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Type 2 Diabetes in Children (cont.)

Exams and Tests

Many children have had no symptoms before they are diagnosed with type 2 diabetes. Usually, the illness is discovered when a blood or urine test taken for another reason shows diabetes.

A doctor may want to assess your child for type 2 diabetes if he or she has a body mass index (BMI) or weight above the 85th percentile for his or her age and gender or weighs more than 120% of ideal and has any two of these risk factors:3

  • Family history of type 2 diabetes
  • Being a Native American, African American, Latino, Asian American, or Pacific Islander
  • Signs of not being able to use insulin properly (insulin resistance) or conditions associated with it, such as:

Some children have very high blood sugar levels at the time of diagnosis. A child with very high blood sugar can become confused, sleepy, or unconscious, and may develop diabetic ketoacidosis (DKA), which is an emergency. DKA is most common in people with type 1 diabetes and in some African-American people who have type 2 diabetes.

If a doctor suspects that your child may have type 2 diabetes, he or she will do a medical history, physical exam, and blood glucose testing. If the results of these tests meet the criteria for diagnosing diabetes established by the American Diabetes Association (ADA), your child has diabetes.

If a child has no diabetes symptoms, two blood tests done on separate days are needed to confirm the diagnosis. Tests used to diagnose diabetes are:

  • A hemoglobin A1c test. This test estimates blood sugar for the past 2 to 3 months.
  • A blood glucose test. A fasting blood sugar test (done after not eating or drinking for 8 hours) is preferred.
  • A glucose tolerance test. The child has a fasting blood sugar test and then drinks a sweet liquid with a certain amount of glucose in it. The child's blood sugar is tested two hours later.

Other possible tests

If it is hard to tell whether your child has type 2 or type 1 diabetes, your doctor may do a C-peptide test or an autoantibodies test. (Autoantibodies are produced when the body's immune system does not work right.) These tests may not be able to confirm the type of diabetes your child has. Getting a definite diagnosis may take months or years. In either case, your child's sugar levels will need to be controlled right away.

Sometimes a doctor will do a quick home blood sugar test or a urine test for sugar to see whether a child may have diabetes. Although these tests are simple and can show possible diabetes, additional testing is needed to make sure your child actually has the disease.

Monitoring tests if diagnosed with diabetes

Because your child is at risk for diabetes complications (eye, heart, kidney, nerve, liver, and blood vessel problems), he or she needs to see a doctor regularly throughout life.3

Kinds and frequency of tests and examinations for type 2 diabetes3


Exams and tests

Every 3–6 months

  • Have a medical checkup to review blood sugar levels since the last checkup and evaluate whether your child's treatment plan needs to be changed. Bring your child's home blood sugar records to this appointment. Keep a record with notes of special issues such as changes in diet, in activity, and when your child has low blood sugar problems. Bring this record to the appointment too. During each visit, the doctor will check your child's blood pressure.
  • Have a hemoglobin A1c or similar blood test (glycosylated hemoglobin or glycohemoglobin) to estimate your child's average blood sugar level over the previous 2 to 3 months. This test may be done every 3 to 6 months.
  • Your child may need to have a blood sugar test (blood glucose test). If so, you may want to run a home blood sugar test when your doctor draws blood for the test. This is a good way to check the accuracy of your home meter.
Every 6 months
  • Have a dental exam to check for gum problems.
Every year
  • See an eye specialist (an ophthalmologist or an optometrist) for an exam. If your child is at low risk for vision problems, your doctor may consider follow-up exams every 2 years.
  • Have a screening test for kidney function. Urine tests look for the amount of protein in the urine (proteinuria), an indicator of kidney damage. Typically, you give a single urine sample, to test for an albumin-to-creatinine ratio.
  • Your child may need a thorough medical examination of his or her feet at least once a year. Yearly foot exams are recommended for all people with diabetes. And it may help your child understand the importance of proper foot care.4
  • At the time of diagnosis and as needed
  • Have a cholesterol and triglyceride level test to see whether diabetes may be raising the cholesterol level in your child's bloodstream.
  • Have liver enzymes tested to see whether diabetes and obesity may be harming liver function.

Early detection

Starting at age 10 or at the beginning of puberty, a child who has a body mass index (BMI) in the 85th percentile or higher for his or her age or whose weight is more than 120% of ideal and has two of the following risk factors needs to be tested for diabetes every 3 years:3

  • Family history of type 2 diabetes
  • Being a Native American, African American, Latino, Asian American, or Pacific Islander
  • Signs of not being able to use insulin properly (insulin resistance) or conditions associated with it, such as:

If the results of a glucose test show that your child's blood sugar is higher than normal but not yet at the level of diabetes (prediabetes), the test should be repeated 3 months later to see whether your child has developed diabetes.1 If your child eats a healthy diet and gets regular exercise, he or she may not develop diabetes.

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