Type 2 diabetes is becoming more common in children and teenagers, but we don’t know enough about how lifestyle changes can help them manage it. Researchers looked at 26 studies to see how physical activity, diet, sleep, and screen time affect kids with type 2 diabetes. They found that when kids combined exercise with healthy eating and got better sleep, their blood sugar control improved. However, doing just exercise or just changing diet alone didn’t seem to help as much. The research shows that lifestyle changes are helpful, but scientists need to do more studies to understand exactly how much these changes matter for young people.

The Quick Take

  • What they studied: Whether lifestyle changes like exercise, healthy eating, reducing screen time, and getting good sleep help kids and teens with type 2 diabetes control their blood sugar and improve their overall health
  • Who participated: The review looked at 26 different research studies involving children and teenagers under 18 years old who have type 2 diabetes. Most studies were done in the United States. Some studies tested lifestyle programs, while others just observed what happened when kids made lifestyle changes on their own
  • Key finding: When kids combined exercise with healthy eating and improved their sleep, their blood sugar control (measured by HbA1c) got better. However, doing just exercise or just changing diet by itself didn’t show clear benefits. The combination approach worked best
  • What it means for you: If you’re a young person with type 2 diabetes, making multiple lifestyle changes together—not just one change—appears more helpful. This suggests talking to your doctor about a complete plan that includes exercise, better food choices, and good sleep habits. However, more research is needed to know exactly how much improvement to expect

The Research Details

This was a systematic review, which means researchers searched seven major medical databases for all published studies about lifestyle and type 2 diabetes in kids. They looked for studies published from the beginning of each database through February 2025. They only included studies written in English that looked at how physical activity, diet, sleep, or screen time affected kids under 18 with type 2 diabetes.

The researchers found 26 studies that met their requirements. Fifteen of these studies were experiments where researchers told kids to make lifestyle changes and then measured what happened. The other 11 studies were observational, meaning researchers just watched what happened naturally without telling kids what to do. The experimental studies lasted anywhere from 9 weeks to 12 months.

The researchers carefully checked the quality of each study to make sure the results were trustworthy. They looked at things like whether the studies were designed well, whether they had enough participants, and whether the researchers measured things correctly.

A systematic review is important because it brings together all the research on one topic instead of relying on just one study. This gives us a better picture of what the evidence shows. Since type 2 diabetes in kids is a growing problem, understanding what lifestyle changes actually work is really important for doctors, parents, and young people themselves

The strength of this review depends on the quality of the 26 studies it included. The researchers checked each study’s quality, which is good. However, the studies were very different from each other—some were short programs, others were longer; some focused on exercise, others on diet. This makes it harder to compare results. Also, most studies were done in the USA, so the findings might not apply to kids in other countries with different cultures and food systems. The researchers noted that there simply isn’t as much research on kids as there is on adults with type 2 diabetes

What the Results Show

The main finding was about blood sugar control, measured by a test called HbA1c. When kids combined exercise with healthy eating and got better sleep, their HbA1c improved, meaning their blood sugar was better controlled. This is the most important measure because it shows how well diabetes is being managed.

However, when researchers looked at studies where kids only changed one thing—like just exercising or just changing their diet—the results weren’t clear. Some studies showed improvement, but others didn’t. This suggests that doing multiple things together works better than focusing on just one change.

The research also found that exercise alone did help with weight and body measurements, even if it didn’t always improve blood sugar control. This is still important because maintaining a healthy weight helps with diabetes management overall.

The researchers noted that the studies they reviewed were quite different from each other, which made it hard to draw strong conclusions. Some programs lasted just a few weeks, while others lasted a year. Some had lots of participants, others had very few. This variety made it difficult to say exactly how much improvement kids could expect

Beyond blood sugar control, the research looked at other health measures. Exercise appeared to help kids lose weight and improve their body composition. The studies also measured things like cholesterol, triglycerides (a type of fat in blood), blood pressure, and mental health. However, the evidence for how lifestyle changes affect these measures was unclear or limited. Some studies showed improvements in these areas, but not all studies measured the same things, making it hard to draw firm conclusions

There’s much more research on lifestyle changes in adults with type 2 diabetes than in kids. In adults, we know that exercise and healthy eating definitely help manage the disease. This review shows that the same appears to be true for kids, but the evidence isn’t as strong yet. Scientists have done fewer studies with young people, and the studies that do exist are smaller and shorter than adult studies. This means we need more research specifically designed for kids and teens

Several important limitations exist. First, most studies were done in the USA, so the results might not apply to kids in other countries. Second, the studies were very different from each other, making it hard to combine their results. Third, many studies were small and lasted only a few weeks or months, so we don’t know if benefits last longer. Fourth, some studies didn’t measure all the health outcomes, so we have incomplete information. Finally, the researchers noted that we simply don’t have enough research on kids compared to adults, so more studies are needed to give us clearer answers

The Bottom Line

Based on this research, kids and teens with type 2 diabetes should aim for a combination approach: regular physical activity, healthy eating, and good sleep habits. The evidence suggests this combined approach is more effective than trying to change just one thing. However, the confidence level is moderate because the research is still limited. Talk with your doctor or diabetes educator about creating a plan that includes all these elements. Start with small, manageable changes rather than trying to do everything at once

This research is most relevant for kids and teenagers with type 2 diabetes, their parents, and their doctors. It’s also important for school nurses, health teachers, and anyone working with young people on diabetes management. If you have type 1 diabetes or don’t have diabetes, this research doesn’t directly apply to you, though the general benefits of exercise and healthy eating apply to everyone

Based on the studies reviewed, improvements in blood sugar control appeared within weeks to months of starting lifestyle changes. However, most studies lasted less than a year, so we don’t know how long benefits last or whether they improve over longer periods. Expect to see changes within a few weeks to a few months, but understand that maintaining these changes long-term is important

Want to Apply This Research?

  • Track three things daily: minutes of physical activity, meals eaten (focusing on healthy choices), and hours of sleep. Use the app to set goals like 60 minutes of activity, 3 healthy meals, and 8-9 hours of sleep per night. Review weekly progress to see patterns
  • Start with one small change this week—maybe adding a 15-minute walk or swapping one sugary drink for water. Next week, add another change. By combining small changes over time, you’ll build the complete lifestyle approach that research shows works best
  • Check your blood sugar numbers (HbA1c) with your doctor every 3 months. Use the app to track daily habits between doctor visits. Look for patterns—do certain activities or foods affect your numbers? Share this information with your doctor to adjust your plan as needed

This research summary is for educational purposes only and should not replace professional medical advice. If you or someone you know has type 2 diabetes, work with a doctor, diabetes educator, or registered dietitian to create a personalized treatment plan. Lifestyle changes should be made under medical supervision, especially for children and teenagers. Always consult with healthcare providers before starting new exercise programs or making significant dietary changes. The findings in this review are based on limited research in young people, and individual results may vary.