulin-producing cells are destroyed and the body is not able to produce insulin naturally. This means that sugar is not stored away but is constantly released from energy stores giving rise to high sugar levels in the blood. This in turn causes dehydration and thirst (because the high glucose ‘spills over’ into the urine and pulls water out of the body at the same time). To exacerbate the problem, because the body is not making insulin it ‘thinks’ that it is starving so does everything it can to release even more stores of energy into the bloodstream. So, if left untreated, patients become increasingly unwell, lose weight, and develop a condition called diabetic ketoacidosis, which is due to the excessive release of acidic energy stores and causes severe changes to how energy is used and stored in the body.
Keeping track of the number of calories provided by different foods can become complicated, so patients usually are advised to consult a nutritionist or dietitian. An individualized, easy to manage diet plan can be set up for each patient. Both the American Diabetes Association and the American Dietetic Association recommend diets based on the use of food exchange lists. Each food exchange contains a known amount of calories in the form of protein, fat, or carbohydrate. A patient's diet plan will consist of a certain number of exchanges from each food category (meat or protein, fruits, breads and starches, vegetables, and fats) to be eaten at meal times and as snacks. Patients have flexibility in choosing which foods they eat as long as they stick with the number of exchanges prescribed.

The good news is that behavior still seems to help shape whether someone with the genetic disposition actually develops type 2—and that changes in diet and exercise can sometimes be enough to ward off the disease. "People sometimes have the misconception that if we say something is genetic, then they can't do anything about preventing diabetes and its complications," says Hanis. But he notes that in a landmark study, lifestyle interventions prevented or delayed type 2 in nearly 60 percent of people at high risk. "If we focus on changing the environment, we can prevent diabetes," he says. "As we understand the genetics, we can prevent more of it."

It is recommended that all people with type 2 diabetes get regular eye examination.[13] There is weak evidence suggesting that treating gum disease by scaling and root planing may result in a small short-term improvement in blood sugar levels for people with diabetes.[79] There is no evidence to suggest that this improvement in blood sugar levels is maintained longer than 4 months.[79] There is also not enough evidence to determine if medications to treat gum disease are effective at lowering blood sugar levels.[79]


The ketogenic, or keto, diet calls for dramatically increasing your fat intake and consuming a moderate amount of protein and a very low amount of carbs, with the aim of kicking your body into a natural metabolic state called ketosis, in which it relies on burning fat rather than carbs for energy. Ketosis is different from diabetic ketoacidosis, a health emergency that occurs when insulin levels are low in conjunction with high levels of ketones. (37) Ketones are by-products of metabolism that are released in the blood when carb intake is low.
Diabetes insipidus is considered very rare in less 20,000 cases diagnosed per year. Diabetes mellitus is more common, with type 2 diabetes being more common than type 1. There are more than 3 million cases of type 2 diabetes. Unlike diabetes mellitus, diabetes insipidus is not treated by controlling insulin levels. Depending on your symptoms, your doctor may prescribe a low-salt diet, hormone therapy, or have you increase your water intake. 
People with full-blown type 2 diabetes are not able to use the hormone insulin properly, and have what’s called insulin resistance. Insulin is necessary for glucose, or sugar, to get from your blood into your cells to be used for energy. When there is not enough insulin — or when the hormone doesn’t function as it should — glucose accumulates in the blood instead of being used by the cells. This sugar accumulation may lead to the aforementioned complications.
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