Treatment

Treatment for type 2 diabetes is lifelong and includes:

• Healthy eating
• Regular physical activity
• Blood sugar monitoring
• Insulin or other medications
• Weight loss surgery

As your child grows and changes, so will his or her diabetes treatment plan. You'll work closely with your child's diabetes treatment team — doctor, certified diabetes educator and dietitian — to keep your child's blood sugar level as close to normal as possible in order to prevent complications later.

Blood sugar monitoring

Your doctor will let you know how often you need to check and record your child's blood sugar. Children who take insulin usually need to test more frequently, possibly three times a day or more. Checking your blood sugar usually requires finger sticks, although some blood glucose meters allow for testing at other sites. Testing is the only way to make sure that your child's blood sugar level remains within his or her target range — which may change as your child grows.

Healthy eating

Because kids are still growing, the focus is on slowing down weight gain instead of losing weight. Your child's dietitian will likely suggest that your child — and the rest of the family — consume fewer animal products and sweets.

Your dietitian is also likely to recommend that you:

• Eat lower calorie, lower fat foods
• Decrease portion sizes, and don't ask kids to finish everything on their plate
• Substitute a fruit or vegetable for a carbohydrate-rich food
• Replace high-calorie beverages, such as soft drinks or fruit juices, with water
• Eat at home more frequently instead of eating at restaurants
• Have kids help make meals
• Eat at the dinner table instead of in front of the TV

Physical activity

Physical activity lowers blood sugar. Encourage your child to get regular aerobic physical activity for at least an hour a day and, better yet, exercise with your child. Activity time doesn't have to be all at once — you can break it down into smaller chunks of time.

Medication

There are three medications that have been approved by the Food and Drug Administration for treating type 2 diabetes in children — metformin (Glumetza, others), liraglutide (Victoza) and insulin. Metformin is a pill and liraglutide and insulin are taken by injection.

Metformin reduces the amount of sugar a child's liver releases into the bloodstream between meals and helps the body's cells use insulin more effectively. Liraglutide helps the body release more insulin from the pancreas after meals, when blood sugar levels are higher. Both drugs may have digestive system side effects, such as nausea or diarrhea.

Insulin

Sometimes, insulin may also be needed if your child's blood sugar levels are very high. With lifestyle changes and other medications, your child may be able to be weaned off insulin.

There are a number of different insulins, but a long-acting insulin, such as insulin glargine (Lantus), is often used for type 2 diabetes in children. Insulin is typically delivered via a syringe or an insulin pen. An insulin pump programmed to dispense specific amounts of insulin might also be an option for children who need to take insulin more frequently.

Weight loss surgery

These procedures are not an option for everyone. But, for teens who are significantly obese — a BMI above 35 — having weight loss surgery may lead to a remission in type 2 diabetes.

Signs of trouble

Despite your best efforts, sometimes problems will arise. Certain short-term complications of type 2 diabetes — such as low blood sugar, high blood sugar and ketoacidosis — require immediate care.

Low blood sugar (hypoglycemia)

Hypoglycemia (sometimes called an "insulin reaction") is a blood sugar level below your child's target range. Blood sugar can drop for many reasons, including skipping a meal, eating fewer carbohydrates than you planned to, getting more physical activity than normal or injecting too much insulin. Children with type 2 diabetes have less risk of low blood sugar than do kids with type 1 diabetes.

Signs and symptoms of low blood sugar include:

• Pale complexion
• Sweating
• Shakiness
• Hunger
• Irritability
• Nervousness or anxiety

If your child has a low blood sugar reading:

• Give your child fruit juice (1/2 cup or 118 milliliters), glucose tablets, hard candy, regular (not diet) soda or another source of sugar
• Retest the blood sugar in about 15 minutes to make sure it has gone up into the normal range
• If the blood sugar is still low, re-treat with more sugar and then retest in another 15 minutes

High blood sugar (hyperglycemia)

Hyperglycemia is a blood sugar level above your child's target range. Blood sugar levels can rise for many reasons, including illness, eating too much, eating the wrong types of foods, and not taking enough diabetes medication or insulin.

Signs and symptoms of high blood sugar include:

• Frequent urination
• Increased thirst or dry mouth
• Blurred vision
• Fatigue
• Nausea

If you suspect hyperglycemia, check your child's blood sugar. You might need to adjust your child's meal plan or medications. If your child's blood sugar is persistently above his or her target range, call your child's doctor or seek emergency care.

Diabetes ketoacidosis

A severe lack of insulin causes your child's body to produce certain toxic acids (ketones). If excess ketones build up, your child may develop a potentially life-threatening condition known as diabetic ketoacidosis (DKA). DKA is more common in children with type 1 diabetes, but can sometimes occur in children with type 2 diabetes.

Signs and symptoms of DKA include:

• Thirst or very dry mouth
• Increased urination
• Exhaustion
• Nausea, vomiting or abdominal pain
• A sweet, fruity smell on your child's breath
• Confusion

If you suspect DKA, check your child's urine for excess ketones using over-the-counter ketone strips. If the ketone levels are high, call your child's doctor or seek emergency care.