Treatment of type 2 diabetes in children focuses on keeping blood sugar levels within a target range. Children may need higher blood sugar goals than adults because their bodies are still developing; also, they may not be able to recognize symptoms of low blood sugar. To reach his or her target blood sugar, your child needs to eat healthy meals of appropriate portion size and get daily exercise. Treatment also may include medicine.

Healthy eating

A healthy diet with the right amount of calories will help your child achieve target blood sugar levels and maintain a healthy weight. The meal plan designed for your child will spread carbohydrate (starches and sugary foods) throughout the day. This helps prevent high blood sugar after meals as well as weight gain. A registered dietitian can design a meal plan that fits your child's needs. For more information, see the topic Healthy Eating for Children.

Being physically active

Physical activity is extremely important. It helps the body use insulin correctly and helps control weight. Your child does not have to start a rigorous exercise program, but being more active can help control blood sugar. For example, your child could play outside with friends, take brisk walks with family members, and participate in individual or team sports. Children and teens need to get at least 60 minutes of moderate-intensity physical activity most days of the week, preferably daily.⁷ Limiting TV and video or computer games may encourage activity.

Medicines

Your child may need medicines if 3 months of eating healthy meals and getting regular physical activity have not lowered your child's blood sugar to his or her target level.

• Oral medicines for diabetes help the body produce more insulin, decrease the body's resistance to insulin, or slow the absorption of carbohydrate from the intestine. Your child may need one medicine at some times and more than one at other times.
• Some children need daily insulin shots-alone or with oral medicines. Even if your health professional does not prescribe daily insulin, your child may need to take insulin temporarily when first diagnosed or during illness or surgery. If the progression of diabetes cannot be stopped, your child eventually may need to take insulin daily.

Checking blood sugar, blood pressure, and cholesterol

Your child's blood sugar level needs to be checked regularly. Your child will probably have to test before breakfast and 2 hours after meals.

If your child has high blood pressure or high cholesterol, those conditions need to be treated.

• High blood pressure is usually treated with angiotensin-converting enzyme (ACE) inhibitors because these medicines also protect the circulatory system and the kidneys from damage caused by diabetes. Sexually active teens should be warned that ACE inhibitors should not be taken during pregnancy.
• Weight loss and well-controlled blood sugar can help lower your child's cholesterol. Your child's health professional may recommend medicine if these lifestyle changes do not lower cholesterol. Sexually active teens should be warned against becoming pregnant while taking these medicines.

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