Being overweight is closely tied to the development of Type 2 Diabetes. Diabetes is increasingly seen in children because of an increase in the rate of obesity.Overweight children have an increased likelihood of insulin resistance. As the body struggles to regulate insulin, high blood glucose leads to a number of potentially serious health problems.In the past 30 years, obesity in children has doubled and obesity in adolescents has quadrupled. Genetics may also play a role. For instance, the risk of Type 2 Diabetes increases if one parent has or both parents have the condition.Type 2 Diabetes is an asymptomatic disease. Most children and adults don't even realize that they have Diabetes and a lot of children remain undiagnosed. It is only during routine screening that these children are diagnosed with Type 2 Diabetes. Some common symptoms of Type 2 Diabetes include:Increased thirstFrequent or night time urinationBlurry visionUnusual fatiguePuberty and DiabetesPuberty is the period of sexual development marking the transition from childhood to adulthood. It usually occurs around age 11 for girls and 12 for boys. Puberty's physical, psychological and social changes have an impact on Diabetes management. During puberty, testosterone in boys and oestrogen in girls starts increasing production. It is a period of relative insulin resistance. Obesity can also create insulin resistance. So an obese child is already insulin resistant it worsens during puberty and the chances of developing Type 2 Diabetes increase during puberty.The hormonal changes at puberty affect blood glucose control, often making it more difficult to manage glucose levels. Insulin's effectiveness declines by about 30- 50 per cent because growth hormones and sexual hormones create insulin resistance. In non-diabetic children, the pancreas compensates for this resistance by secreting more insulin. But if the child is pre-diabetic then the risk of progressing to Diabetes increases. Pre-diabetes is a condition where blood glucose levels are high but not high enough to be classified as Type 2 Diabetes..Type 1 versus Type 2 DiabetesAlthough Type 1 and 2 Diabetes are different their long-term consequences are the same. But in Type 1 Diabetes the pancreas actually stops functioning all together. Type 1 Diabetes is an autoimmune disease i.e. antibodies are being produced which damage the beta cells of the pancreas and the pancreas stop making insulin, so gradually the pancreatic function goes down. C-peptide test would be very low in such cases so what happens is your blood glucose starts rising and they have symptoms. Type 1 Diabetes cannot go undiagnosed for long as the child develops symptoms such as excess thirst (polydipsia), excess production of urine (polyuria), unexplained weight loss or sudden bedwetting in a normal child. If these initial symptoms are not caught on time, then the child may develop diabetic ketoacidosis (a life-threatening condition in which the ketones levels are abnormally high) On the other hand, Type 2 Diabetes is very often asymptomatic (has no symptoms). Sometimes it can be symptomatic when the blood glucoses levels are very high, children may often show symptoms such as polyuria and polydipsia. They can also present Type 1 Diabetes like symptoms. But the C-peptide test helps to resolve the diagnostic dilemma between Type 1 and Type 2 Diabetes..Other factorsExam stress and peer pressure don't lead to Diabetes. These are misconceptions. Major stress can increase the risk of onset of Type 2 Diabetes only if an individual is already pre-diabetic. But you just don't develop Diabetes because of exam pressure.If obese children have Type 2 Diabetes, then they can develop high blood pressure and high cholesterol levels. The guideline for treating children with high cholesterol differs from that of adults. Children are treated only when cholesterol levels are very high along with comorbidity like Diabetes. Diet and exercise is recommended.Sometimes an insulin sensitizer like metformin is suggested..Risk of complicationsAll children with Diabetes are at a risk of complications like:Heart and blood vessel disease like heart disease, stroke, high cholesterol and high blood pressure.Nerve damage (neuropathy) caused by high blood glucose levels which damage tiny blood vessels (capillaries), especially in the legs. This causes sensation of tingling, numbness, burning or pain.Kidney damage (nephropathy) caused by high and fluctuating blood glucose levels. This can lead to kidney failure or irreversible end-stage kidney disease, requiring dialysis or a kidney transplant.Damage to the eye (retinopathy) is caused by high glucose levels for a long period of time. Cataracts and retinopathy can cause loss of vision.Susceptibility to skin conditions like bacterial infections, fungal infections and itching increases with Diabetes..Advice to readersThe youngest patient that I have treated with Type 2 Diabetes was 5 and half years old. Preventing obesity is of primary importance as it not only reduces the risk of Diabetes but also hypertension (high blood pressure), dyslipidaemia (increased cholesterol levels) and heart disease later in life.Studies have shown that exercise has a dramatic effect on reducing insulin resistance. Parents need to be more vigilant with regards to their children's lifestyle.Limiting intake of fats and sweets in your child's diet and ensuring that children get adequate physical activity each day is paramount. These are two easy ways to help your child get down to and stay at a healthy weight and normal blood glucose levels.