diabetes mellitus

Summary

Type 2 diabetes is a condition where the body does not use insulin properly and does not produce enough insulin to keep blood sugar levels normal. In children, obesity is the most common cause of type 2 diabetes.

Many children with type 2 diabetes do not show symptoms and are diagnosed during routine check-ups, especially if they have risk factors like a family history of diabetes, obesity, or dark patches of skin (acanthosis nigricans).

The good news is that type 2 diabetes can often be prevented or delayed with healthy lifestyle changes, such as maintaining a healthy weight and being physically active.

Diagnosis and When to Seek Help

A doctor may check for type 2 diabetes if your child:

Is overweight or obese
Has a family history of diabetes
Develops dark, velvety skin patches (acanthosis nigricans)
Has symptoms like frequent urination, increased thirst, or unexplained tiredness

A diagnosis is confirmed through blood tests that measure blood sugar levels. In some cases, diabetes is discovered during routine screenings for school, sports, or annual check-ups.

Management

The main goals of treatment are to:

Help children reach and maintain a healthy weight
Improve their ability to exercise
Reduce acanthosis nigricans
Keep blood sugar levels within a healthy range (HbA1c target: below 7%)
Prevent long-term complications like vision problems, high blood pressure, and high cholesterol

Treatment usually starts with lifestyle changes, including a balanced diet and regular exercise. In some cases, medications like metformin or insulin may be needed. Some newer medications, such as GLP-1 receptor agonists and SGLT2 inhibitors, are approved for children aged 10 and older in some countries.

Follow-Up and Monitoring

Children with type 2 diabetes need regular doctor visits to check their blood sugar levels, monitor their growth, and adjust their treatment if needed. Long-term care focuses on preventing complications and maintaining a healthy lifestyle.

Early diagnosis and treatment can help children manage diabetes effectively and lead a healthy, active life. If you have concerns about your child’s risk for diabetes, talk to a healthcare provider.

History and Exam

Key diagnostic factor

presence of risk factors
acanthosis nigricans
polyuria
polydipsia

Other diagnostic factors

hypertension
yeast infections
skin infections
urinary tract infections

Risk factors

obesity
genetic predisposition/family history
high-risk ethnic background
puberty

Diagnostic Investigations

1st investigations to order

urine dipstick
random plasma glucose
fasting plasma glucose
HbA1c

Investigations to consider

2-hour plasma glucose
random C-peptide

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Other Related Conditions

Insomnia

Parasomnia (night terrors)

Narcolepsy

Delayed Sleep Phase

Restless leg syndrome

Behavioural sleep conditions

Rhythmic movement disorder

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Social and emotional functioning refers to a child’s ability to understand, express, and manage their emotions, as well as to interact effectively with others. These skills are fundamental for building positive relationships, developing empathy, and coping with the everyday challenges of growing up.

Children who experience difficulties in social and emotional functioning may struggle with recognizing their own feelings or those of others, regulating emotional responses, or responding appropriately in social situations. This can lead to challenges such as anxiety, low self-esteem, difficulty making friends, or misunderstandings with peers and adults.

In the school environment, social and emotional difficulties can impact a child’s engagement, cooperation, and overall learning experience. Emotional distress may manifest as withdrawal, irritability, or disruptive behaviour, which can further affect academic progress and peer relationships.

Assessment of social and emotional functioning as part of a neuropsychological evaluation typically includes behavioural observations, standardized rating scales, and information gathered from parents, teachers, and sometimes the child. This comprehensive approach helps identify strengths and areas for support in emotional regulation, social skills, and adaptive behaviours.

Understanding a child’s social-emotional profile allows for the development of tailored strategies to enhance emotional wellbeing, build resilience, and improve social communication. Early intervention and supportive environments can empower children to navigate their emotions more effectively, fostering confidence and meaningful connections.

At Offspring Health, we aim to provide transparent information about the costs involved in neurodevelopmental and educational assessments.

Neuropsychological assessments typically involve multiple sessions that usually take between 8 and 16 hours in total, depending on the complexity and individual needs. Our hourly rate is $260, so the total cost typically ranges between $2,300 and $4,230.

Fees generally cover:

Initial consultation and history gathering
Testing sessions where your child will complete various fun and interactive tasks
Liaison with schools or health professionals as needed
Comprehensive case analysis and report preparation
Feedback sessions with families and, where applicable, educators or other professionals

Please note that standard neuropsychological assessments are generally not covered by Medicare. However, some assessments and therapy services may be funded through the National Disability Insurance Scheme (NDIS) for eligible participants. We recommend discussing funding options with your NDIS planner or support coordinator prior to booking. Private health insurance may offer partial rebates depending on your level of coverage.

What’s the next step?

Please phone reception for a discussion about your needs or email psychology@offspringhealth.com