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  • Denise Scott

Type 2 Diabetes in Children - What You Can Do About It

Last week, I discussed what type 2 diabetes is and some of the risk factors and causes; this article outlines what you can do about it and preventive measures.

Parents are the ones who are in charge of making changes that are good for the entire family. Children who are overweight, especially those with insulin resistance, are at risk for progressing to T2D. You cannot change your inherited factors, but you can change lifestyle factors. You also can control what you purchase and bring into your home. You cannot eat highly processed, sugary foods if unavailable.

A visible sign of insulin resistance is darkened and thickened skin behind the neck and under the armpits, called acanthosis nigricans. If present, it is a sign of insulin resistance. If seen, show your doctor, so they can test for insulin resistance and T2D.

Ways to start:

  • Reduce portion sizes without feeling a need to finish everything on the plate

  • Substitute fruit or vegetables for a carbohydrate-rich food

  • Replace high-calorie beverages, such as soft drinks or fruit juices, with water

  • Eat at home more frequently instead of eating at restaurants or getting take-out

  • Have your child help make meals

  • Eat at the dinner table instead of in front of the TV

Family enjoying an outdoor hike together. Find physical activities you can enjoy as a family to make it fun!


Since age is a crucial factor, creating healthy habits should start before puberty; most cases of T2D present during the teen years. Physical activity is vital and should be encouraged at all ages. Creating family habits of visits to the park, walks in the neighborhood, basketball games, hiking, swimming, bike riding, etc., get young children interested and make it fun when the whole family is involved. Exercise can be very playful and does not necessarily mean organized sports, although that is beneficial too. Plenty of free options are available, not requiring uniforms or driving to practices and games, but parents set the example. Starting young can help to develop a lifelong habit of physical exercise. Physical activity helps the body use insulin better, decreasing insulin resistance. The goal is an hour a day of physical activity, which does not have to be all at once - even 15-20 minutes several times a day is beneficial.

Involve your kids in house and yard work. Sweeping, vacuuming, raking, dusting, and more burn calories. Make it a race.

Screen Time

In addition to physical activity, limiting screen time is vital since a lot of calorie consumption takes place mindlessly in front of a screen. Consider allowing 30 minutes of screen time after 30 minutes of exercise or a similar trade. Encourage active screen time, such as dance or exercise games or programs that require active participation.

Eating Habits

I believe in talking about healthy eating habits, not dieting. In practice, my first goal with patients was not to lose weight, but to prevent weight gain. A young child should not be on a weight loss diet, which could interfere with growth and development. A doctor and dietician should guide a child with insulin resistance or type 2 diabetes.


  • I have emphasized this in past blogs, but the first focus should be their beverage intake. Simply eliminating or drastically reducing sugary beverages saves tremendous calories and can lead to slowed weight gain or some weight loss. Simultaneously, increase water intake. That is the first step.

(One 12-ounce can of soda contains about 150 calories. Drinking 2-3 a day will cause weight gain of a pound a week. Larger servings add more calories more quickly.)

Various sugared beverages (soda, juice, Kool-Aid) on a blue background. Eliminating sources of sugary beverages saves calories and reduces sugar intake.


  • Follow My Plate guidelines (see 9/13/23). Filling half the plate with fruits and vegetables is another step.

  • Easy substitutions when cooking and grocery shopping can improve the quality of your diet. Most of these substitutions switch simple carbohydrates to complex carbohydrates. These are listed here: 12/28/22).

  • Teach your children about food labels and serving sizes to decide which foods are healthier. I recommend a parent count out the number of crackers or chips in a serving size, or take a box of cereal and have their child pour what they want into a bowl, then measure a serving size into a measuring cup to demonstrate the difference. It is surprising how quickly one can consume an extra 500 calories a day. Doing this daily for a week leads to a pound of weight gain, for a month, 4 pounds, for a year…52 pounds!!!

Mother and daughter grocery shopping. Take your child to the store as a way to discuss healthy food choices and why you choose your selections.

No wonder during COVID, we saw kids who gained twenty pounds in a few months!

  • Have meals together at the dinner table, not in front of the TV.

  • Involve your child in meal preparation and grocery shopping to teach about healthy eating.

  • Serve smaller portions and leave serving dishes off the table - let your child ask for seconds if desired. Give seconds of meat, veggies, and fruit rather than pasta, rice, or potatoes.

  • Reduce purchasing and consuming processed foods, especially foods with added sugar.

  • Increase intake of fiber-rich foods such as vegetables, beans, and whole grains.

Photo of high fiber foods including fruit, vegetables, nuts, and legumes. Fiber slows the release of sugar into the bloodstream preventing blood sugar spikes.

Fiber increases the feeling of fullness, slows digestion, and prevents spikes in blood sugar.

  • Include a protein source with snacks. Protein has less of an impact on raising blood sugar than carbohydrates.

Even meals on the go, between activities, can be healthy. See Healthy Meals on the Go from 9/20/23,

You can start slowly, creating one or two new habits a week. It is never too late to start - your child's future health is at stake.

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