Two things are important in helping you to treat your Type 2 diabetes – lifestyle changes and medication.
By 'lifestyle changes', we mean losing weight and being more active. For most children and young people with Type 2 diabetes, it’s the first type of treatment recommended.
Lifestyle changes are just as important as any medication your doctor might give you. And it’s something that your whole family can be involved in, not just you.
Your dietitian will give you detailed individual advice, but here are a few tips to get you started:
Cut down on sugary drinks and aim to cut them out completely
Sugary drinks like fruit juice, full sugar squash and fizzy drinks just give your body unnecessary extra calories that will make you put on weight and make your blood glucose level go up. If plain water leaves you cold, go for diet drinks or no added sugar squash instead.
Eat meals on time
Getting rid of distractions like TV, reading or computer games will help you eat more slowly.
Eat your meals from a plate or bowl
Avoid eating directly from the packet, eat more slowly and don’t go back for seconds!
Cut back on high fat and high sugar foods
High fat foods are things like pastries, pies, fried foods, processed meats and cheese. High sugar foods include sugary drinks, sweets and cakes.
Go for foods that have green or amber colours for fat, sugar and salt.
Check food labels
Go for foods that have green or amber colours for fat, sugar and salt. You don't have to cut all these foods out completely, but try to have them less often or have smaller portions.
Make sure your meals are the right size
Too much of any food is going to make you put on weight.
Eat breakfast every day
Breakfast is important because if you start your day with healthy food, you are more likely to eat healthier foods throughout the day. Something like wholegrain breakfast cereal, porridge or granary bread will fill you up until lunchtime, so you’ll be less likely to snack on crisps and sweets.
Choose healthier snacks
Instead of crisps or sweets, try fruit, low-fat yogurt or, if you can’t resist your crisps, go for a low-fat variety.
Try wholemeal or wholegrain varieties
Wholemeal and wholegrain pasta, rice and bread will leave you feeling fuller for longer, so try them instead of the white varieties.
Aim to eat five portions of fruit and veg a day
One portion of fruit is two small plums/satsumas or one medium-sized apple or orange.
One portion of vegetables is three heaped tablespoons of cooked peas, carrots, broccoli or three heaped tablespoons of baked beans. Fruit and vegetables fill you up and are relatively low in calories, too.
Cut back on the time you spend in front of the TV or computer
While you’re in front of the screen you’re not really burning up energy.
Get more active as a family
Activity with others can be a lot more fun. Try walking to school or taking the stairs instead of the lift. You could even get yourself a pedometer to see how many steps you can do.
Find more tips on eating healthily and being more active.
By 'medication', we mean tablets or insulin injections. Your doctor might suggest you try some medication, as well as making changes to your food and activity.
Medication isn’t instead of the lifestyle changes we’ve suggested - it’s important you keep up with your healthy living as this will help your medication to work better. The first medication your doctor will give you is likely to be a tablet called Metformin.
Metformin lowers your blood glucose by helping your body use its own insulin better, and stopping your liver making glucose.
Metformin lowers your blood glucose by helping your body use its own insulin better, and stopping your liver making glucose. It can also help you lose weight and lower your blood fats.
It can give you some diarrhoea or tummy problems when you first start taking it, so your doctor might just give you a small dose to begin with and gradually increase it as you get used to it. For most people, the tummy problems go away quite quickly so it’s worth persevering with.
If Metformin doesn’t seem to be working, your doctor might increase your dose or suggest you go on to insulin injections.
If you need insulin injections, you might just have a once-a-day injection of a long-lasting insulin, at least to start with. But your doctor might suggest you also take another type of insulin (called 'rapid acting') with your meals as well.
What are 'complications' and what might they do to me?
Doctors often use the word 'complications' to describe the other health problems that can happen if you have diabetes.
While these apply to Type 1 as well as Type 2 diabetes, unfortunately for children or young people with Type 2, they tend to happen earlier, and are sometimes present when you first get diagnosed with Type 2.
Because we know these complications can happen to people with diabetes, your doctor will check for them very carefully both when you’re diagnosed and every year after that.
And we know that the better you can look after your diabetes, the less chance there is of getting any of these complications.
Health problems to be aware of:
Heart or blood vessel problems (known as 'cardiovascular disease')
This can cause things like heart attacks and strokes. It’s very unlikely that you’ll have a heart attack or a stroke as a child, but you might already have high blood pressure and/or high blood fat levels, which might make them more likely when you’re older.
If your doctor finds you’ve got high blood pressure or high blood fat levels, he or she can give you tablets to lower them. Losing weight and getting active really helps as well.
Kidney problems (known as 'nephropathy')
The first sign of kidney problems is when your kidneys starting to leak protein (called 'albuminuria'). If this isn’t looked after properly, your kidneys could fail completely and you’d need dialysis or a kidney transplant.
Again, this isn’t likely to happen when you’re a child but if you’ve got high blood pressure, as well as Type 2 diabetes, it could be more likely when you’re older.
Problems with eyes and nerves can also be more common, but these can be treated by your doctor.
If your kidneys do start leaking protein, your doctor can give you tablets to stop it happening. And again, losing weight and getting active helps.
Problems with eyes and nerves
Problems with your eyes (called 'retinopathy') and nerves (called 'neuropathy') can also be more common in people with diabetes, but these can be treated by your doctor.
And, remember the important bit – keeping your diabetes under control will not only help reduce the chance of you getting any of these complications, but if you do have any already it will help control them.
How will I know if my Type 2 diabetes is under control?
This is something both you and your paediatric diabetes team can check for.
Your paediatric diabetes specialist nurse or PDSN will give you a monitor to check your blood glucose levels and show you how to use it. They’ll also discuss with you what level you should be aiming for how often you need to check your blood glucose levels.
As a general guide you should do a few tests a week, both before and after meals. But there are times when you’ll need to test a bit more often:
- When you’re newly diagnosed with Type 2 diabetes
- If you’re ill (being unwell can make blood glucose levels high)
- If you’re levels are higher than usual (you’ll need to talk to your doctor or nurse about changing your medication)
- If your treatment or medication has recently been changed (to check the change is working)
- If your levels are too low (some medications can make blood glucose levels too low – again, you’ll need to talk to your doctor or nurse)
What your team can do
As well as seeing your PDSN at home, you’ll also need to come to the hospital regularly to see your doctor and dietitian.
At least twice a year they will do a blood test called an HbA1c, which measures your overall diabetes control. For most that test should be less than 48mmols/mol (6.5%), but we’re all different so your doctor might suggest a different level for you.
As well as this, every year you’ll get a full examination which checks for any problems with your heart, kidneys, eyes and nerves. If any problems are found, your doctor will be able to give you some treatment.