Type 2 Diabetes in Children

Care, Guidance, and Support for Children with Type 2 Diabetes

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Every child with Type 2 diabetes has unique needs and circumstances. Duke Children diabetes experts customize your child’s treatment to offer the care, support, and information your family needs. Our pediatric endocrinologists, nurses, diabetes educators, dietitians, and social workers help your child manage their diabetes and lead a healthy life.

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What Is Type 2 Diabetes?

Insulin is a hormone that takes sugar (called glucose) from your bloodstream and delivers it into your body’s cells to be used for energy. In Type 2 diabetes, your child’s body creates insulin but either doesn’t produce enough or doesn’t use it well. This causes your child to have high blood sugar levels, which can lead to serious health complications over time.

To manage your child’s type 2 diabetes, our diabetes team will provide guidance about eating, drinking, and exercise habits. Some children with type 2 diabetes also benefit from medicines or insulin injections to help manage their blood sugars.  The Duke Children’s diabetes care team is experienced in working with children of all ages and their families. We’ll ensure your child gets the best-quality medical care and has the understanding and support they need to control their blood sugar and adopt healthy lifestyle habits to help manage their diabetes.

Our Locations

Duke Health offers locations throughout the Triangle. Find one near you.

Diagnosis and Evaluation

Your pediatrician may have already diagnosed your child’s diabetes through blood and urine tests. After you've been referred, your pediatric endocrinologist will do a thorough exam and additional tests to confirm the diagnosis and evaluate your child’s health. During the exam, your will:

  • Learn about your child’s health history, your family history, and your child’s eating, drinking, and exercise habits.
  • Order blood and urine tests to confirm what type of diabetes your child has, check for any hormone imbalances or other problems that may have made them prone to diabetes, and check for any medical problems commonly linked to diabetes.
  • Depending on the results, your doctor may perform additional tests. As it is important for all children with type 2 diabetes to see an eye doctor for regular check-ups, your diabetes doctor may also refer you to an eye doctor if your child has not had a recent eye exam.
  • Evaluate your child’s weight and the percentage of muscle and fat in their body.
  • Ask your child questions to evaluate their mental health and screen for depression. We perform this screening every year to make sure your child gets the support they need. 
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Treatments and Services

Diabetes changes over time, so your child's care team will adapt your child's treatment plan as needed.


Metformin lowers the amount of sugar released by the liver into the bloodstream. It increases the effect of insulin, which helps lower blood sugar. Medicine alone won’t control Type 2 diabetes; your child will still need to manage their diet and exercise and control their weight.


While many children with type 2 diabetes do not need to use insulin, daily insulin injections may be necessary to manage daily blood sugar levels. Our diabetes educators will teach you and your child how to test blood sugar and give injections. They’re knowledgeable about the latest glucose monitoring and insulin delivery devices -- such as pens, injections, and pumps -- and can help you and your child find what’s right for your circumstances. Our social workers can provide information about your child’s condition and care needs to their teachers, sports coaches, and others.

Additional Medicines for Type 2 Diabetes

The medicines that are approved to help children manage their type 2 diabetes are frequently changing, and your doctor will discuss any additional medicines beyond metformin and insulin that may help your child. Some of our patients find benefit from adding a GLP-1 agonist medicine (i.e., Ozempic, Victoza, Saxenda) to help control blood sugars and weight to manage their diabetes. Your doctor will talk to you about whether these medicines might be helpful for your child.

Diet and Exercise

Eating right to maintain a healthy weight and blood sugar levels is crucial for managing Type 2 diabetes. Physical activity is also an essential part of your child’s treatment plan. Duke Children’s diabetes educators and dietitians can teach you and your family about nutrition, menu planning, and ways to adopt a healthy diet. In addition, weight-control and exercise specialists can offer your child expert guidance through the Duke Healthy Lifestyles program.

Education and Support

Twice each month, our diabetes educators lead comprehensive diabetes management classes that focus on all aspects of living with diabetes -- including what diabetes is, what you can eat, how to avoid complications, and exercising with diabetes. Classes for children over 16 cover advanced topics, such as how to transition into living with diabetes as an adult.

Ongoing Care

Regular checkups ensure your child is managing the physical and psychological aspects of living with diabetes. Blood sugar levels are monitored using a blood test (A1C or glycated hemoglobin test) that measures blood sugar levels over the previous three months. Your pediatric endocrinologist will evaluate your child’s kidney, thyroid, and liver function, as well as their cholesterol, blood pressure, and physical growth. They will also refer your child to a pediatric eye doctor for regular eye exams. These checkups help prevent common diabetes complications, such as vision or kidney problems.

Best Children's Hospital in NC

Duke Children's Hospital & Health Center is proud to be nationally ranked in 10 pediatric specialties.

Why Choose Duke

Nationally Recognized
We are recognized by the American Diabetes Association for our diabetes self-management education. In addition, we were the first center in the Southeast to offer specialized care for children with Type 2 diabetes and insulin resistance.

A Team of Specialists
We address all the health challenges that can occur with obesity and Type 2 diabetes -- from high blood pressure and sleep apnea to hormone and other problems. We evaluate your child’s overall health and work closely with pediatricians, cardiologists, nephrologists (kidney doctors), orthopedic specialists, and other specialists to tailor your child’s treatment to their unique needs.

Family-Centered Care
Family-centered care helps you manage life with diabetes. Our care team will help you and your child understand and follow treatment guidelines, and incorporate good eating, drinking, and exercise habits into your family’s lifestyle. Through one-on-one support from our care team as well as our comprehensive diabetes classes, we empower your child and you to take control of your child’s health.

Experienced Pediatric Endocrinologists
Your child will receive care from experienced pediatric endocrinologists. Our doctors are also researchers who are seeking new ways to improve diagnosis and treatment for children of all ages with diabetes.

This page was medically reviewed on 03/20/2023 by