With thirty percent of kids who are overweight in the U.S., it’s well known that childhood obesity is a problem. Yet type-2 diabetes—a condition that’s associated with obesity and was previously only seen in adults—is not only being diagnosed in kids but it’s on the rise.

Between 2008 and 2009, more than 5,000 kids were diagnosed with type-2 diabetes. And an April 2017 study published in the New England Journal of Medicine showed the rate of newly diagnosed cases of type-2 diabetes in children between ages 10 and 19 increased by 4.8 percent.

What is type-2 diabetes?

Type-2 diabetes is a condition that affects the way the body uses glucose, or sugar, in the blood. When you eat, your pancreas produces insulin, a hormone, which turns glucose into energy for your body to use.

For people with type-2 diabetes however, their bodies either fight the effects of insulin or don’t produce enough insulin to keep blood glucose levels normal. The pancreas therefore, must make more insulin to get glucose into the cells but over time, it simply can’t keep up and sugar builds up in the blood.

What causes type-2 diabetes?

The causes of type-2 diabetes are unknown but experts agree genetics, weight and a lack of physical activity are all risk factors.

Weight

The primary risk factor for type-2 diabetes is excess weight yet kids with type-2 diabetes aren’t necessarily overweight. The more fatty tissue a child has, the more resistant the cells in the body are to insulin. Excess fat in the abdominal area also increases a child’s risk.

Inactivity

Kids who spend too many hours on the iPad or in front of the TV instead of doing something active are more likely to have type-2 diabetes. Exercise and physical activity not only control weight but they help the body use glucose for energy and increase insulin sensitivity.

Family history

Type-2 diabetes tends to run in families so kids with a parent or sibling with type-2 diabetes have an increased risk.

Race

People of African American, Hispanic, American Indian and Asian American races have a higher risk than those who are Caucasian.

PCOS

Girls who have polycystic ovary syndrome (PCOS), a hormonal disorder, have an increased risk for type-2 diabetes, although experts have yet to understand why.

Gender

Girls have a higher risk for type-2 diabetes than boys.

Symptoms of type-2 diabetes in children

If you think your child might be at risk for type-2 diabetes, here are the early warning signs you should look for.

Fatigue

Since the body isn’t getting the fuel it needs from glucose, kids can have unexplained fatigue or feel sleepy.

Thirst

Elevated blood glucose levels can cause excessive thirst.

Frequent bathroom breaks

Since high blood glucose levels pull fluid from the body, having to urinate frequently is common.

Hunger

Without enough insulin in the cells to be used as energy, kids with type-2 diabetes turn to food to get energy so they’ll often feel hungry.

Sores

If your child has sores or infections that seem to linger, it could be a sign of diabetes.

Skin changes

Darkened patches of skin, usually in the armpits or on the neck is a telltale sign of diabetes.

How to prevent type-2 diabetes

Whether your kids are overweight or not, type-2 diabetes should be on your radar. Here are some ways to prevent your child from getting type-2 diabetes.

Offer healthy foods

You never want to put your child on a diet, but paying close attention to the foods he eats is important.

Be sure to offer plenty of fruits and vegetables, lean protein including beans, as well as healthy fats like nuts and seeds. Avoid processed, packaged foods and simple carbohydrates and offer foods complex carbohydrates like sweet potatoes, pumpkin and whole grains.

Cut down on sugar

Aside from candy, ice cream and soda, sugar can hide in seemingly “healthy” foods like yogurt, granola bars and sports drinks. So make it a habit to read labels and compare brands.

Watch portion sizes

Curbing the size of servings can be tough, especially when you go out to eat, but it’s important to serve kid-friendly portions. The American Heart Association has a guide to help you get started.

Encourage healthy habits

Be sure to model healthy eating habits by eating meals together at the dinner table (not in front of the TV) and teaching your kids to eat slowly and mindfully.

Get moving

According to an April 2011 survey by the YMCA, 74 percent of children between ages 5 and 10 don’t get the recommended 60 minutes of physical activity per day.

Encourage your kids to love exercise by going for a walk before school or after dinner, taking a family bike ride on the weekends or going to the park. Sign up your child for a sports team, a gymnastics or karate class, for example. On fair-weather days, put on some music and have an indoor dance party.