Type 2 diabetes in children

Last reviewed: 3 Sep 2022
Last updated: 26 Feb 2021

Summary

Definition

History and exam

Key diagnostic factors

  • presence of risk factors
  • acanthosis nigricans
  • polyuria
  • polydipsia
  • nocturia
More key diagnostic factors

Other diagnostic factors

  • hypertension
  • yeast infections
  • skin infections
  • urinary tract infections
  • fatigue
  • blurred vision
  • weight loss
Other diagnostic factors

Risk factors

  • obesity
  • genetic predisposition/family history
  • high-risk ethnic background
  • puberty
  • female sex
  • small for gestation age
  • rapid growth in infancy
  • diabetic in-utero environment
  • bottle feeding
  • high protein intake in infancy
  • polycystic ovaries
  • intra-myocellular lipid content
  • fat deposition in the liver
More risk factors

Diagnostic investigations

1st investigations to order

  • urine dipstick
  • random plasma glucose
  • fasting plasma glucose
  • HbA1c
  • autoantibodies to insulin, islet cell, glutamic acid decarboxylase, and zinc transporter 8
More 1st investigations to order

Investigations to consider

  • oral glucose tolerance test
  • C-peptide
More investigations to consider

Treatment algorithm

ACUTE

ketosis

severe hyperglycaemia: newly diagnosed

ONGOING

HbA1c 53-86 mmol/mol (7% to 10%)

HbA1c >86 mmol/mol (>10%)

Contributors

Authors

Paul Hiers, MD

Pediatric Endocrinology Fellow

Department of Pediatrics

University of Florida

Gainesville

FL

Disclosures

PH declares that he has no competing interests.

Jennifer Miller, MD
Jennifer Miller

Assistant Professor

Department of Pediatrics

University of Florida

Gainesville

FL

Disclosures

JM is an author of a reference cited in this topic.

Acknowledgements

Dr Paul Hiers and Dr Jennifer Miller wish to gratefully acknowledge Dr Arlan Rosenbloom, a previous contributor to this topic.

Disclosures

AR is an author of a number of references cited in this topic.

Peer reviewers

Julian P. Hamilton-Shield, MB, ChB, MD(Bristol), MRCP, FRCPCH, FRCPCH

Professor

Diabetes and Metabolic Endocrinology

School of Clinical Sciences

University of Bristol

UK

Disclosures

In the past, JPHS received speaking honoraria from Sanofi-Aventis, Roche, Abbott, Novo-Nordisk, and Nutricia. None of these talks were directly pertinent to the treatment of type 2 diabetes.

Kristen Nadeau, MD

Professor of Pediatrics

University of California

Sacramento

CA

Disclosures

KN declares that she has no competing interests.

Dennis Styne, MD

Professor of Pediatrics

Rumsey Chair of Pediatric Endocrinology

University of California

Sacramento

CA

Disclosures

DS declares that he has no competing interests.

  • Type 2 diabetes in children images
  • Differentials

    • Glucose intolerance
    • Type 1 diabetes mellitus (T1DM)
    • Monogenic diabetes
    More Differentials
  • Guidelines

    • Diabetes (type 1 and type 2) in children and young people: diagnosis and management
    • Type 2 diabetes in adults: management
    More Guidelines
  • Patient leaflets

    Diabetes: what is it?

    Diabetes type 2: what treatments work?

    More Patient leaflets
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