Diagnosing Type 2 Diabetes In Children

Diagnosing Type 2 Diabetes In Children

It’s vital to diagnose type 2 diabetes in children promptly, to prevent complications, protect their future health and ensure they get the care and treatment they need. 

Some signs and symptoms can indicate that your child may have type 2 diabetes, but tests from your doctor can confirm the diagnosis. 

 

How do you diagnose type 2 diabetes in children?

 

The GP or paediatrician will diagnose diabetes from your child’s clinical history, an examination and blood tests. Common signs and symptoms of type 2 diabetes in children include: 

  • Passing more urine. They may go more frequently, get up at night to go to the loo, or start bed-wetting, having been dry at night
  • Feeling very thirsty, although they’re drinking plenty of fluids
  • They may seem weak, tired and lower in energy than usual
  • They may suddenly lose weight without trying
  • They may seem more hungry, even after meals
  • They may get repeated infections, including candida infections in their mouth, genitals or body creases
  • Any cuts, scrapes or grazes may take longer to heal
  • They may complain about blurred vision
  • They may complain of more vague symptoms like recurrent tummy pain or headaches
  • You may notice that they’re moody, develop new behavioural problems or start to perform less well at school
  • Their growth is impaired

 

When to suspect type 2 diabetes in children

 

Type 1 diabetes is more common in children than type 2 diabetes. However, more children and young people are developing type 2 diabetes. The management of type 1 and type 2 diabetes is different, so it’s crucial to get the correct diagnosis. 

Your doctor may suspect type 2 diabetes in your child or teenager if:

  • There is a strong history of type 2 diabetes in your family
  • They are obese
  • If they are of black or Asian origin. Type 2 diabetes is more common in certain races and ethnic groups
  • If they show signs of insulin resistance. Children and young people with type 2 diabetes may develop a thick, dark, velvety discolouration in their skin creases, armpits, elbows and groin- a condition called acanthosis nigricans. Polycystic ovary syndrome (PCOS) is often associated with insulin resistance in girls. They may have irregular or absent periods, excess facial and more hair growth on their bodies
  • They don’t need insulin or need less than 0.5 units/kg body weight/day to control their diabetes
  • They have no additional features that suggest type 1 diabetes, such as ketones in the urine

 

Tests for type 2 diabetes in children

 

If you are worried that your child may have diabetes, their GP or paediatrician will need to do blood tests to measure the concentration of glucose in their blood. They may do a finger-prick test to get an immediate indication of your child’s glucose levels. However, they will always do a blood test from a vein in their arm to confirm the results. If the finger-prick test is high, they may refer your child to a specialist hospital team for further tests and treatment.

They will consider a diagnosis of type 2 diabetes if their glucose levels are persistently high. This is defined as:

  • Fasting plasma glucose concentration (FPG) of 7.0mmol/L or more: 

The nurse or doctor will take this sample after your child has not eaten or drunk anything but water fasted for at least eight hours. It’s usually easiest to arrange this test first thing in the morning. 

  • Random venous plasma glucose concentration of 11.1 mmol/L or more:

The doctor or nurse can take the sample from your child at any time of the day.

The HbA1c is a blood test that shows your child’s average blood glucose levels over the previous two to three months. It is useful to monitor blood glucose control in children already known to have diabetes but shouldn’t be used to diagnose diabetes in children.

 

Can you test for type 2 diabetes at home?

 

Some home tests can indicate that your child may have diabetes but won’t confirm the diagnosis. In a child, it’s particularly important to get a quick and accurate diabetes diagnosis. You should always take your child to see your doctor and ask them to send a blood sample to the lab and ensure your child has a definitive diagnosis.

  • A simple finger-prick blood test can indicate raised blood sugar levels
  • Urine dipsticks will show if their kidneys are leaking glucose

 

If your child has type 2 diabetes, what happens next?

 

If your GP suspects that your child may have type 2 diabetes, they should arrange an immediate same-day referral to a multidisciplinary paediatric diabetes team in your local hospital. The team will confirm the diagnosis and provide immediate care.

Find out more about type 2 diabetes in children

For more information on diagnosing diabetes, or to speak to one of our specialists at the London Diabetes Centre, contact us today.

Sources:

https://cks.nice.org.uk/topics/diabetes-type-2/

https://www.nhs.uk/conditions/type-2-diabetes/getting-diagnosed/

https://www.nice.org.uk/guidance/ng18/chapter/Recommendations#type-2-diabetes

https://cks.nice.org.uk/topics/diabetes-type-2/diagnosis/diagnosis-in-children-young-people/

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