Diabetes type 2 is spreading among children at alarming rate. In expert's opinion, both genetics and environmental factors such as fatness and lack of exercise play a vital role in the occurrence of diabetic type 2. Prevention and treatment of type 2 diabetes in children is a great challenge because it has vast behavioral influence due to obesity in children. We have to wake up and find the root causes, primary and secondary prevention efforts, and evidence-based treatment for children with type 2 diabetes to arrest this fastest growing disease.

Type 2 diabetes mellitus is a permanent disease that develops when the pancreas cannot make enough insulin or when the body's tissues cannot use insulin well. A person becomes diabetic when the level of blood sugar is too high and remains all the time. Over time, high blood sugar can create problems with the eyes, heart, blood vessels, nerves, and kidneys. Diabetes carries an increased risk for heart attack, stroke, and complications related to poor circulation. People with diabetes do have a higher risk of blindness than people without diabetes. One of the most common complications of diabetes is diabetic neuropathy in which the nerves are damaged that run throughout the body, connecting the spinal cord to muscles, skin, blood vessels, and other organs. People with diabetes can develop many different foot problems. When diabetes hit the child, he may feel sadness and think that life seems hopeless. It is a sign of severe depression. It can be said that diabetic type 2 not only attack physically but patient may be mentally weak which affect his school performance. Regular monitoring is necessary to enhance the student's school performance. Efforts should be made to maintain the blood glucose in the target range as determined by the health care team. If it is untreated, both high and low blood glucose levels can affect the student's ability to concentrate on schoolwork and participate in school activities. Various risk factors which lead to type 2 diabetes in children are racial background, family history of type 2 diabetes, clinical evidence of insulin resistance, and female gender. Obesity appears to be an important risk factor. The increase in the dominance of obesity in children has strongly paralleled the increase in the prevalence of type 2 in this age group. The major factor which leads to amplify in the rates of obesity in children is excessive caloric intake and a more sedentary lifestyle. Calories rich fast foods are easily available in large quantities and assessed by children. Today children spent more time in watching TV, playing video games, and working on the computer which produced a generation of overweight children. Many elementary and secondary schools, face financial limitation so that these institutions do not organize their physical activity programs but children at the same time take calorie rich foods at lunch which leads to obesity. Other cause of obese children is parental expectations of academic performance which have further contributed to the sedentary lifestyle of many children who spend their play time in studying to perform well in school. Another risk factor is having relatives with type 2 diabetes. Reports indicate that 35 -100 percent of children with type 2 diabetes in childhood had relatives with diabetes. Lastly, one's sex can provide extra risk. It has been found in numerous researches that girls are more prone to diabetes type 2 than boys got in childhood.

Initially, children with this disease do not exhibit symptoms. If there are symptoms, they usually are mild such as they urinate more often, Feeling a little more thirsty than normal, Losing a little weight for no clear reason. A simple blood test is done to diagnose diabetes. The diagnosis of type 2 diabetes in childhood can be a complex task requiring the test of biochemical characteristics as well as clinical signs. One important clinical sign for type 2 diabetes in childhood is acanthosis nigricans (AN), in which brownish-black, velvety skin patches usually found on the back of the neck, in the armpits, or on the thighs. AN shows high levels of insulin which indicate type 2 diabetes in childhood. The diagnosis of type 2 diabetes mellitus in a child usually will be made by an intelligent health care professional in a clinical setting. Psychosocial evaluation is recommended at diagnosis and informally at every visit. Assessment may be performed on the basis of patient history or by using a standardized screening tool. Health care professionals and dietitians should screen for eating disorders as part of the standard nutrition evaluation for all children with diabetes type 2. The family's strengths and needs should be assessed so that required support can be offered. diabetes type 2 is prevalent in major section of the population. Clinicians suggest effective primary prevention and public health programs to advance people's standard of living. Some programs have been started in the public schools, community programs and homes. In the model programs, patient with diabetes type 2 in childhood have been treated with oral diabetes medications, a healthy eating plan, and exercise. Basically the treatment is aimed in eliminating symptoms of hyperglycemia, assisting the patient to maintain a body weight, decreasing cardiovascular risk factors such as hypertension, hyperlipidemia, hyperglycemia, microalbuminuria, sedentary lifestyle, and of tobacco products and achieving overall improvement in the child's physical and emotional well-being. In the course of treatment, patient is advised for dietary modification, increase physical activity, decreased sedentary behaviors, and pharmacologic intervention. Education and other interventions that augment self-care behaviors are essential for the successful management of type 2 diabetes mellitus.

Prevention is the best way to escape from disease. Every possible effort should be made to reduce the risk, incidence, and consequences of diabetes type 2 among children. Primary health care professionals must conduct program in two areas. Firstly, they should impart education in general community and secondly, they must perform clinically based activities. Clinically based health promotion activities should not replica of community-wide health promotion but these programs should propose extra benefits. For example, if major health education is offered at the community level, then motivational interviewing and mutual problem solving can be offered in the clinical setting. When diabetes type 2 is the established diagnosis, secondary prevention efforts by primary health care professionals are important for the prevention of complications. Early diagnosis and best medical care are the major steps of effective secondary prevention. Primary prevention efforts can focus on the prevention of obesity in children. The role of health care professionals is very crucial in increasing community wakefulness about the importance of programs and facilities for physical activity and resources for healthy nutrition. Health care professionals must convey prevention messages to the community on healthful lifestyles and good nutrition through local media such as radio, television, newspapers, and posters. Prevention messages need to be selflessly developed to resound with community and tribal culture and beliefs. Children whose body mass are greater than the 85th percentile for their age should be given effective counseling on nourishment, weight control, and physical activity. This step is highly important because data suggest that diabetes type 2 can be prevented by lifestyle interventions.

In the line of treatment, parents must follow some steps to control the disease. They must track of child's blood sugar levels. This will help to learn how different foods and activities affect his or her blood sugar. Doctor can guide them to perform this task. Parents must educate their child how to make healthy food choices. Parents must encourage child to remain active. They must watch that child does not have to start a strict exercise program, but being more active can assist control blood sugar. Sometimes it is observed that Even if parents are cautious and does at their best; still child can face problems with high or low blood sugar. It is highly important to know the signs and symptoms of severe disease which can takes place due to diabetes.

It is essential to keep watch on the trend of disease spreading in community and immediately take corrective action instead of making situation worse. Children are the future of any society therefore it is proposed that every person must come forward and report to health care unit for occurrence of this disease. Medical experts are doing their best to curb the situation but public awareness and initiative will be helpful to build healthy society. To handle the cases of diabetes type 2, the team of a physician, a registered dietitian, a nurse clinician, a social worker, patient and the family should be developed. The diabetes team monitors the patient's knowledge about diabetes and its acute and chronic complications. The team must continually evaluate the patient's habits attitudes toward nutrition and physical activity. The team also promotes the use of medications, and problem-solving skills to perform better in school.

Type 2 diabetes mellitus in children is a matter of concern for society which will lead to significant increased morbidity and death during adulthood. Children with this disease do not execute normal function and their educational career is greatly affected. Medical professionals must address manifold medical and psychosocial concerns within the context of a medical home with the objective of organizing wide-ranging services from health care professionals and the community. Health care professionals face many the challenges of inspiring people to accept significant behavioral changes that look after for families affected by diabetes type 2. Several interventions have proved effectual in preventing diabetes complications among adults, and assessment of these interventions in children with diabetes type 2 is immediately required. It is anticipated that clinical trials using behavioral and treatment interventions for children with diabetes will be developed. The increasing awareness among people and influential efforts on behalf of medical expert will improve the health of children with diabetes type 2 over their lifetime.