Type 2 diabetes is increasing alarmingly in recent years, and not only in adults, but also in children and adolescents. This increase is closely related to childhood overweight and obesity.This is compounded by an increasingly sedentary lifestyle and an abundance of ultra-processed foods. Type 2 diabetes is a disorder in which the body is unable to produce enough insulin or use it properly to convert glucose from food into energy. A disease once considered almost exclusively an adult condition is now beginning to affect children and adolescents as well, with significant consequences for their present and future health.
Understanding what this disease is, why it appears at early ages, which children are at higher risk, and what we can do at home and with the help of the pediatrician to prevent or detect it early is fundamental. Families have a key role in the prevention of type 2 diabetesAnd small changes maintained over time can make a big difference.
Types of diabetes in children
We can find mainly two types of diabetes in childhood: type 1 diabetes and type 2 diabetes. Diabetes in children Type 1 diabetes is known as juvenile diabetes and usually begins suddenly with weight loss, excessive thirst, and frequent urination. It can occur in people who are thin or of normal weight. Type 1 diabetes occurs due to a near-total lack of insulin because the immune system destroys the pancreatic cells that produce it, so it must always be treated with insulin injections and cannot be prevented with current knowledge.
Type 2 diabetes can also appear in childhood and adolescence, and it usually occurs in people who are overweight and/or have a sedentary lifestyle, although not exclusively. In type 2 diabetes there is insulin resistanceThe body produces it, but the cells don't use it properly, or not enough is produced to meet the body's needs. Type 2 diabetes often starts slowly: children may have vague symptoms or no symptoms at all, which sometimes means it goes undetected for years.
Some people can manage their type 2 diabetes with a healthy diet and exercise, but others need to take diabetes pills or insulin as directed by their doctor. Without proper control, excess blood glucose can damage the eyes, kidneys, nerves, heart, and blood vessels. over time.
Type 1 diabetes cannot be prevented with current knowledge, while Type 2 diabetes can significantly reduce the risk of developing it with changes in diet, exercise, and lifestyle from childhood. The earlier these healthy habits are started, the greater the chances of preventing the disease or delaying it for many years.
Children at risk for type 2 diabetes
Not all children have the same risk of developing type 2 diabetes. There are genetic, family, hormonal, and lifestyle factors. which make some children more vulnerable. Although it is not possible to change genetic inheritance, it is possible to act on many modifiable factors, such as weight, diet, daily movement, and rest.
Children who have increased risk of developing type 2 diabetes are:
- Children who are overweight or obeseespecially when fat accumulates in the abdominal area, as it promotes insulin resistance.
- Children and adolescents who do very little physical activity and spend many hours sitting or in front of screens, which increases the risk even if their weight is still normal.
- Having parents or close blood relatives with type 2 diabetes (parents, grandparents, or siblings) indicates a family genetic predisposition , which is important.
- Having higher than normal levels of glucose in the blood, or having high levels of blood pressure, cholesterol, or triglycerides, which is known as metabolic syndrome.
- Having had low or high birth weight, or having been born prematurely, situations related to subsequent changes in glucose metabolism.
- Children whose mother had gestational diabetes during pregnancy, as this increases the risk of metabolic disorders in childhood.
- Women with polycystic ovary syndrome, since increases insulin resistance and is associated with a higher probability of type 2 diabetes.
- Belonging to population groups at higher risk (for example, in some countries a higher risk has been observed in populations of Latin, African or Asian origin).
In children with several of these risk factors combined, regular pediatric check-ups and blood tests These tests are especially important because they allow for the early detection of conditions like prediabetes and enable intervention before the disease fully develops. A simple fasting glucose test or a glycated hemoglobin (HbA1c) test may be sufficient to assess the situation and determine if more intensive measures are necessary.
In addition, some children may exhibit physical signs associated with insulin resistance, such as areas of darker, thickened skin around the neck or armpits (acanthosis nigricans). If you notice these patches and your child is overweight, it's advisable to discuss it with your pediatrician to consider a more comprehensive metabolic evaluation.
Prevention of type 2 diabetes in children
Children and adolescents may be able to prevent type 2 diabetes or delay its onset for many years by making small changes in their daily lives. These small changes can make a big difference to your healthEven moderate weight loss in overweight children can help reduce the risk of developing diabetes, improve blood pressure, and normalize blood lipid levels.
Weight loss is a delicate matter in childhood and adolescence, so it should always be approached as a process to gain health, never as a strict diet, and, when necessary, with the support of nutrition and pediatric professionals, and monitoring of the signs of eating disorder. In many cases, It is enough to stop the weight gain while the child continues to grow in height. so that the body mass index improves naturally.
The most effective prevention strategies are based on three mutually reinforcing pillars: healthy eating, regular physical activity, and a good night's sleepIn addition to this, it is important to control screen time, provide health education, and offer emotional support to the child, since chronic stress also contributes to hormonal dysregulation and weight gain.
Below you will find practical tips for the whole family, since the example set by adults is crucial for children. When parents take care of their diet, exercise, and prioritize rest, Children are more likely to adopt those habits without experiencing them as an obligation.
Lose weight with a healthy diet
It is necessary to make some changes to the eating habits of the whole family, so that the child does not feel singled out and everyone benefits. A balanced diet helps control weight and keep blood glucose levels stable.as well as preventing other chronic diseases such as hypertension or high cholesterol.
Scientific evidence shows that dietary patterns rich in fruits, vegetables, whole grains, legumes, and plant-based proteins are associated with a lower risk of developing type 2 diabetes, while habitual consumption of sugary drinks and ultra-processed foods This clearly increases that risk. That's why it's so important to check what you eat at home every day.
Some helpful recommendations are:
- Drink enough water every dayOffer water with meals, snacks, and throughout the day. Avoid using juices or soft drinks as your regular beverage.
- Limit sugary drinks as much as possible (sodas, packaged juices, sports drinks, commercial smoothies or sugary coffee), since They provide many calories and almost no nutrients.For thirst, water is always the best thing.
- Eat more fresh fruits and vegetables daily, including them in all main meals and snacks. Ideally, aim for at least five servings of fruits and vegetables per day.
- Eat healthy snacks instead of less healthy options. For example, offer carrots, cucumber, apple, tangerine, banana, or grapes mid-morning or between meals instead of pastries, cookies, or salty snacks.
- Avoid fast food and... ultra-processed products rich in sugars, saturated fats and salt, such as industrial pastries, ready-made meals, fatty sausages and packaged sweets.
- Choose foods that are grilled, baked, steamed, or stewed with little fat, prioritizing cooking methods without frying.
- Avoid fried or highly processed foods, such as salty snacks, potato chips, breaded snacks, and fast food.
- Choose whole-grain and low-fat foods: whole-grain bread, brown rice, whole-grain pasta, legumes, and semi-skimmed or skimmed dairy products as recommended by the pediatrician.
- Avoid eating fried potatoes frequently; it's better to have baked potatoes or boiled potatoes with a little extra virgin olive oil.
- Fill your plates with more vegetables than other types of foodusing the visual rule of half a plate of vegetables, a quarter of a plate of whole grains and a quarter of healthy protein (eggs, fish, legumes, lean meat or tofu).
In addition, it is advisable to increase the consumption of foods high in fiber such as legumes (lentils, chickpeas, beans), natural nuts in small quantities, and whole grains. Fiber helps glucose enter the bloodstream more slowly.It promotes satiety, improves intestinal transit, and contributes to weight control.
It is also useful to learn to read the nutritional labels of the products to identify the amount of added sugars and saturated fats per serving. In this way, children and teenagers can develop a critical eye towards packaged foods and make healthier choices when eating out or choosing a snack.
In children at high risk, it is recommended that the pediatrician assess the need to refer the child to a pediatric dietitian-nutritionist. Each child has specific needs depending on their age, physical activity, family situation and possible associated illnesses, so the nutrition plan must be personalized, for example if Your teenage son wants to be a vegetarian or follows any special guidelines. A tailored plan increases adherence and makes the changes sustainable in the long term.
Lose weight avoiding a sedentary life
La sedentary life It's a major problem for anyone because, in the long run, it can lead to serious health problems, both physical and emotional. Spending many hours sitting in front of screens or without moving around promotes weight gain, worsens physical condition, and increases insulin resistance. Therefore, it's essential that a sedentary lifestyle not become the norm in families, thus helping to prevent type 2 diabetes.
Leading health organizations recommend that children and adolescents perform at least 60 minutes of moderate or vigorous physical activity per dayIt doesn't have to be all at once: you can accumulate it in 10-15 minute blocks throughout the day. The important thing is to move regularly, increase your heart rate, and reduce long periods of sitting.
Physical activity has numerous benefits: It helps maintain a healthy weight, improves glucose control, strengthens bones and muscles, reduces stress, and improves mood.Furthermore, when practiced with family or friends, it strengthens bonds and is experienced as something fun, not as an obligation.
Some practical tips they can be the following:
- Limit screen time (tablets, televisions, smartphones, computers or any other device) to no more than two hours of leisure time per day, and offer active play alternatives.
- Get active as a family. Do at least 60 minutes of physical activity together every day or almost every day: go for a walk, ride a bike, swim, go to the park, play ball, or go for a gentle jog depending on your age.
- Dancing at home to music that everyone likes, because It's a fun way to exercise without the children perceiving it as an imposition.
- Walk more and take the car or public transport less (or get off one stop early to walk a stretch), so that movement is integrated into the daily routine.
- Enroll your children in extracurricular activities that involve physical exercise and that they enjoy: team sports, martial arts, dance, skating, athletics, etc.
- Avoid using the elevator and use the stairs whenever possible (adapting it to the child's age and physical condition), because small changes in movement They add up throughout the day.
- Turn some household chores into active games, such as picking up toys against the clock, helping to clean, watering plants or walking the dog, so that the child understands the activity as something positive.
One way to motivate children and teenagers to exercise, or at least eliminate their sedentary lifestyle, is by setting small goals. Rewards should be non-material and never related to food.For example, if your child has managed to eat healthily all week or has exercised with the family, they can choose some rewards such as: having a sleepover with their friends, choosing the movie to watch as a family, deciding on the board game for Sunday afternoon, or choosing the weekend outing.
Another useful tool is to keep a small activity log, whether in a notebook, a calendar on the fridge, or a simple app. Start marking the days with physical activity. It helps older children and teenagers become aware of their achievements and maintain their motivation.
The importance of sleep in the prevention of type 2 diabetes
Nighttime rest is another key factor that is sometimes overlooked. Sleeping fewer hours than recommended or having poor quality sleep has been linked to increased appetite, preference for less healthy foods, and weight gainIn addition, lack of sleep increases stress on the body, alters hormones such as leptin and ghrelin, and can contribute to insulin resistance.
Children and teenagers need to sleep a sufficient number of hours according to their age, and it is not enough to accumulate sleep from the weekend. Regularity of schedules and quality of rest They are equally important: a child who goes to bed at a different time each day or who sleeps with lights and screens on rests worse even if they spend many hours in bed.
Some guidelines to promote healthy sleep In children and adolescents they are:
- Respect regular bedtimes and wake-up times, including weekends if possible, to maintain a stable body rhythm.
- Avoid screens at least one hour before going to sleep, as blue light makes it difficult to fall asleep and keeps the brain alert.
- Offer light dinners, avoiding heavy and very fatty meals right before bedtime, which can cause heavy digestion and nighttime awakenings.
- Create a relaxing bedtime routine: bath, reading, quiet conversation, deep breathing, or soft music, to help the body disconnect.
- Ensure a suitable environment in the room: relative silence, darkness and comfortable temperature, avoiding the use of screens inside the bedroom.
Something as simple as getting enough sleep helps children grow strong and healthy.to better regulate their appetite and maintain a more appropriate weight, reducing the risk of developing metabolic diseases such as type 2 diabetes.
Signs to be alert
Children and adolescents with type 2 diabetes often feel perfectly fine and don't notice any signs that might suggest they have the disease. Therefore, in many cases, Type 2 diabetes is diagnosed late or after a routine blood test. However, it is essential that all parents, and even older children, understand the most common symptoms of type 2 diabetes so they can see a doctor as soon as possible and begin treatment if necessary.
The most frequent warning signs are:
- Increased thirst and a need to drink water very frequently throughout the day.
- Frequent urination during the day or at night (getting up several times to urinate).
- Blurred vision or difficulty focusing, especially if it appears suddenly.
- Unusual tiredness or fatigue, even without having made great physical efforts.
- Constant hunger or increased appetite without a clear explanation.
- Unexplained weight loss, despite eating the same or more than before.
- Wounds that are slow to heal, frequent infections (e.g., urinary or skin infections), or persistent itching.
- Areas of darker, thickened skin on the neck, armpits, or groin may indicate significant insulin resistance.
If you notice that your child has any of these symptoms or that something about their health seems off, you should go to your health center immediately so they can assess whether it is indeed type 2 diabetes or another condition, such as prediabetes. A simple fasting blood test, or even a finger prick, can detect it. elevated glucose levels that indicate the need for actionAnd, if confirmed, consult I have a son with diabetes, what now?.
It is necessary to be aware of the importance of eating healthy, fresh, and good quality food, as well as not having a sedentary life, but it is also very important attend regular pediatric check-upsRespect the healthcare professional's guidelines and avoid self-medication. The best example starts at home: when adults take care of their own health, children are much more likely to adopt healthy habits naturally.
Taking care of your diet, encouraging daily movement, prioritizing rest, limiting screen time, and being attentive to warning signs not only reduces the risk of type 2 diabetes in childhood and adolescence, but also build a solid foundation of health that will accompany children throughout their lives and help them reach adulthood with a lower risk of chronic diseases.
