Type 1 Diabetes in Children: Causes, Diagnosis, and Treatment
Type 1 diabetes (formerly called “insulin-dependent diabetes” or “juvenile diabetes”) is one of the most common chronic diseases in childhood. This disease requires lifelong care and monitoring, but with proper management, the child can live a healthy life.
Causes of Type 1 Diabetes in Children
Type 1 diabetes is an autoimmune disease, meaning that the body’s immune system mistakenly attacks and destroys the beta cells of the pancreas (which produce insulin).
The most important factors involved:
Genetic background
Having a family history of type 1 diabetes can increase the risk of developing the disease, but many affected children do not have a family history.
Environmental factors
Some viral infections (such as measles, rubella, Coxsackie, etc.) may play a role in triggering the autoimmune response.
Abnormal immune system reactions
In some children, the immune system suddenly destroys healthy pancreatic cells for no reason.
Important note: Contrary to popular belief, type 1 diabetes is not related to lifestyle, diet, or being overweight.
Diagnosis of type 1 diabetes in children
The diagnosis of type 1 diabetes usually occurs after the sudden onset of symptoms. These symptoms include:
Extreme thirst
Frequent urination
Sudden weight loss
Fatigue
Blurred vision
In advanced cases: nausea, vomiting, rapid breathing, and a fruity odor from the breath (signs of diabetic ketoacidosis)
Diagnostic tests:
Fasting blood sugar measurement
A blood sugar level higher than 126 mg/dL can be a sign of diabetes.
The HbA1c (glycosylated hemoglobin) test
reflects the average blood sugar over the past 2 to 3 months. A number above 6.5% is abnormal.
An oral glucose tolerance test (OGTT)
is sometimes used to confirm the diagnosis.
Autoimmune antibody testing (e.g. GAD65, IA-2)
is used to diagnose type 1 diabetes and differentiate it from type 2.
Treatment methods for type 1 diabetes in children
Since in type 1 diabetes, a child’s body is unable to produce insulin, treatment always involves insulin injections.
Main treatments:
Insulin therapy
Injected with a syringe or insulin pen
Or using an insulin pump
Types of insulin: short-acting, rapid-acting, long-acting, and combined
Regular blood sugar monitoring
Using a glucometer or continuous glucose monitor (CGM)
Daily measurement frequency: at least 4–6 times
Balanced and regular diet
Adjusted in consultation with a nutritionist
Including adjusting the amount of carbohydrates, fats, proteins, and the number of meals
Regular exercise
With proper planning, it can help better control blood sugar
Requires awareness of low blood sugar during or after exercise
Education and psychological support
Education of the child and parents to better understand and manage the disease
Emotional support to reduce the child’s anxiety about injections, controls, and restrictions
The future of a child with type 1 diabetes
With regular treatment and follow-up, the child can:
Be fully active in school and social activities Be
Exercise and enjoy life
Prevent long-term complications of diabetes (such as eye, kidney, nerve, and heart damage)
Technological advances such as smart insulin pumps, blood sugar sensors, and diabetes apps have played a big role in making the management of this disease easier.
Practical Nutrition Tips for Children with Type 1 Diabetes
A child with diabetes should have a balanced, varied and predictable diet. The main goal of nutrition is to help keep blood sugar levels within a normal range.
Simple tips for parents:
Stable meals and snacks
A regular meal plan prevents blood sugar fluctuations.
Each meal should contain a controlled amount of carbohydrates.
Understanding carbohydrates
Simple sugars (such as sweets, soda, fruit juice) raise blood sugar quickly.
Complex carbohydrates (such as wholemeal bread, brown rice, baked potatoes) raise blood sugar more slowly.
Insulin to carbohydrate ratio
Many children with type 1 diabetes inject insulin according to a specific ratio based on the amount of carbohydrates they eat.
This ratio is determined by a doctor or dietitian.
Beverages
Use water instead of industrial juices or sodas
Natural fruit juice is allowed only in conditions of low blood sugar (in limited quantities)
Snacks
Fruit, plain yogurt, nuts, vegetables with hummus or low-fat cheese are good options.
Managing low blood sugar (hypoglycemia)
Hypoglycemia is an excessive decrease in blood sugar (usually below 70 mg/dL) that can be dangerous if not recognized in time.
Common symptoms of hypoglycemia:
Shaking
Cold sweat
Rapid heartbeat
Extreme hunger
Sudden drowsiness or irritability
Confusion or lack of concentration
Urgent actions:
Test blood sugar
If hypoglycemia is confirmed:
Give 15 grams of fast-acting carbohydrates, such as:
Half a glass of fruit juice
A spoonful of honey or jam
3–4 glucose tablets
Recheck blood sugar after 15 minutes
If it is still low, repeat the above step again.
After recovery:
If it is a long time until the main meal, give a snack containing protein or fat.
The role of family and siblings
Diabetes is not just a child’s problem; the whole family must participate in the adaptation process.
Tips for parents:
Educate siblings about diabetes (to the extent they understand)
Avoid discrimination or focusing too much attention on the sick child
Share responsibilities to reduce psychological burden
Encourage gradual self-care (appropriate to the child’s age)
The future of diabetes: Research hopes
In recent years, extensive research has been conducted to treat or prevent type 1 diabetes.
The most important developments:
Cell therapy and beta cell transplantation
Research to regenerate insulin-producing cells in the pancreas
Immunotherapy
Attempts to stop the body’s autoimmune response
Artificial pancreas
Combination of insulin pump and glucose sensor for automatic insulin regulation
Type 1 diabetes vaccine
In early stages of research to prevent the onset of autoimmunity
Final message
Type 1 diabetes is a serious but manageable disease. With education, support, discipline, and technology, your child can live a completely normal and successful life.
With love, awareness, and patience, diabetes can be a life-changing opportunity for learning, growth, and greater family bonding.
Below, I will delve into some additional and deeper aspects of the lives of children with type 1 diabetes, including:
The role of exercise in diabetes management
Maturity and hormonal changes in diabetic adolescents
Tips to boost your child’s self-confidence
Strategies to prepare your child for independent living in the future
The role of exercise in type 1 diabetes management
Regular physical activity is an important pillar in diabetes management. Exercise increases the sensitivity of cells to insulin and improves blood sugar control.
Important tips for exercise in children with diabetes:
Monitor blood sugar before and after exercise:
To prevent low blood sugar (hypoglycemia)
Have a snack before exercise if needed:
For example, a banana, plain biscuits or diluted fruit juice
Have sugary foods with you:
For example, glucose tablets or fruit juice for emergencies
Inform the coach or sports teacher about the child’s condition
Choosing appropriate sports:
For example, walking, cycling, swimming, soccer or dancing – any activity that the child is interested in and does regularly
Puberty and diabetes: hormonal challenges
A child’s entry into puberty (usually from 9 to 13 years old) is accompanied by extensive physiological changes that can affect diabetes.
Expected changes:
Increased resistance to insulin due to the secretion of puberty hormones (such as growth and estrogen or testosterone)
More fluctuations in blood sugar
Need to review insulin doses regularly
Increased psychological sensitivity and desire for independence, which sometimes leads to ignoring treatment
Solutions:
Maintain an open dialogue with the teenager without judgment
Involve him in decisions about treatment
Regular visits to the doctor to adjust the insulin dose
Emotional support and, if necessary, adolescent psychological counseling
How to boost the self-confidence of a child with diabetes?
Many children with diabetes may feel “different” or “limited”. Emotional support from family and the environment is crucial.
Recommendations:
Emphasize the child’s abilities and talents, not the disease
Inform friends and teachers to reduce pity or discrimination
Encourage the child to talk about their disease without shame
Find successful role models (such as athletes or artists with diabetes)
Record small successes in managing diabetes to provide motivation
Prepare the child for independent living in the future
Children with diabetes should gradually learn simple responsibilities in managing their disease from an early age.
Stages of developing responsibility:
In elementary school: learning how to measure blood sugar
In middle school: injecting insulin under parental supervision
In adolescence: making decisions about nutrition, insulin, and physical activity
Also:
Learning how to deal with specific situations (travel, parties, exam stress)
Learning how to manage crises (e.g., low blood sugar when alone)
Using technologies such as diabetes management apps
Conclusion
With proper care, a child with type 1 diabetes can:
. Be successful in school
. Have good friends
. Exercise and have fun
. Have a suitable job and an independent life as an adult
Diabetes is not a limitation, it is a different path in life that can be successfully navigated with family, knowledge, and social support.
In the following, I will add some very practical and educational sections on the topic of type 1 diabetes in children, especially for everyday situations such as school, travel, parties, as well as useful tools to manage the disease more easily.
Diabetes Management at School
One of the concerns of parents is the presence of a diabetic child at school and his/her absence from home. Education and coordination with school officials are the main keys to parents’ peace of mind.
Important points:
Informing teachers and school principals:
About the symptoms of hypoglycemia, how to help, food and medicines for the child
Training the school health officer or nurse:
If the school has a nurse, he/she should be familiar with the child’s treatment plan.
Prepare a child’s emergency kit:
Includes:
Glucometer
Blood sugar test strips
Glucose tablets or juice
Insulin and syringe or insulin pen
Note with parent contact information
Put an appropriate snack in your child’s bag
Encourage your child to report any feelings of weakness, dizziness, or shakiness to the teacher
Travel and vacations: How to stay on top of your diabetes management
Traveling can be a fun and adventurous experience for your child, but it requires careful planning.
Practical advice:
Bring enough insulin, blood sugar test strips, and glucose tablets
Keep insulin in an insulated bag or portable cooler
Have a doctor’s prescription and the child’s medical ID card
Coordinate with the airline or train (if flying)
Bring healthy snacks with you on the trip
Adjust insulin injection times if changing time zones
Attending parties and birthday parties
A child with diabetes should also be able to enjoy the festivities, without experiencing a sharp drop or spike in blood sugar.
Solutions:
Talk to the host parents in advance (if possible)
Give a snack at home before going to the party
Remind the child to measure blood sugar during the party
Choose healthier foods from the reception table
If eating sweets or cakes, inject the appropriate insulin according to the doctor’s instructions
Useful tools and technologies for diabetes management
Technological advances have made diabetes management easier and more accurate for children.
Useful tools:
CGM (Continuous Glucose Monitor)
A sensor that continuously measures blood sugar and alerts parents.
Insulin Pump
A small device that continuously injects insulin and is used instead of manual injections.
Diabetes management apps
To record meals, insulin doses, blood sugar changes, and remind you when to inject
Child medical alert bracelet
With disease information and emergency contact numbers
Resources and support groups for parents
Connecting with other parents and using reputable educational resources can create more synergy and comfort.
Suggestions:
Support groups for parents of diabetic children on social media
Webinars and hospital training classes
Consulting with a child psychologist to reduce stress
Following a specialist doctor and official resources (Iranian Diabetes Association, Jocelyn, ADA, etc.)
General summary
A child with type 1 diabetes needs the following to live a healthy life:
Continuous education
Psychological and emotional support
Regular nutrition and treatment
Preparation for different situations
Participation of family, school, and those around them