If you have children, you know they give us plenty to worry about. But there’s a health threat that may not be on your radar: diabetes. Rates of both Type 1 and Type 2 diabetes in kids have increased over the past few years.

For Type 1 diabetes, the reason isn’t totally clear. Researchers from Rady Children’s Hospital San Diego recently compared rates of childhood Type 1 diabetes during the COVID-19 pandemic to rates during the year prior. The results, published in JAMA Pediatrics, found a 57% spike.

But there was a documented increase even before then: The Centers for Disease Control and Prevention (CDC) reported that between 2002 and 2015, Type 1 diabetes increased 1.9% annually.

Over the same span, Type 2 diabetes increased 4.8% annually. This is likely linked to rising rates of childhood obesity. The spikes in both types of diabetes are cause for concern.

“We know this was happening even before COVID, but new research has come out during the pandemic that’s concerning and shows that COVID could be contributing to the rise of new cases,” says Jennifer Osipoff, MD. She’s a pediatric endocrinologist at Stony Brook Children’s Hospital in Stony Brook, New York.

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Understanding diabetes

Types 1 and 2 diabetes are similar in that they both involve insulin. This is the hormone that works like a key to unlock your cells so sugar (glucose) can enter. Your cells need this sugar to produce energy. If it doesn’t get in, it builds up in the bloodstream and damages organs.

But there are key differences in how Types 1 and 2 work. Type 1 diabetes occurs when your immune system mistakenly attacks the cells in the pancreas that make insulin. There’s no known way to prevent this type of diabetes.

With Type 2 diabetes, your cells stop responding to insulin. The “key” doesn’t work as it should. This form of diabetes is largely preventable. With healthy lifestyle choices, you can significantly lower your risk.

Type 2 diabetes used to be called adult onset diabetes. But today, it’s increasingly affecting children.

Why childhood diabetes is on the rise

Certain factors could trigger Type 1 diabetes, says Frank Martin, PhD. He’s the senior director of research at the JDRF (Juvenile Diabetes Research Foundation). This includes environmental triggers, such as viruses. But Martin cautions that it’s too early to blame COVID-19 for the increase in cases.

“It could be that the stress of the pandemic brought it on in some children,” Martin says. But it’s more likely that the pandemic caused many kids to miss regular pediatric visits over the past couple of years. That means early signs of Type 1 diabetes may have gone undetected, he says.

Children are more at risk for either type of diabetes if they have a family history of the disease, Dr. Osipoff says. But for Type 2 diabetes, lifestyle factors such as weight and diet play the biggest role.

“We’ve seen a lot of weight gain among kids during the pandemic because of poor diet choices and sedentary behavior,” she says. A CDC study published in September 2021 found that the percentage of obese kids and teens rose from 19% in August 2019 to 22% in August 2020.

Know the warning signs

Both Type 1 and Type 2 diabetes are serious diseases, stresses Dr. Osipoff. It’s important for parents to be aware of the symptoms so that they can get a prompt diagnosis and treatment. Warning signs include:

• Fatigue, which could indicate that your child’s body is struggling to turn sugar into energy
   
• Increased thirst and urination due to uncontrolled blood sugar pulling fluid from tissue
   
• Blurred vision due to blood sugar levels changing rapidly, which can cause swelling of the eye lens
   
• Fruity-smelling breath, which could be a sign of high levels of ketones, a kind of acid created by the fat-burning process
   
• Extreme hunger, because your child’s body is craving more fuel
   
• Unexplained weight loss due to your child’s body burning fat and muscle for energy 
   
• Extreme moodiness or restlessness along with at least one other symptom
   
• Thickened, dark, velvety skin in body creases, such as the back of their neck or armpits (typically present only in people with Type 2 diabetes)

How to prevent childhood diabetes

There are three key ways to lower your child’s risk of developing Type 2 diabetes, Dr. Osipoff says. Make sure your child:

• Maintains a healthy weight
• Eats a healthy diet
• Exercises regularly

Talk to your doctor about diabetes screening if your child is overweight and has risk factors, such as a family history of Type 2 diabetes. This screening usually starts at age 10 and is repeated every three years.

Unfortunately, there’s nothing you can do to reduce your child’s risk of developing Type 1 diabetes, Martin says. That’s why it’s so important to keep an eye out for symptoms, especially if you have a family history of the disease.

If you have a close relative with Type 1 diabetes, it’s especially important that you get your child vaccinated against COVID-19, Dr. Osipoff says. “While we don’t know for sure that COVID-19 is a cause of Type 1 diabetes, it has long been speculated that some viral illnesses can trigger the condition in someone with a genetic susceptibility to it. So it’s very important to be cautious.”

Treatment options for diabetes

Multiple medications (approved by the U.S. Food & Drug Administration) are available to treat diabetes in kids. Research shows that adopting certain healthy lifestyle changes could even send Type 2 diabetes into remission. Here’s what you need to know about treating this condition.

Schedule a daily hour of high-energy play

Physical activity is especially important for people with diabetes because it helps the body use insulin better. The CDC recommends that kids 6 to 17 years old get at least 60 minutes of exercise each day. They can do it in 10- to 15-minute chunks.

Swap out processed carbs

Eating a balance of healthy foods that contain protein (such as chicken and eggs) and high fiber (such as fruits, vegetables and whole grains) is one of the best ways to control blood sugar.

It’s important to limit TV time, too, according to the CDC. Research shows that kids eat more when watching TV than when doing other activities, even sedentary ones.

Use a monitor

Blood sugar monitoring is a vital part of managing your child’s diabetes. Children who take insulin usually need to test more frequently, possibly three times a day or more.

A continuous glucose monitor can read your child’s blood sugar levels in real time. Thanks to technology, there are lots of tools you can use to help manage your child’s diabetes.

Talk to your doctor about medication

There are effective medicinal treatments for both types of diabetes, including:

• Metformin (Riomet®, Fortamet® and Glumetza®): This pill helps to control the amount of sugar in your child’s blood and increases the body’s response to insulin.
   
• Liraglutide (Victoza®): This is an injection that helps your child’s body release the right amount of insulin when blood sugar levels are high.
   
• Insulin injections: This gives your child a boost of insulin if their body is struggling to produce it. There are different types of insulin injections, such as:
  • Insulin lispro (Humalog®)
  • Insulin aspart (NovoLog®)
  • Insulin glulisine (Apidra®)
  • Insulin glargine (Basaglar®, Lantus®, Toujeo® and Semglee®)
  • Insulin detemir (Levemir®)
  • Insulin degludec (Tresiba®)

The better controlled your child’s diabetes is, the more likely they are to lead a healthy and productive life, Dr. Osipoff says.

Make sure you’re on track with their treatment plan, and remember: We’re here to help. Print out the Optum Perks discount card and bring it to the pharmacy to see if you can save money on your child’s prescription medications.

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