Taking Medicines as Prescribed
Sometimes, diet and exercise are enough to control blood sugar levels in kids with type 2 diabetes. But some will need to take pills that help insulin work better. These pills are not a form of insulin.
Sometimes pills for diabetes — even when combined with diet and exercise — still aren't enough to keep blood sugar levels under control, and a child with type 2 diabetes must take insulin. The acids and digestive juices in the stomach and intestines would break down and destroy insulin if it was swallowed, so it can't be taken in a pill. The only way to get insulin into the body is with an injection or an insulin pump.
There is no-one-size-fits-all insulin schedule — the types of insulin used and number of daily injections a child needs will depend on the diabetes management plan. Usually, kids inject a combination of different types of insulin to handle the sugar that circulates in the blood after eating and between meals. Also, you can't turn off the action of insulin once it's injected, so insulin doses need to be adjusted to handle the rise in blood sugar that happens with meals and provide the insulin the body needs between meals and overnight.
Eating meals at regular times can make this easier. Eating on schedule may work well for younger kids, but sticking to a routine can be a challenge for older kids, whose school, sleep, and social schedules vary. The diabetes health care team can help you work through problems with scheduling meals and insulin injections.
Remember, a balanced diet, regular physical activity, and a healthy weight can improve blood sugar levels greatly. Some kids who follow the treatment plan for type 2 diabetes can even stop taking insulin altogether.
Monitoring Blood Sugar Levels
Treating type 2 diabetes also involves checking blood sugar levels regularly and responding to the results. Controlling blood sugar levels helps kids with diabetes feel well, grow and develop normally, and reduce the risk of long-term diabetes complications.
The diabetes treatment plan will recommend how many times a day to check blood sugar levels, which is the only way to know the effectiveness of your child's day-to-day blood sugar control.
The diabetes health care team also will explain what your child's target blood sugar levels are. In general, kids with type 2 diabetes should test their blood sugar levels with a blood glucose meter at least twice a day, but might need to test more often if they're taking insulin, have been just diagnosed, or have problems with blood sugar control.
The care team may recommend that your child use a continuous glucose monitor (CGM). A CGM is a wearable device that can measure blood sugar every few minutes around the clock. It's measured by a needle-like sensor that's inserted under the skin and secured in place. Sensors can stay in place for about a week before they have to be replaced. The more frequent CGM blood sugar readings can help you and the care team do an even better job of troubleshooting and adjusting your child's insulin doses and diabetes management plan to improve blood sugar control.
A blood glucose meter or CGM measures the blood sugar level at the moment of testing. Another blood sugar test, the glycosylated hemoglobin (hemoglobin A1c or HbA1c) test, shows how blood sugar levels have been running over the past few months.
Putting it All Together
Treating and managing diabetes can seem overwhelming at times. But the diabetes health care team is there for you.
Your child's diabetes management plan should be easy to understand, detailed, and written down for easy reference. You also should have the names and phone numbers of the health care team members in case of emergencies or if you have questions.
You might hear of alternative or complementary treatments, such as herbal remedies and vitamin or mineral supplements. Although research continues into their possible benefits, studies thus far haven't proved their effectiveness. They also could be dangerous for kids and teens with type 2 diabetes, especially if used to replace medically recommended treatments. Talk to the diabetes health care team if you have questions.
Each day, researchers all over the world are working to find a cure for diabetes, and advances have made treatment easier and more effective. Insulin might soon be available in pill, patch, and spray forms, and scientists continue to improve results of pancreas or islet cell transplants. Versions of an "artificial pancreas" — a device that senses blood sugar continuously and gives insulin directly based on the blood sugar level — also are being tested.
Date reviewed: January 2018