Treating Type 2 Diabetes

When someone has type 2 diabetes, their cells don’t respond normally to the hormone insulin. This is called insulin resistance and it can lead to high blood sugar levels.

If your child or teen has been diagnosed with type 2 diabetes, the diabetes care team will make a personalized care plan to guide your child's treatment. There is no one-size-fits-all treatment for type 2 diabetes. Some children do well with changes to their eating habits and physical activity. Other kids need oral medicine, and some may need injections to control their blood sugar.

What Is a Diabetes Care Plan?

A diabetes care plan is a set of instructions for you and your child to follow. The goal is to help your child develop healthy habits and keep their blood sugar levels in a safe range. The care team will teach you how to use the plan. 

There are 5 parts to a care plan for type 2 diabetes:

• eating a healthy, balanced diet
• getting regular physical activity
• managing weight
• taking medicine
• checking blood sugar (glucose) levels

Eating a Healthy Diet

A very important part of treatment is helping your child eat well. Offer plenty of fresh vegetables, fruits, lean protein, and whole grains. The key is to eat a balanced diet with the right amounts of carbohydrates (carbs), proteins, and fats.

Teach your child to get their calories from healthy foods, not sugary drinks. Show them healthy portion sizes. A registered dietitian can be a good resource. They can help you read food labels, choose and cook healthy foods, and show you the right amounts to serve. If your care team doesn’t include a dietitian, ask your doctor to recommend one.

Getting Physical Activity

Moving the body helps insulin work better and lowers blood sugar levels. Kids with type 2 diabetes need physical activity every day. If your child isn’t used to being active, start slowly and set clear goals. They can begin with at least 15 minutes every day and increase the amount as they're able. Also include recovery time. Joining a sports team isn’t a must — activities like walking the dog, doing chores, and playing outside are good options. The key is to move every day.

Because exercise can lower blood sugar, your child should check their sugar levels before, during, and after exercise if they are on insulin. The care team can tell you other things to know about your child's physical activity.

Managing Weight

Many kids with type 2 diabetes have excess weight. Living a healthy lifestyle is the best way to help your child grow and develop properly. Eating well and staying active may slow weight gain and can even lead to weight loss. There are health benefits from losing even a little bit of weight.

Taking Medicines for Type 2 Diabetes

If living a healthy lifestyle doesn’t do enough to keep glucose levels in the healthy range, kids with type 2 diabetes may need one or more medicines.

The medicines work in different ways and include:

Metformin

• How it works: It helps the body's own insulin work better by bringing blood sugar into a healthy range. It can also help stop weight gain.
• Form: It's a pill.

Glucagon-Like Peptide 1 (GLP-1) receptor agonists

• How they work: They lower blood sugar and help the body’s own insulin work better. They also decrease appetite, which may lead to weight loss.
• Form: It’s an injection given under the skin, usually either once a day or once a week.
• Brand name examples: liraglutide (Victoza®), exenatide (BYDUREON BCise®), and dulaglutide (Trulicity®)

Sodium-glucose cotrasporter-2 (SGLT-2) inhibitors

• How they work: They lower blood sugar by sending more glucose out of the body in pee (urine).
• Form: It’s a pill. It comes in two forms, either by itself or combined with metformin.
• Brand name examples: empagliflozin (Jardiance®) or empagliflozin combined with metformin (Synjardy®)

Insulin (a manmade form of the body's natural hormone)

• How it works: It helps sugar get into the cells for energy. Doctors often prescribe it for people when they’re first diagnosed with type 2 diabetes if they have very high blood sugar and HbA1c levels, or later on if other treatments don’t keep blood sugar levels in check. Some kids need it for a short time only.
• Form: It's given by injection or with a pump.

Even if your child takes medicines for diabetes, they should follow the diet and physical actvity recommendations listed in their care plan. Living a healthy lifestyle may improve some kids' glucose levels so much that the doctor could decide to cut back on some medicines.

Checking Glucose Levels

In the diabetes care plan, you can see your child’s healthy glucose range. The goal is to keep sugars in this range as much as possible.

Daily, you and your child will check glucose levels. Kids and teens do this using a blood glucose meter or a continuous glucose monitor (CGM). If your child uses a blood glucose meter and is on insulin, they’ll check their blood sugar about four times each day. If they wear a CGM, it will automatically measure sugar levels day and night.

A few times a year, your child will have a test called glycosylated hemoglobin (hemoglobin A1c or HbA1c). This blood test tells your child’s average blood glucose levels over the past 3 months. The goal is an A1c of 7% or lower.

The care team will look at your child’s glucose levels to see how well the care plan is working and make changes if needed.