Type 2 Diabetes in Children

The same medicines are used to treat adults and children with type 2 diabetes. These medicines increase Reference insulin Opens New Window production, make the body better able to use insulin (decrease Reference insulin resistance Opens New Window), or slow the intestinal absorption of Reference carbohydrate Opens New Window.

Sometimes a child needs more than one medicine to adequately control diabetes. Two or more medicines taken together may work more effectively than a single medicine. Taking two medicines together also may reduce possible side effects by allowing lower doses of each. But in some cases, taking two medicines can increase the risk of certain side effects, such as low blood sugar (Reference hypoglycemia Opens New Window).

Some children need daily insulin shots—alone or with other medicines. Even if your doctor does not prescribe daily insulin, your child may need to take insulin temporarily when first diagnosed or during illness or surgery. At some point in adulthood, he or she will likely need insulin, because over time the Reference pancreas Opens New Window Reference Opens New Window does not produce enough insulin. Insulin also may be needed during pregnancy and breast-feeding.

If your child has high cholesterol or high blood pressure, medicine for those conditions may be needed. Even blood pressure slightly above normal increases the risk for eye and kidney damage from diabetes.

Medicine choices

Medicines that decrease insulin resistance:

• Reference Biguanides, such as metformin and other medicines that are combined with metformin
• Reference Thiazolidinediones, such as pioglitazone and rosiglitazone

Medicines that increase insulin production:

• Reference Sulfonylureas, such as glimepiride, glipizide, and glyburide
• Reference Meglitinides, such as nateglinide and repaglinide
• Reference DPP-4 inhibitors, such as linagliptin, saxagliptin, and sitagliptin

Medicines that slow intestinal absorption of carbohydrate:

• Reference Alpha-glucosidase inhibitors, such as acarbose or miglitol

If you are having trouble controlling your blood sugar with pills, your doctor may suggest one of these medicines, which are given as a shot:

• Reference Incretin mimetics, such as exenatide and liraglutide
• Reference Amylinomimetics, such as pramlintide

Some doctors treat children with Reference insulin injections.

Medicines to control blood pressure and cholesterol

Some children may need medicines to lower their blood pressure and cholesterol to reduce the risk for later complications.

• Reference Angiotensin-converting enzyme (ACE) inhibitors or Reference angiotensin II receptor blockers (ARBs) may be used to lower your child's blood pressure.
• Reference Statins may be used if a healthy diet and physical activity do not lower cholesterol. Sexually active teens should be warned against becoming pregnant while taking these medicines.

What to think about

Metformin is the medicine of choice for children with type 2 diabetes. It usually keeps blood sugar levels within a Reference target range without increasing the likelihood that the child will gain weight. If after 3 to 6 months of treatment with metformin the child's blood sugar levels are not consistently within a target range, other medicine usually is added.

Insulin may be given as a single nighttime dose, as several smaller doses throughout the day, or both. Insulin doses for children with type 2 diabetes are usually high—to overcome the body's Reference resistance to insulin Opens New Window—which may increase the risk for weight gain.

Although Reference alpha-glucosidase inhibitors are safe for children, they may cause abdominal gas, making them less acceptable to teens than other diabetes medicines.

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