In the world of diabetes, Type 2 sufferers are the vast majority. But in the world of kids and diabetes, Type 1 is the most prominent. The child with Type 2 finds himself dealing with a new disease, and he probably knows few peers who are in a similar situation. This can be troubling and challenging for the child and the caregiver alike.

Their Own Minority

While some studies show the number of children with Type 2 is increasing, they are still in the minority when it comes to the total number of kids with diabetes. A child with Type 2 will almost certainly not have any peers in school who have the same illness and she will have to face different challenges than a child with Type 1.

Children with Type 2 face a different challenge than those with Type 1: While children with Type 1 must change their lives to accommodate shots and blood checks, children with Type 2 usually need to make lifestyle changes, such as restrictions on their diet and a need for increased exercise. These kinds of lifestyle changes can be hard for a child, particularly if a parent is not pushing for it to happen.

That means that although kids with Type 1 can eat the same as most kids, kids with Type 2 may have to change their diet drastically. Although this can be alienating and even embarrassing for children, it must be done because noncompliance can be particularly troubling. People with Type 2, for the most part, do not go into the metabolic crisis known as diabetic ketoacidosis ( DKA); they can linger at a high A1c, which is the average of their blood sugar levels over an extended period, and blood glucose average for a long time, long enough to cause complications (see Chapter 5 for more on DKA and A1c). People with Type 1 need complete insulin replacement, so they tend to slip into a dangerous place quickly and must immediately deal with their situation. Such immediacy does not apply to Type 2 sufferers; Type 2 diabetes can be damaging in the patient's ability to ignore it.

The Blame Game

As hard as it is to deflect the questions of blame when dealing with Type 1 diabetes, it's even harder with Type 2. Since so much of the reason for the disease is tied to lifestyle, weight, and activity levels, a child and her parent can feel as if they had some control in the onset of diabetes. With Type 2, blame can come along with shame; shame from parents or caregivers that they let their child's lifestyle affect her health; shame from a child for being overweight and for having a medical issue that is usually connected with the elderly.

Parents should avoid lashing out at a child who develops Type 2. The best action is to connect with a pediatric endocrinology team that specializes in Type 2 diabetes and in children and weight issues in children and then move forward, realizing that there are good solutions available.